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    <TITLE>Juventus fan klub upisnica</TITLE>
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<b><center><font face=verdana, arial size=4>Upisnica</font></center></b>
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Ime i prezime:
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<input type="text" name="Ime i prezime" size="75">
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Datum rođenja:
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Mjesto rođenja: 
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Adresa: 
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<input type="text" name="Adresa" size="75">
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Grad: 
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Telefon: 
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<input type="text" name="Telefon" size="75">
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Mobitel: 
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<input type="text" name="Mobitel" size="75">
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Email: 
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Slanjem ove upisnice slažete se da će te:<br>
- poštovati Statut Udruge<br>
- plačati članarinu<br>
- dopustiti da se Vaši podaci upotrebe isključivo za potrebe članstva<br>
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Napomena: treba ispuniti sva polja, te nakon toga uplatiti članarinu. Upisnica nije važeča bez uplate članarine
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<INPUT TYPE="submit" NAME="posalji" VALUE="Pošalji"> 
<INPUT TYPE="reset" NAME="odustani" VALUE="Odustani">
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