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1 forms found in the DOM

Name: form — POST /index.php

<form name="form" enctype="multipart/form-data" action="/index.php" method="post">
  <input type="hidden" name="submitted_when" value="1731205297">
  <p style="display:none"> email address: <label for="email">Leave this field email-address blank:</label>
    <input id="email" name="email" size="56" value=""><br> Homepage: <label for="homepage">Leave this field homepage blank:</label>
    <input id="homepage" name="homepage" size="55" value=""><br> URL: <label for="url">Leave this field url blank:</label>
    <input id="url" name="url" size="61" value=""><br> Comment: <label for="comment">Leave this field comment blank:</label>
    <textarea id="comment" name="comment" cols="50" rows="10"></textarea><br>
  </p>
  <div class="client-details">
    <h2><span class="step-number">1</span><span class="step-heading">Údaje <strong>o klientovi</strong></span></h2>
    <div class="client-details-inputs">
      <div class="client-input client-name"><input type="text" name="field2" id="field2" maxlength="" placeholder="Jméno a příjmení *" value="" class="form-input-text input-text" required=""></div>
      <div class="client-input client-email"><input type="text" name="field3" id="field3" placeholder="E-mail *" value="" maxlength="" class="form-input-email input-text" required=""></div>
      <div class="client-input client-zip"><input type="text" name="field4" id="field4" maxlength="" placeholder="PSČ *" value="" class="form-input-text input-text" required=""></div>
      <div class="client-input client-phone"><input type="text" name="field5" id="field5" maxlength="" placeholder="Telefon *" value="" class="form-input-text input-text" required=""></div>
      <div class="client-input client-consumption"><input type="text" name="field6" id="field6" maxlength="" placeholder="Roční spotřeba el. (MWh)" value="" class="form-input-text input-text"></div>
      <div class="client-other-info"><textarea name="field7" id="field7" class="form-input-textarea input-text" cols="25" rows="8" placeholder="Další informace"></textarea></div>
    </div>
  </div>
  <h2><span class="step-number">2</span><span class="step-heading"><strong>Doplňující</strong> informace</span></h2>
  <div class="other-info-inputs">
    <div class="other-info-inputs-col other-info-inputs-col-1">
      <h3>Způsob <strong>vytápění</strong> domu:</h3>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Plyn8" name="field8" value="Plyn"><label for="wb_Plyn8" class="input-radio-label">Plyn</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Elektřina8" name="field8" value="Elektřina"><label for="wb_Elektřina8" class="input-radio-label">Elektřina</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Tuhá_paliva8" name="field8" value="Tuhá paliva"><label for="wb_Tuhá_paliva8" class="input-radio-label">Tuhá paliva</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Tepelné_čerpadlo8" name="field8" value="Tepelné čerpadlo"><label for="wb_Tepelné_čerpadlo8" class="input-radio-label">Tepelné čerpadlo</label></div>
    </div>
    <div class="other-info-inputs-col other-info-inputs-col-2">
      <h3>Způsob <strong>ohřevu TUV</strong>:</h3>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Plyn9" name="field9" value="Plyn"><label for="wb_Plyn9" class="input-radio-label">Plyn</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Elektřina9" name="field9" value="Elektřina"><label for="wb_Elektřina9" class="input-radio-label">Elektřina</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Tepelné_čerpadlo9" name="field9" value="Tepelné čerpadlo"><label for="wb_Tepelné_čerpadlo9" class="input-radio-label">Tepelné čerpadlo</label></div>
    </div>
    <div class="other-info-inputs-col other-info-inputs-col-3">
      <h3><strong>Mám zájem</strong> o:</h3>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Instalaci_pro_RD10" name="field10" value="Instalaci pro RD"><label for="wb_Instalaci_pro_RD10" class="input-radio-label">Instalaci pro RD</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Instalaci_pro_firmy10" name="field10" value="Instalaci pro firmy"><label for="wb_Instalaci_pro_firmy10" class="input-radio-label">Instalaci pro
          firmy</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Výkup_a_dodávka_elektřiny10" name="field10" value="Výkup a dodávka elektřiny"><label for="wb_Výkup_a_dodávka_elektřiny10" class="input-radio-label">Výkup a
          dodávka elektřiny</label></div>
    </div>
    <div class="other-info-inputs-col other-info-inputs-col-4">
      <h3><strong>Typ instalace</strong>:</h3>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Fotovoltaika13" name="field13" value="Fotovoltaika"><label for="wb_Fotovoltaika13" class="input-radio-label">Fotovoltaika</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Tepelné_čerpadlo13" name="field13" value="Tepelné čerpadlo"><label for="wb_Tepelné_čerpadlo13" class="input-radio-label">Tepelné čerpadlo</label></div>
      <div class="input-radio-container"><input class="radio input-radio" type="radio" id="wb_Kombinace13" name="field13" value="Kombinace"><label for="wb_Kombinace13" class="input-radio-label">Kombinace</label></div>
    </div>
  </div>
  <h2><span class="step-number">3</span><span class="step-heading">Údaje <strong>České spořitelny</strong></span></h2>
  <div class="client-ceska-sporitelna-details">
    <div class="ceska-sporitelna-input ceska-sporitelna-email"><input type="text" name="field11" id="field11" maxlength="" placeholder="Číslo zaměstnance *" value="" class="form-input-text input-text" required=""></div>
    <div class="ceska-sporitelna-input ceska-sporitelna-cluid"><input type="text" name="field12" id="field12" maxlength="" placeholder="CLUID *" value="" class="form-input-text input-text" required=""></div>
  </div>
  <div class="form-bottom">
    <div class="form-bottom-gdpr">
      <p>Odesláním formuláře souhlasíte se <a href="/">zpracováním osobních údajů.</a></p>
    </div>
    <div class="form-bottom-submit"><input type="submit" name="submit" class="btn form-btn-send" value="Odeslat"></div>
  </div>
  <table class="form">
  </table>
</form>

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FORMULÁŘ PRO ZADÁVÁNÍ POPTÁVKY



email address: Leave this field email-address blank:
Homepage: Leave this field homepage blank:
URL: Leave this field url blank:
Comment: Leave this field comment blank:



1ÚDAJE O KLIENTOVI




2DOPLŇUJÍCÍ INFORMACE


ZPŮSOB VYTÁPĚNÍ DOMU:

Plyn
Elektřina
Tuhá paliva
Tepelné čerpadlo


ZPŮSOB OHŘEVU TUV:

Plyn
Elektřina
Tepelné čerpadlo


MÁM ZÁJEM O:

Instalaci pro RD
Instalaci pro firmy
Výkup a dodávka elektřiny


TYP INSTALACE:

Fotovoltaika
Tepelné čerpadlo
Kombinace


3ÚDAJE ČESKÉ SPOŘITELNY



Odesláním formuláře souhlasíte se zpracováním osobních údajů.





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