<table>
	<tr>
		<td class="lz_form_field" width="150"><strong><!--lang_client_your_name-->:</strong></td><td width="220"><input name="name" class="lz_form_box" maxlength="32"></td>
	</tr>
	<tr>
		<td class="lz_form_field"><strong><!--lang_client_your_email-->:</strong></td><td><input name="email" class="lz_form_box" maxlength="50"></td>
	</tr>
	<tr>
		<td class="lz_form_field"><!--lang_client_your_company-->:</td><td><input name="company" class="lz_form_box" maxlength="50"></td>
	</tr>
</table>