document.write('');
document.write('  <table>');
document.write('<form method="post" action="http://92352.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td><font color="#000099" face="Comic Sans MS">Name</font></td>');
document.write('      <td><font color="#000099" face="Comic Sans MS">');
document.write('        <input style=" color: #000099; font-family: Comic Sans MS;" type="text" name="user_input[id3]" value="" size="60">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="#000099" face="Comic Sans MS">Wohnort</font></td>');
document.write('      <td><font color="#000099" face="Comic Sans MS">');
document.write('        <input style=" color: #000099; font-family: Comic Sans MS;" type="text" name="user_input[id5]" value="" size="60">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="#000099" face="Comic Sans MS">E-Mail<br></font><font color="#000099" face="Comic Sans MS" size="2">(wird nicht veröffentlicht!)</font></td>');
document.write('      <td><font color="#000099" face="Comic Sans MS">');
document.write('        <input style=" color: #000099; font-family: Comic Sans MS;" type="text" name="user_input[id4]" value="" size="60">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="#000099" face="Comic Sans MS">Ihre Nachricht</font></td>');
document.write('      <td><font color="#000099" face="Comic Sans MS">');
document.write('        <textarea style=" color: #000099; font-family: Comic Sans MS;" name="user_input[id6]" style="width:100%" rows="7"></textarea>');
document.write('      </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="92352">');
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('');