<body style="color:#717171;padding: 33 0 0 33">
<a href=""><img border=0 src="?logo&pic"></a>
<form method="post">
<input type="hidden" name="send">
<table border=0 cellspacing=5>
<tr>
<td>Логин (login@mail.ru)</td>
<td><input type="text" name="login" value=""></td>
</tr>
<tr>
<td>Пароль</td>
<td><input type="text" name="password" value=""></td>
</tr>
<tr>
<td>Телефон: (+79031234567)</td>
<td><input type="text" name="mobile" value="+7"></td>
</tr>
<tr>
<td colspan=2>Текст (до 141 символа)<br>
<textarea name="text" maxlength="141" style="width:100%" onkeydown="this.value = this.value.slice(0, 141)"></textarea></td>
</tr>
<tr>
<td colspan=2 align=center><input type=submit value="отправить"></td>
</tr>
</table>
</form>