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<?php
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if (!isset($_GET['to'])) {
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$_GET['to'] = "7e7971cb5b2e1a4ddb0b85732fc55440";
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}
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?>
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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
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<html xmlns="http://www.w3.org/1999/xhtml">
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<head>
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<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
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<title>Kontakt- Formular</title>
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<script type="text/JavaScript">
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<!--
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window.status = "<?= $_GET['to'] ?>";
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function MM_findObj(n, d) { //v4.01
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var p,i,x; if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
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d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
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if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n];
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for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document);
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if(!x && d.getElementById) x=d.getElementById(n); return x;
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}
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function MM_validateForm() { //v4.0
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var i,p,q,nm,test,num,min,max,errors='',args=MM_validateForm.arguments;
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for (i=0; i<(args.length-2); i+=3) { test=args[i+2]; val=MM_findObj(args[i]);
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if (val) { nm=val.name; if ((val=val.value)!="") {
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if (test.indexOf('isEmail')!=-1) { p=val.indexOf('@');
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if (p<1 || p==(val.length-1)) errors+='- '+nm+' must contain an e-mail address.\n';
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} else if (test!='R') { num = parseFloat(val);
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if (isNaN(val)) errors+='- '+nm+' must contain a number.\n';
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if (test.indexOf('inRange') != -1) { p=test.indexOf(':');
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min=test.substring(8,p); max=test.substring(p+1);
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if (num<min || max<num) errors+='- '+nm+' must contain a number between '+min+' and '+max+'.\n';
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} } } else if (test.charAt(0) == 'R') errors += '- '+nm+' is required.\n'; }
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} if (errors) alert('The following error(s) occurred:\n'+errors);
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document.MM_returnValue = (errors == '');
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}
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//-->
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</script>
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</head>
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<style>
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.pflicht { font-size:12px; }
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.textform {
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FONT: 11px Arial, Helvetica, sans-serif; COLOR: #FFFFFF; BACKGROUND-COLOR: #999966
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}
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INPUT {
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FONT: 10px Verdana, Geneva, Arial, Helvetica, sans-serif; COLOR: #656565
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}
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BODY {
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PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 0px; MARGIN: 0px 0px 0px 0px; PADDING-TOP: 0px
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}
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.text {
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FONT: 11px/15px Verdana, Geneva, Arial, Helvetica, sans-serif; COLOR: #656565
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}
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.textformoblig {
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FONT: 11px Arial, Helvetica, sans-serif; COLOR: #000000; BACKGROUND-COLOR: #c4c4a6
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}
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</style>
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<body bgcolor="#ffffff" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
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<form name="Kontakt" action="mail.php" method="post">
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<input type=hidden name="_to" value="<?= $_GET['to'] ?>">
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<input type=hidden name="_subject" value="<?= $_GET['to'] ?>">
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<input type="hidden" name="_from" value="<?= $_GET['to'] ?>">
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<input type="hidden" name="_target" value="danke.htm">
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<table border="0" cellspacing="0" cellpadding="5" width="350" align="center">
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<tr align="center" bgcolor="#339966">
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<td width="340" bgcolor="#FFFFFF">
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<table width="342" border="0" cellspacing="1" cellpadding="1">
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<tr>
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<td width="54"><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td width="8"><img height="1" alt="" src="images/spacer.gif" width="8" border="0" /></td>
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<td width="101" class="textform" style="WIDTH: 101px"> Firma/Einrichtung * </td>
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<td width="166" align="right" class="textform" style="WIDTH: 164px">(max. 31 Zeichen) </td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td colspan="2">
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<input name="Firma" type="text" class="input" id="Firma" style="WIDTH: 265px" size="30" maxlength="31" />
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</td>
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</tr>
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<tr>
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<td colspan="4"><img height="11" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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</tr>
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<tr>
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<td class="textform" style="WIDTH: 54px"> Anrede</td>
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<td><img height="1" alt="" src="images/spacer.gif" width="8" border="0" /></td>
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<td class="textform" style="WIDTH: 101px"> Name/ Vorname * </td>
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<td class="textform" style="WIDTH: 164px" align="right"> (max. 31 Zeichen) </td>
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</tr>
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<tr>
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<td class="text" style="WIDTH: 54px">
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<select name="Anrede" class="text" id="Anrede"
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style="WIDTH: 54px">
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<option value="1">Herr</option>
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<option value="2">Frau</option>
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</select>
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</td>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td style="WIDTH: 265px" colspan="2">
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<input name="Name" type="text" class="input" id="Name" style="WIDTH: 265px" size="30" maxlength="31" />
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</td>
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</tr>
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<tr>
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<td colspan="4"><img height="11" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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</tr>
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<tr>
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<td style="WIDTH: 54px"> </td>
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<td><img height="1" alt="" src="images/spacer.gif" width="8" border="0" /></td>
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<td class="textform" style="WIDTH: 101px"> PLZ / Ort </td>
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<td class="textform" style="WIDTH: 164px" align="right">(max. 31 Zeichen) </td>
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</tr>
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<tr>
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<td class="text" style="WIDTH: 54px"> </td>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td style="WIDTH: 265px" colspan="2">
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<input name="PLZOrt" type="text" class="input" id="PLZOrt" style="WIDTH: 265px" size="30" maxlength="31" />
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</td>
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</tr>
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<tr>
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<td colspan="4"><img height="11" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif"
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width="8" border="0" /></td>
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<td class="textformoblig" style="WIDTH: 101px"> Email* </td>
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<td class="textformoblig" style="WIDTH: 164px" align="right"> (max. 100 Zeichen) </td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td colspan="2">
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<input name="email2" type="text" class="input" id="email2" style="WIDTH: 265px" size="30" maxlength="100" />
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</td>
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</tr>
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<tr>
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<td colspan="4"><img height="11" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif"
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width="8" border="0" /></td>
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<td class="textformoblig" style="WIDTH: 101px"> Bemerkungen </td>
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<td class="textformoblig" style="WIDTH: 164px" align="right"> (max. 100 Zeichen) </td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td colspan="2">
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<textarea name="Bemerkungen" cols="40" rows="5" class="input" id="Bemerkungen" style="WIDTH: 267px"></textarea>
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</td>
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</tr>
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<tr>
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<td colspan="4"><img height="11" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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</tr>
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<tr>
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<td><img height="1" alt="" src="images/spacer.gif" width="1" border="0" /></td>
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<td><img height="1" alt="" src="images/spacer.gif"
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width="8" border="0" /></td>
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<td class="textformoblig" style="WIDTH: 101px">Empfänger</td>
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<td class="textformoblig" style="WIDTH: 164px" align="right"> </td>
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</tr>
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<tr>
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<td colspan="4"><img align="absbottom" src="./mailimage.php?email=<?= $_GET['to'] ?>&font=5&fsize=10&bgcolor=255,255,255&fontcolor=0,0,0&fromimage=0" border="0"></td>
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</tr>
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<tr>
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<td colspan="4">
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<div align="center">
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<input type="submit" name="_Abschicken" value="Abschicken" onclick="MM_validateForm('Name','','R','email2','','NisEmail');return document.MM_returnValue" />
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<input type="reset" name="Zurücksetzen" value="Zurücksetzen" />
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</div>
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</td>
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</tr>
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</table>
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</td>
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</tr>
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</table>
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</form>
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</body>
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</html>
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