[Купэ]

<form name="SIMPLE_FORM_1" action="/" method="POST" enctype="multipart/form-data"><input type="hidden" name="sessid" id="sessid" value="e5add60f08397d3c8cf9fd6a7293ea75"><input type="hidden" name="WEB_FORM_ID" value="1">
	<input type="text" name="form_text_1" placeholder="Название оборудования">

	<input type="text" name="form_text_2" placeholder="Телефон">
		<input type="text" name="form_email_3" placeholder="E-mail">
	
	<input type="checkbox" value="4" name="form_checkbox_SIMPLE_QUESTION_255[]" class="niceCheck"><span style="color:#fff;">Получить полный прайс-лист</span>
	<div class="clr"></div>

	 <input name="form_file_5" class="inputfile" size="0" type="file"><span class="bx-input-file-desc"></span>
<input type="hidden" name="web_form_apply" value="Y">
<input type="submit" id="submit" name="web_form_submit" value="">
<span style="display: block; text-align: center; margin: -5px 0 0 0; font-size: 14px;">Мы ответим в течение 15 минут</span>

</form>