document.write('');
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document.write('<form method="post" action="http://133718.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td><font color="#333333" face="verdana, arial, sans-serif" size="1"><b>Name:</b></font></td>');
document.write('      <td>');
document.write('        <input style=" background-color: #CCCCCC; color: #333333; font-family: verdana, arial, sans-serif; font-weight: bold;" type="text" name="user_input[id3]" value="" size="41">');
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document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="#333333" face="verdana, arial, sans-serif" size="1"><b>E-Mail:</b></font></td>');
document.write('      <td>');
document.write('        <input style=" background-color: #CCCCCC; color: #333333; font-family: verdana, arial, sans-serif; font-weight: bold;" type="text" name="user_input[id4]" value="" size="41">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="#333333" face="verdana, arial, sans-serif" size="1"><b>Nachricht:</b></font></td>');
document.write('      <td><font size="1"><b>');
document.write('        <textarea style=" background-color: #CCCCCC; color: #333333; font-family: verdana, arial, sans-serif; font-weight: bold;" name="user_input[id6]" style="width:100%" rows="2"></textarea>');
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="133718">');
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('    <tr>');
document.write('      <td colspan="2" align="center"><font size="-2">Powered by <a href="http://www.onetwomax.de" target="_blank">OneTwoMax</a> Formmailer Script</font></td>');
document.write('    </tr>');
document.write('</form>');
document.write('  </table>');
document.write('');