<?php include 'header.php'; ?>
<div align="center">
<form method="post" action="dteklendi.php">
<b>Destek Talebi Baþlýðý:</b><br />
<input name="destekad" type="text" class="text" size="60" /><br />
<b>Aciliyet:</b><br />
<select name="destekaciliyet">
<option value="Acil">Acil</option>
<option value="Orta">Orta</option>
<option value="Normal">Normal</option>
</select><br />
<b>Destek Talebi:</b><br />
<textarea name="destekicerik" cols="50" rows="6"></textarea><br />
<input type="submit" value="Destek Talebini Oluþtur" />
</form>
</div>
<?php include 'footer.php'; ?>