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<table cellpadding="0"  border="0" width="100%" cellspacing="0"><tr><td  class="sentertekst" align="center" colspan="2" id="1"><div style="text-align: center;" class="sentertekst" align="center"><a  href="omoss.php?side=kontakt">&nbsp;OM JAPSEDELER.NO</a><span style="color: #bdbdbc; font-weight: 400">&nbsp;|&nbsp;<a  href="register_form_form.php?side=kontakt">REGISTRER DEG</a><span style="color: #bdbdbc; font-weight: 800">&nbsp;|&nbsp;</span><a  href="sendpass_form_form.php?side=kontakt">GLEMT PASSORD?</a>&nbsp;</div></td></tr></table> </div>
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	<td valign="top"  width="339" >
		
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						<tr>

						<td width="339" valign="top" class="kontakt_linje_left">

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								<tr>

							<td width="339" colspan="2" bgcolor="#dddbdb" valign=top>
					
				<p align="center" bgcolor="#000000" ><span style="font-size: 100%; font-weight: 800 " class="header_register">DINE OPPLYSNINGER</span></p>
				 </td>

						</tr>
								<tr><td width=339 colspan="2" valign="top"><img src="inc/empty.gif" width="350px" height="1"></td></tr>
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								<td width="146"><span style="font-size:10pt;">Fornavn: *</span></td>

								<td width="156" style="padding-top: 2px; text-align: right"><input style="width:175px" type="text"  name="firstname" value="" maxlength="100"></td>

                    </tr>

					 <tr>

                        <td width="146"><span style="font-size:10pt;">Etternavn: *</span></td>

                      <td width="156" style="padding-top: 2px; text-align: right"><input type="text" style="width:175px" name="lastname" value="" maxlength="100"></td>

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                        <td width="146"><span style="font-size:10pt;">Epost: *</span></td>

                       <td width="156" style="padding-top: 2px; text-align: right"><input type="text" style="width:175px" size="33" name="email" value="" maxlength="100"></td>

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                    <td width="146"><span style="font-size:10pt;">Adresse:</span></td>

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                    <td width="146"><span style="font-size:10pt;">Postnummer: *</span></td>

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                    <td width="146"><span style="font-size:10pt;">Tlf:</span></td>

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					<tr><td colspan=2>&nbsp;</td></tr>
					<tr><td colspan=2>&nbsp;</td></tr>
               <td width="146"><span style="font-size:10pt;">* Obligatorisk</span></td>
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                    					<td width="300" colspan="2" text-align: center>
					<br><br><div title="Kommuniser med oss live her." style="texta-align: center">
					&nbsp;&nbsp;&nbsp;&nbsp;<center><iframe  src="tom_tull_content.php" scrolling="no"  frameborder="no" width="300" height="150" name="content" allowTransparency="true" backgroundColor="transparent"></iframe></center>
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	<td class="kontakt_linje_center">&nbsp;&nbsp;</td>
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			<table border="0" width="315" align="center" cellpadding="0"  >
					<tr>

                        <td colspan="2" valign="top"><span style="font-size:10pt;">Viktig: dersom din forespørsel gjelder
						deler bør registreringsnummeret (skiltnummeret) på kjøretøyet det gjelder inkluderes.
						</span></td>

                        
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                        <td width="116"><span style="font-size:10pt;">&nbsp;</span></td>

                        <td width="116"><span style="font-size:10pt;">&nbsp;</span></td>
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                    <tr>

                        <td width="116"><span style="font-size:10pt;">Delebeskrivelse:</span></td>

                        <td width="116"><span style="font-size:10pt;">Regnr/skiltnr:</span></td>
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                        <td width="156"><input type="text" style="width:232px" name="del1" maxlength="50"></td>

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					</tr>
					<tr>

                        <td width="156"><input type="text"  style="width:232px" name="del3" maxlength="50"></td>

                        <td width="156"><input type="text"  style="width:83px" name="reg3" maxlength="50"></td>
					</tr>
					<tr>

                        <td width="156"><input type="text"  style="width:232px" name="del4" maxlength="50"></td>

