<form action="http://prestupnikn1.justclick.ru/subscribe/process/?rid[0]=first" method="post" target="_blank" id="subscr-form-8058" onsubmit="return jc_chkscrfrm(this, false, false, false, false)" >
<style type="text/css">
	#subscr-form-8058 table{
width:300px;
	}
	#subscr-form-8058 td{
font:14px Arial,Helvetica,sans-serif;
text-align:center;
	}
	#subscr-form-8058 input{
color:#000;
font-size:14px;
text-align:left;
-webkit-border-radius:4px;
-moz-border-radius:4px;
border-radius:4px;
border:#ccc 1px solid;
padding:4px;
width:200px;
	}#subscr-form-8058 input[name="lead_subscribe"]{
padding:4px 9px;
width:210px;
background:#09c url(http://s4.uploads.ru/hkyVt.png);
border:#186FA5 1px solid;
color:#fff;
font-weight:bold;
text-align:center;
	}
</style>
	<table align="center" border="0" cellspacing="0" cellpadding="3"><tbody>
<tr>
	<td><input name="lead_name" type="text" onblur='if(this.value=="") this.value="Введите ваше имя"'  onfocus='if(this.value=="Введите ваше имя") this.value=""' value="Введите ваше имя"/></td>
</tr>
<tr>
	<td><input name="lead_email" type="text" onblur='if(this.value=="") this.value="Введите ваш e-mail"'  onfocus='if(this.value=="Введите ваш e-mail") this.value=""' value="Введите ваш e-mail"/></td>
</tr>
<tr>
	<td><input name="lead_subscribe" type="submit" value="Подписаться!" /></td>
</tr></tbody>
	</table>
<script language="JavaScript" src="http://prestupnikn1.justclick.ru/media/subscribe/helper2.js.php"></script>
<script language="JavaScript">jc_setfrmfld()</script>
</form>