document.write('');
document.write('  <table align="center">');
document.write('<form method="post" action="http://172230.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="5"><b>Tickets bestellen</b></font></td>');
document.write('      <td><b></b></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2"><font face="Arial">Alle Felder müssen ausgefüllt werden!</font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">Name *</font></td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id3]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">Adresse *</font></td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id5]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">PLZ / Ort</font></td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id6]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">E-Mail *</font></td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id4]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">Ticket</font></td>');
document.write('      <td>');
document.write('        <select name="user_input[id7]">');
document.write('          <option value="0">Kategorie 2 inkl. Car-Fahrt [139.-]');
document.write('</option>');
document.write('          <option value="1">Kategorie 1 inkl. Car-Fahrt [153.-]</option>');
document.write('        </select>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial">Anzahl Tickets</font></td>');
document.write('      <td>');
document.write('        <select name="user_input[id8]">');
document.write('          <option value="0">1');
document.write('</option>');
document.write('          <option value="1">2');
document.write('</option>');
document.write('          <option value="2">3');
document.write('</option>');
document.write('          <option value="3">4');
document.write('</option>');
document.write('          <option value="4">5');
document.write('</option>');
document.write('          <option value="5">6');
document.write('</option>');
document.write('          <option value="6">7');
document.write('</option>');
document.write('          <option value="7">8');
document.write('</option>');
document.write('          <option value="8">9');
document.write('</option>');
document.write('          <option value="9"></option>');
document.write('        </select>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td align="right"><font face="Arial" size="1"><i>ACHTUNG &gt;&gt; Mindestteilnehmerzahl für Carfahrt &gt;&gt; 30 &lt;&lt; !!</i></font></td>');
document.write('      <td align="right"></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="172230">');
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('    <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>');
document.write('    </tr>');
document.write('</form>');
document.write('  </table>');
document.write('');