document.write('');
document.write('  <table cellspacing="5" cellpadding="6" style="border: 1px solid #f5f5f5">');
document.write('<form method="post" action="http://18938.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016" colspan="2"><font color="#f5f5f5" size="2"><b>Kontaktformular maximes-page.net</b></font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016" colspan="2"><font color="#f5f5f5" size="2">mit * gekennzeichnete Felder müssen ausgefüllt werden</font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2"><b>Name *</b></font></td>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2">');
document.write('        <input style=" background-color: #e2cbb9;" type="text" name="user_input[id1]" value="" size="50">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2"><b>Vorname</b></font></td>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2">');
document.write('        <input style=" background-color: #e2cbb9;" type="text" name="user_input[id2]" value="" size="50">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2"><b>E-mail *</b></font></td>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2">');
document.write('        <input style=" background-color: #e2cbb9;" type="text" name="user_input[id3]" value="" size="50">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2"><b>Betreff *</b></font></td>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2">');
document.write('        <input style=" background-color: #e2cbb9;" type="text" name="user_input[id5]" value="" size="50">');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2"><b>Nachricht *</b></font></td>');
document.write('      <td bgcolor="#3a1016"><font color="#f5f5f5" size="2">');
document.write('        <textarea style=" background-color: #e2cbb9;" name="user_input[id4]" 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="18938">');
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('');