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<FORM action="mailto: [email protected]" method="post" enctype="text/plain">
<TABLE WIDTH="71%" BORDER="0" align="center" CELLPADDING="4" CELLSPACING="0">
<TR>
<td colspan="2" bgcolor="#FFC6C6" style="">
<font face="Arial" size="2" color="#000000"><b style="font-size:20px;">PRIJAVA / ENTRY FORM</b><br />
<label style="font-size:15px;">IZLOZBA PASA 2011<br /></label><br /></font>
</td>
</tr>
<tr valign="top">
<td colspan="2" style="">
<h3 style="font-size:14px;padding:10px 0 6px 0;border-top:1px dotted #CCCCCC;margin:14px 0;position:static;" id="rasa" name="rasa"></h3>
</td>
</tr>
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<td width="34%" align="left" style="">
<font face="Arial" size="2" color="#000000"><b>Rasa / Breed</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td width="65%" style=""><input id="rasa" name="rasa" value="" size="30" class="validate[required]" type="text" /></td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Pol / Sex</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<div style="float:left;width:33%;padding-bottom:5px;">
<input id="pol" name="pol" value="Pas/Dog" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color="#000000"> Pas/Dog </font>
</div>
<div style="float:left;width:33%;padding-bottom:5px;">
<input id="zenka" name="zenka" value="Ženka/Bitch" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color="#000000"> Ženka/Bitch </font>
</div>
<div style="clear:both;"></div>
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Boja/Colour</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="boja" name="boja" value="" size="30" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>FCI grupa /FCI group</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="fcigroup" name="fcigroup" value="" size="5" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Razred / Dog class</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<div style="width:100%;padding-bottom:5px;">
<input id="razred" name="razred" value="BABY / BABY CLASS 4–6 mes/months" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color="#000000"> BABY / BABY
CLASS 4–6 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="mladih 6-9" name="mladih 6-9" value=" RAZRED MLADIH / PUPPY CLASS 6-9 mes./months" class="validate[required]" type="checkbox" />
<font face="Arial" size="2" color=
"#000000"> RAZRED NAJMLAĐIH / PUPPY CLASS 6-9 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="mladih 9-18" name="mladih 9-18" value="RAZRED MLADIH / JUNIOR CLASS 9-18 mes./months" class="validate[required]" type="checkbox" />
<font face="Arial" size="2" color=
"#000000"> RAZRED MLADIH / JUNIOR CLASS 9-18 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="intermedia" name="intermedia" value="RAZRED INTERMEDIA / INTERMEDIATE CLASS 15-24 mEs./months" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color=
"#000000"> RAZRED INTERMEDIA / INTERMEDIATE CLASS 15-24 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="zreli" name="zreli" value="RAZRED ZRELIH / OPEN CLASS od 15 mes./months" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color=
"#000000"> RAZRED ZRELIH / OPEN CLASS od 15 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="sampioni" name="sampioni" value="RAZRED ŠAMPIONA / CHAMPION CLASS od 15 mes./months" class="validate[required]" type="checkbox" />
<font face="Arial" size="2" color=
"#000000"> RAZRED ŠAMPIONA / CHAMPION CLASS od 15 mes./months </font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="radni" name="working" value="RAZRED RADNIH / WORKING CLASS " class="validate[required]" type="checkbox" />
<font face="Arial" size="2" color=
"#000000"> RAZRED RADNIH / WORKING CLASS” ;</font>
</div>
<div style="width:100%;padding-bottom:5px;">
<input id="veterani" name="veterani" value="RAZRED VETERANA / VETERAN CLASS" class="validate[required]" type="checkbox" /><font face="Arial" size="2" color=
"#000000"> RAZRED VETERANA / VETERAN CLASS </font>
</div>
<div style="clear:both;"></div>
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td colspan="2" bgcolor="#FFC6C6" style="">
<h3 style="font-size:14px;padding:10px 0 6px 0;border-top:1px dotted #CCCCCC;margin:14px 0;position:static;" id="element_5" name="element_5"></h3>
<div style="padding-bottom:8px;color:#000000;">
<small><font face="Arial">ZA ŠAMPIONE DOSTAVITI KOPIJU ŠAMPIONATA.<br />
A copy of the recognized Champion title for the Champion class to be included.</font></small>
</div>
</td>
</tr>
<tr valign="top">
<td colspan="2" style="">
<h3 style="font-size:14px;padding:10px 0 6px 0;border-top:1px dotted #CCCCCC;margin:14px 0;position:static;" id="element_6" name="element_6"></h3>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Ime psa / Name of dog</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="imepsa" name="ime psa" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Broj pedigrea / Pedigree, No</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="broj pedigrea" name="broj pedigrea" value="" size="30" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Dat. rođenja / Date of birth</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="datum rodjenja" name="datum rodjenja" value="" size="30" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Otac / Father</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="otac" name="otac" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Majka / Mother</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="majka" name="majka" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Odgajivač / Breeder</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="odgajivac" name="odgajivac" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Vlasnik / Owner</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="vlasnik" name="vlasnik" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Ulica / Street</b></font>
</td>
<td style="">
<input id="ulica" name="ulica" value="" size="50" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Broj / No</b></font>
</td>
<td style="">
<input id="br" name="br" value="" size="10" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Mesto / Residence</b></font>
</td>
<td style="">
<input id="mesto" name="mesto" value="" size="50" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Broj pošte / Post code</b></font>
</td>
<td style="">
<input id="broj poste" name="broj poste" value="" size="10" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Tel / Phone</b></font>
</td>
<td style="">
<input id="telefon" name="telefon" value="" size="50" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>E-mail</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="e-mail" name="e-mail" value="" size="50" class="validate[required]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Zemlja / Country</b></font>
</td>
<td style="">
<input id="zemlja" name="zemlja" value="" size="50" class="validate[optional]" type="text" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Kopija pedigre / Copie Pedigree</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="pedigre" name="pedigre" class="validate[required]" type="file" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
</tr>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Šampionat sertifikat / Champion sertificat</b></font>
</td>
<td style="">
<input id="ch sertifikat" name="ch sertifikat" class="validate[optional]" type="file" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
<tr valign="top">
<td style="" align="left">
<font face="Arial" size="2" color="#000000"><b>Dokaz o uplati / Proof of payment</b></font> <span style="color:red;"><small>*</small></span>
</td>
<td style="">
<input id="uplatnica" name="uplatnica" class="validate[required]" type="file" />
<div style="padding-bottom:8px;color:#000000;"></div>
</td>
<TD width="1%">
</TD></TR>
<tr valign="top">
<td align="left" bgcolor="#FFC6C6" style=""> </td>
<td bgcolor="#FFC6C6" style=""><input type="submit" name="submit" value="Submit">
<input type="reset" name="reset" value="Reset"></td>
<TD> </TD>
</TR>
</TABLE>
</FORM>
[Ovu poruku je menjao Nikola Poša dana 25.03.2014. u 21:38 GMT+1]