document.write('');
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document.write('<form method="post" action="http://56684.formmailer.onetwomax.de/">');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>Name</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <input style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" type="text" name="user_input[id3]" value="" size="35">');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>E-Mail</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <input style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" type="text" name="user_input[id4]" value="" size="35">');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>PLZ &amp; Ort</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <textarea style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" name="user_input[id6]" style="width:100%" rows="1"></textarea>');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>Model Jahr</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <input style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" type="text" name="user_input[id7]" value="" size="4">');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>Model</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <input style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" type="text" name="user_input[id8]" value="" size="35">');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#CECEFF">');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>Homepage</b></font></td>');
document.write('      <td bgcolor="#CECEFF"><font color="#000042" face="Verdana" size="2"><b>');
document.write('        <input style=" border: 1px solid #000042; background-color: #CECEFF; color: #000042; font-family: Verdana; font-weight: bold;" type="text" name="user_input[id9]" value="http://" size="35">');
document.write('      </b></font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2" align="center" valign="middle">');
document.write('        <input type="hidden" name="mq" value="\'">');
document.write('        <input type="hidden" name="action" value="send_mail">');
document.write('        <input type="hidden" name="entry" value="56684">');
document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('        <input type="reset" name="reset" value="Zur&uuml;cksetzen">');
document.write('      </td>');
document.write('    </tr>');
document.write('</form>');
document.write('  </table>');
document.write('');