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<![CDATA[
<div>
<table height="100%" cellspacing="0" cellpadding="0" width="100%" border="0">
<tbody>
<tr>
<td valign="top" width="23" background="/images/linie.gif"></td>
<td valign="top"><font face="Verdana" size="1"><font size="2"><font face="Tahoma">
<p><font face="Verdana" size="1"><strong>Fragen Sie uns<br/>
<br/>
</strong></font><font face="Verdana" size="1">Ihre Anfrage wird von uns sorgfältig und umgehend<br/>
bearbeitet.<br/>
Sollten Sie zusätzliche Wünsche oder weitere Fragen haben, können Sie diese am Ende des Formulars in dem Feld "sonstiges" eingeben.</font></p>
<p><font face="Verdana" size="1">Wir freuen uns auf Ihre Nachricht.<br/>
</font></p>
</font></font></font></td>
</tr>
</tbody>
</table>
</div>
<div>
<p><strong><font face="Verdana" color="#9393d1" size="5">Anfrageformular</font></strong><br />
<font face="Verdana" size="2"><strong>Hier können Sie uns Ihre Anfrage senden.<br />
<br />
<br />
<br />
<form action="http://www.dhtm.de/dialog.php" method="post">
<table cellspacing="0" cellpadding="0" width="500" border="0">
<tbody>
<tr>
<td>
<table cellspacing="0" cellpadding="0" width="100%" bgcolor="#808080" border="0">
<tbody>
<tr>
<td>
<table cellspacing="1" cellpadding="3" width="100%" border="0">
<tbody>
<tr class="cellheader">
<td width="125">Ihre Daten</td>
<td class="cell4"> </td>
</tr>
<tr class="cell2">
<td width="125">Firma</td>
<td><input class="feld" size="40" name="Firma" type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">Ansprechpartner:</td>
<td><input class="feld" size="40" name="Ansprechpartner" type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">Straße, Nr.:</td>
<td><input class="feld" size="40" name="Strasse" value=" " type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">PLZ, Ort:</td>
<td><input class="feld" size="7" name="PLZ" type="text" /> <input class="feld" size="27" name="Ort" type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">Telefon:</td>
<td><input class="feld" size="40" name="Telefon" type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">Telefax:</td>
<td><input class="feld" size="40" name="Telefax" type="text" /></td>
</tr>
<tr class="cell2">
<td width="125">E-Mail:</td>
<td><input class="feld" size="40" name="eMail" type="text" /></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table height="50" width="100%" border="0">
<tbody>
<tr>
<td width="125"> </td>
</tr>
</tbody>
</table>
<table cellspacing="0" cellpadding="0" width="100%" bgcolor="#808080" border="0">
<tbody>
<tr>
<td>
<table cellspacing="1" cellpadding="3" width="100%" border="0">
<tbody>
<tr class="cellheader">
<td valign="top" width="125">Ihre Anfrage</td>
<td class="cell4"> </td>
</tr>
<tr class="cell2">
<td valign="top" width="125">Titel</td>
<td><input class="feld" size="40" name="Jobtitel" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Produkt</td>
<td><input class="feld" size="40" name="Produkt" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Format (beschnitten)</td>
<td><input class="feld" size="40" name="Format_Beschnitten" value=" " type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Auflage</td>
<td><input class="feld" size="40" name="Auflage" value=" " type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Umfang</td>
<td><input class="feld" size="40" name="Umfang_Seiten" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Umschlag<br />
Farbigkeit</td>
<td>
<p><input class="feld" size="40" name="Umschlag_Farbigkeit" value=" " type="text" /></p>
</td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">
<p>Umschlag<br />
Material</p>
</td>
<td>
<p><input class="feld" size="40" name="Umschlag_Material" value=" " type="text" /></p>
</td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">
<p>Inhalt<br />
Farbigkeit</p>
</td>
<td><input class="feld" size="40" name="Inhalt_Farbigkeit" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Inhalt<br />
Material</td>
<td><input class="feld" size="40" name="Inhalt_Material" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Weiterverarbeitung</td>
<td><input class="feld" size="40" name="Weiterverarbeitung" type="text" /></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">gelieferte Vorlagen</td>
<td><textarea class="textbox" rows="5" cols="40" name="Vorlagen_geliefert"></textarea></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Verpackung,<br />
Transport</td>
<td><textarea class="textbox" rows="5" cols="40" name="Verpackung_Transport"></textarea></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Gestaltung / Satz / Repro</td>
<td><textarea class="textbox" rows="5" cols="40" name="Gestaltung_Satz_Repro"></textarea></td>
</tr>
<tr class="cell2">
<td valign="top" width="20%">Liefertermin</td>
<td><input class="feld" size="12" name="Liefertermin" type="text" /></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table height="20" width="100%" border="0">
<tbody>
<tr>
<td width="100%"> </td>
</tr>
</tbody>
</table>
<table cellspacing="0" cellpadding="0" width="100%" bgcolor="#808080" border="0">
<tbody>
<tr>
<td>
<table cellspacing="1" cellpadding="3" width="100%" border="0">
<tbody>
<tr class="cell2">
<td valign="top" width="125">Sonstiges:</td>
<td><textarea class="textbox" rows="5" cols="40" name="Sonstiges"></textarea></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table height="10" width="100%" border="0">
<tbody>
<tr>
<td width="100%"> </td>
</tr>
</tbody>
</table>
<table cellspacing="0" cellpadding="0" width="100%" bgcolor="#808080" border="0">
<tbody>
<tr>
<td>
<table cellspacing="1" cellpadding="3" width="100%" border="0">
<tbody>
<tr class="cell2">
<td width="100%"><input class="button" type="submit" name="submit" value="Anfrage absenden" /> (nur einmal drücken und Bestätigung abwarten)</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</form>
</strong></font> </p>
</div>
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