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document.write('      <td colspan="2"><font color="#FFFFFF" face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>mit * gekennzeichnete Felder müssen ausgefüllt werden</b></font></td>');
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document.write('      <td><font color="#FFFFFF" face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Name</b></font></td>');
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document.write('      <td><font color="#FFFFFF" face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Betreff *</b></font></td>');
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document.write('        <input style=" color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-weight: bold;" type="text" name="user_input[id5]" value="" size="20">');
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document.write('      <td><font color="#FFFFFF" face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Nachricht *</b></font></td>');
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document.write('        <textarea style=" color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-weight: bold;" name="user_input[id6]" style="width:100%" rows="7"></textarea>');
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document.write('        <input type="hidden" name="entry" value="112943">');
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('      <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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