document.write('');
document.write('  <table>');
document.write('<form method="post" action="http://163221.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td colspan="2">Bestellformular für Fotos</td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2"></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Veranstaltung</td>');
document.write('      <td>');
document.write('        <select name="user_input[id10]">');
document.write('          <option value="0">Bitte auswählen');
document.write('</option>');
document.write('          <option value="1">Presberg 2010');
document.write('</option>');
document.write('          <option value="2">Ransel-Classics 2010');
document.write('</option>');
document.write('          <option value="3">Rhine-on-Skates-2009');
document.write('</option>');
document.write('          <option value="4">Presberg 2009');
document.write('</option>');
document.write('          <option value="5">Ransel-Classics 2009');
document.write('</option>');
document.write('          <option value="6">Presberg 2008');
document.write('</option>');
document.write('          <option value="7">Sauerburg-Classics 2008');
document.write('</option>');
document.write('          <option value="8">Presberg 2007');
document.write('</option>');
document.write('          <option value="9">Sauerburg-Classics 2007');
document.write('</option>');
document.write('          <option value="10">Presberg 2006</option>');
document.write('        </select>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Bestelloption</td>');
document.write('      <td>');
document.write('        <select name="user_input[id9]">');
document.write('          <option value="0">Bitte auswählen');
document.write('</option>');
document.write('          <option value="1">Opt.1:  1752 x 1168 per Mail');
document.write('</option>');
document.write('          <option value="2">Opt.2:  3504 x 2336  per Mail');
document.write('</option>');
document.write('          <option value="3">Opt.3:  1752 x 1168 auf CD ');
document.write('</option>');
document.write('          <option value="4">Opt.4:  3504 x 2336  auf CD ');
document.write('</option>');
document.write('          <option value="5">Opt.5:  1752 x 1168 auf DVD ');
document.write('</option>');
document.write('          <option value="6">Opt.6:  3504 x 2336  auf DVD ');
document.write('</option>');
document.write('          <option value="7">Opt.7:  Foto 10 x 15cm');
document.write('</option>');
document.write('          <option value="8">Opt.8:  Foto 13 x 18cm');
document.write('</option>');
document.write('          <option value="9">Opt.9:  Foto 20 x 30cm');
document.write('</option>');
document.write('          <option value="10">Opt.10:  Foto 30 x 45cm');
document.write('</option>');
document.write('          <option value="11">Opt.11:  Foto 40 x 60cm');
document.write('</option>');
document.write('          <option value="12">Opt.12:  Foto 50 x 75cm');
document.write('</option>');
document.write('          <option value="13">Opt.13: Puzzle 30 x 45cm</option>');
document.write('        </select>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Bestellnummer<br>befindet sich');
document.write('<BR>');
document.write('unter dem Foto</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id6]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>E-Mail</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id4]" value="" size="35">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Vor- und Zuname</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id3]" value="" size="35">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Rechnungsadresse<br>oder Kundennummer</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id7]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2">Alle Preise inkl. MwSt.');
document.write('<BR>');
document.write('Fotos werden per offene Rechnung verschickt!</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="163221">');
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('');