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<table width=100% align=center cellpadding=3 cellspacing=1 bgcolor='#DBEAF5'><form name='feedback' method='post' enctype='multipart/form-data' action='../../enews/index.php'><input name='enews' type='hidden' value='AddFeedback'><tr><td width='16%' height=25 bgcolor='ffffff'>孩子年龄</td><td bgcolor='ffffff'><input name='older' type='text' value=''>(*)</td></tr><tr><td width='16%' height=25 bgcolor='ffffff'>电话</td><td bgcolor='ffffff'><input name='phone' type='text' value=''>(*)</td></tr><tr><td width='16%' height=25 bgcolor='ffffff'>电子邮箱</td><td bgcolor='ffffff'><input name='email' type='text' value=''></td></tr><tr><td width='16%' height=25 bgcolor='ffffff'>预约所在城市</td><td bgcolor='ffffff'><input name='city' type='text' value=''>(*)</td></tr><tr><td width='16%' height=25 bgcolor='ffffff'>称呼</td><td bgcolor='ffffff'><input name='title' type='text' value=''>(*)</td></tr><tr><td bgcolor='ffffff'></td><td bgcolor='ffffff'><input type='submit' name='submit' value='提交'></td></tr></form></table>