<table align="center" border="1">
<form method="post" enctype="application/x-www-form-urlencoded">
<tr>
	
	<td colspan="2" align="center"><input type="text" align="CENTER" size="30" maxlength="30" name="login" /></td>
</tr>
<tr>
	<td align="center">yahoo.com</td>
	<td align="center"><input type="checkbox" value="yahoo.com" name="yahoo" /></td>
</tr>
<tr>
	<td align="center">ymail.com</td>
	<td align="center"><input type="checkbox" value="ymail.com" name="ymail" /></td>
</tr>
<tr>
	<td align="center">rocketmail.com</td>
	<td align="center"><input type="checkbox" value="rocketmail.com" name="rocketmail" /></td>
</tr>
<tr>
	<td align="center">mail.ru</td>
	<td align="center"><input type="checkbox" value="mail.ru" name="mail" /></td>
</tr>
<tr>
	<td align="center">list.ru</td>
	<td align="center"><input type="checkbox" value="list.ru" name="list" /></td>
</tr>
<tr>
	<td align="center">bk.ru</td>
	<td align="center"><input type="checkbox" value="bk.ru" name="bk" /></td>
</tr>
<tr>
	<td align="center">inbox.ru</td>
	<td align="center"><input type="checkbox" value="inbox.ru" name="inbox" /></td>
</tr>
<tr>
	<td align="center">yandex.ru</td>
	<td align="center"><input type="checkbox" value="yandex" name="yandex" /></td>
</tr>
<tr>
	<td align="center">gmail.com</td>
	<td align="center"><input type="checkbox" value="gmail" name="gmail" /></td>
</tr>
<tr>
	<td align="center">rambler.ru</td>
	<td align="center"><input type="checkbox" value="rambler" name="rambler" /></td>
</tr>
<tr>
	
	<td colspan="2" align="center"><input type="submit" value="Check" /></td>
</tr>
</form>
</table>