                        <td width="156"><input type="text"  style="width:83px" name="reg4" maxlength="50"></td>
					</tr>
						<tr>

                        <td width="156"><input type="text"  style="width:232px"  name="del5" maxlength="50"></td>

                        <td width="156"><input type="text" style="width:83px"  name="reg5" maxlength="50"></td>
					</tr>
					
						
									<tr>

                        <td width="156"><input type="text"  style="width:232px"  name="del6" maxlength="50"></td>

                        <td width="156"><input type="text" style="width:83px"  name="reg6" maxlength="50"></td>
					</tr>
					
						<tr>

                        <td width="156"><input type="text"  style="width:232px"  name="del7" maxlength="50"></td>

                        <td width="156"><input type="text" style="width:83px"  name="reg7" maxlength="50"></td>
					</tr>
					
		
					<tr>


                        <td width="116" colspan="2"><span style="font-size:10pt;"><br>For andre spørsmål bruk feltet under:</span></td>
				
                        

                    </tr>
					<tr>

                        <td width="300" colspan="2"><textarea style="font-family: verdana; " name="message" cols="36" rows="6" ></textarea></td>

                       
					</tr>
									<tr>
						<td>
						<br><br><input type="submit" style="width: 200px" value="send skjema">
						</td>
						<td></td>
					</tr>
					<tr>
					<td>&nbsp;</td>
					<td>&nbsp;</td>
					</tr>
					
					<tr>
					<td colspan="2"><br><br>
						<p style="font-size:10pt;">Det er for tiden ikke mulig å hente delebestillinger i lokale for kunder som bor i Bergens-området.
						</p>                       
					
					</td>
						
					</tr>
                    <tr>
					<td>
						
						
					</td>
						<td></td>
					</tr>
                    <tr>
					<td>&nbsp;</td>
					<td>&nbsp;</td>
					</tr>
                    </table>
	</td>
	<td valign="top">&nbsp;&nbsp;&nbsp;</td>

	<td valign="top" width="100%"><table cellpadding=0 cellspacing=0 width="100%"><td valign="top" style="border: 2px solid #dddbdb; padding:23px" width="100%"><br><br><center><iframe style="border: 2px solid #434c78" width="370" height="250" frameborder="0" scrolling="no" marginheight="0" marginwidth="0" src="https://maps.google.no/maps?f=q&amp;source=s_q&amp;hl=en&amp;geocode=&amp;q=Fj%C3%veien+2239,+5054+Bergen,+Hordaland,+Norway&amp;aq=0&amp;oq=Fj%C3%B8sangerveien+2239,+5054,+Hordaland,+Norway&amp;sll=60.375608,5.338984&amp;sspn=0.008867,0.033023&amp;ie=UTF8&amp;hq=&amp;hnear=Fj%C3%B8sangerveien+2239,+Bergenhus,+5054+Bergen,+Hordaland&amp;t=m&amp;z=14&amp;ll=60.37566608,5.338984&amp;output=embed"></iframe><br /><small><a href="https://maps.google.no/maps?q=Fj%C3%B8sangerveien+39,+5054+Bergen,+Hordaland,+Norway&hl=en&ie=UTF8&sll=60.375608,5.338984&sspn=0.008867,0.033023&oq=Fj%C3%B8sangerveien+39,+5054,+Hordaland,+Norway&hnear=Fj%C3%B8sangerveien+39,+Bergenhus,+5054+Bergen,+Hordaland&t=m&z=16" style="color:#0000FF;text-align:left">Se større kart</a></iframe><br /><small></a></small></center>
	
	<br><br><span style="font-size:10pt;">NB VIKTIG: På grunn av flytting og omstrukturering vil normale bestillinger ha lengre leveringstid enn normalt. <br><br>Vi trenger som oftest noe tid på å besvare henvendelser<BR> da våre leverandører kan ha noe behandlingstid på forespørsler / bestillinger.
<br><br>                                   
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	<tr><td colspan=7 width=100%><div id="bottom_line" style="font-size:9pt;" >Copyright (C) 2015 Japsedeler.no. All Rights Reserved.</div></td></tr>


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