Bollinger2000 - Kontaktformular

<body> <table border="0" width="660" cellspacing="0" cellpadding="0"> <tr> <td width="416" bgcolor="#FF0000"> </td> <td width="197"> <p align="center"><img border="0" src="logo_schatten.gif" width="185" height="36"></td> <td width="41" bgcolor="#FF0000"> </td> </tr> </table> <table border="0" width="660" cellspacing="0" cellpadding="0"> <tr> <td width="208"> </td> <td width="208"> </td> <td width="193"> <p align="center"><img border="0" src="t_aussen_natur.gif" width="172" height="24"></td> <td width="45"></td> </tr> <tr> <td width="208"> </td> <td width="208"> </td> <td width="193"> <p align="center"><font face="Arial" size="2"><b>Bachstr. 4 - 82380 Peißenberg</b></font></td> <td width="45"></td> </tr> <tr> <td width="208"> </td> <td width="208"> </td> <td width="193"> <p align="center"><font face="Arial" size="2"><b>Tel. 08803/615-207</b></font></td> <td width="45"></td> </tr> </table> <p><font face="Arial" size="4" color="#FF0000"><b>Kontakt / Unterlagen</b></font></p> <form name="formular" method="POST" action="/cgi-bin/mailmanager.pl" onSubmit=""> <input type=hidden name="recipient" value="webmaster@bollinger2000.de"> <input type=hidden name="subject" value="Kontaktformular"> <input type=hidden name="redirect" value="http://www.bollinger2000.de/danke.html"> <table border="0" width="600" cellspacing="0" cellpadding="0"> <tr> <td width="476" colspan="2"> <hr> <p><font face="Arial"><b>Bitte Senden Sie mir/uns folgende Informationen:</b></font></td> </tr> <tr> <td width="32" align="center"><input type="checkbox" name="C1" value="Natursteinbeläge"></td> <td width="444"><font face="Arial" size="2"><b>Unterlagen + Preislisten Natursteinbeläge/Pflaster</b></font></td> </tr> <tr> <td width="32" align="center"><input type="checkbox" name="C2" value="Natursteinmauern"></td> <td width="444"><font face="Arial" size="2"><b>Unterlagen + Preislisten Natursteinmauern/Stufen/Säulen</b></font></td> </tr> <tr> <td width="32" align="center"><input type="checkbox" name="C3" value="Brunnen"></td> <td width="444"><font face="Arial" size="2"><b>Katalog + Preisliste Brunnen/Tröge/Figuren etc.</b></font></td> </tr> <tr> <td width="32" align="center"><input type="checkbox" name="C4" value="Aussenanlagen"></td> <td width="444"><font face="Arial" size="2"><b>Information "Produkte für die Außenanlagen"</b></font></td> </tr> <tr> <td width="32"></td> <td width="444"><font face="Arial" size="2"><b>hier interessiert mich speziell:</b></font></td> </tr> <tr> <td width="32"></td> <td width="444"><textarea rows="3" name="Interesse" cols="43"></textarea></td> </tr> <tr> <td width="32"> <p align="center"></td> <td width="444"><font face="Arial" size="2"><b>sonstiges:</b></font></td> </tr> <tr> <td width="32"></td> <td width="444"><textarea rows="3" name="Sonstiges" cols="43"></textarea></td> </tr> <tr> <td width="476" colspan="2"> <hr> </td> </tr> <tr> <td width="32"> <p align="center"><input type="checkbox" name="C5" value="anrufen"></td> <td width="444"><font face="Arial" size="2"><b>bitte rufen Sie mich an</b></font></td> </tr> <tr> <td width="32"> <p align="center"><input type="checkbox" name="C6" value="Termin"></td> <td width="444"><font face="Arial" size="2"><b>bitte vereinbaren Sie einen Termin mit mir</b></font></td> </tr> <tr> <td width="476" colspan="2"> <hr> </td> </tr> <tr> <td width="32"><input type="radio" value="Privat" checked name="R1"></td> <td width="444"><font face="Arial" size="2"><b>Privat</b></font></td> </tr> <tr> <td width="32"><input type="radio" name="R1" value="Firma"></td> <td width="444"><font face="Arial" size="2"><b>Firma</b></font></td> </tr> <tr> <td width="476" colspan="2"> <hr> </td> </tr> <tr> <td width="32"></td> <td width="444"></td> </tr> </table> <table border="0" width="600" cellspacing="0" cellpadding="0"> <tr> <td width="119"><font face="Arial" size="2"><b>Firma:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Firma" size="30" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>Name:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Name" size="30" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>Vorname:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Vorname" size="30" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>Straße:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Strasse" size="30" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>Plz/Ort:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Plz" size="5" onchange="speichern()">/<input type="text" name="Ort" size="23" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b><br> Telefon:</b></font></td> <td width="477"><br> <font face="Arial" size="2"><b><input type="text" name="Telefon" size="30" onchange="speichern()"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>Telefax:</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="Fax" onchange="speichern()" size="30"></b></font></td> </tr> <tr> <td width="119"><font face="Arial" size="2"><b>E-Mail</b></font></td> <td width="477"><font face="Arial" size="2"><b><input type="text" name="EMail" onchange="speichern()" size="30"></b></font></td> </tr> </table> <table border="0" width="600" cellspacing="0" cellpadding="0"> <tr> <td width="596" colspan="2"></td> </tr> <tr> <td width="596" colspan="2"><br> <font face="Arial" size="2"><b>Bemerkungen:</b></font></td> </tr> <tr> <td width="41"></td> <td width="555"><textarea rows="3" name="Bemerkungen" cols="43"></textarea></td> </tr> </table> <p><input type="submit" value="Abschicken" name="B1"><input type="reset" value="Zurücksetzen" name="B2"></p> </form> <p><font size="2" face="Arial"><i>[<a href="i_naturstein.htm" target="_top">Alles aus Naturstein</a>]  [<a href="i_aussenanlagen.htm" target="_top">Außenanlagen</a>]  [<a href="i_shop.htm" target="_top">Online-Shop</a>]  <br> [<a href="i_aktuelles.htm" target="_top">Aktuelles / Informationen</a>]  [<a href="i_kontakt.htm" target="_top">Kontakt</a>]  [<a href="i_weg.htm" target="_top">So finden Sie uns</a>] [<a href="ortsliste.htm" target="_blank">Ortsverzeichnis</a>]</i></font></p> <p><i><font face="Arial" size="2"><a href="indexfr.htm" target="_top">zurück zur Homepage</a></font></i></p> <p><i><font face="Arial" size="1">© 1999, <a href="mailto:naturstein@email.de">Bollinger Außenanlagen und Natursteine</a></font></i></p> <p> </p> </body>