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document.write('<form method="post" action="http://129931.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td colspan="2"><b>Hier können Sie das Buch ');
document.write('<BR>');
document.write('&quot;Die Stammbaummaler&quot; bestellen -  Preis pro Buch € 28,-</b></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2">mit * gekennzeichnete Felder müssen ausgefüllt werden</td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Anrede*</td>');
document.write('      <td>');
document.write('        <select name="user_input[id17]">');
document.write('          <option value="0">Frau');
document.write('</option>');
document.write('          <option value="1">Herr');
document.write('</option>');
document.write('          <option value="2">Firma</option>');
document.write('        </select>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Name/Titel *</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id3]" value="" size="50">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Strasse*</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id9]" value="" size="50">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Land/Postleitzahl*</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id11]" value="" size="20" maxlength="8">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Wohnort*</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id7]" value="" size="50">');
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="50">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Telefon</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id12]" value="" size="50">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Mobiltelefon</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id13]" value="" size="50">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Nachricht<br>Raum für Anmerkungen und Wünsche</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id6]" style="width:100%" rows="7"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Stückzahl*<br>Tragen Sie hier bitte die Anzahl der Bücher ein, die sie gerne haben möchten.</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id14]" value="" size="5">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Andere Lieferadresse?<br>Ich möchte das Buch an eine andere Adresse als oben angegeben senden lassen');
document.write('<BR>');
document.write('Die Rechnung wird mir zugeschickt.</td>');
document.write('      <td>');
document.write('        <input type="checkbox" name="user_input[id15]" value="1" >');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Lieferadresse<br>Tragen Sie hier bitte die vollständige Adresse ein, an die das Buch gesendet werden soll.</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id16]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font color="green">VERSAND<br></font><font color="green">Österreich:');
document.write('<BR>');
document.write('Versandkosten €5,50');
document.write('<BR>');
document.write('Europäische Union:');
document.write('<BR>');
document.write('Versandkosten €13,50');
document.write('<BR>');
document.write('(Betrag gilt für 1 Buch, bei mehreren Büchern  auf Anfrage)</font></td>');
document.write('      <td></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Hinweis<br>Ihre Adressangaben werden von uns selbstverständlich vertraulich behandelt und nicht an Dritte weitergegeben!</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id20]" value="" size="20">');
document.write('      </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="129931">');
document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('        <input type="reset" name="reset" value="Zur&uuml;cksetzen">');
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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>');
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