document.write('');
document.write('  <table>');
document.write('<form method="post" action="http://166897.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td colspan="2">Fan of the month</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>Name *</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>E-Mail *</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>Seit wann bist du Twilight Fan? *</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>Dein Lieblings Bis(s) Buch? *</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>Dein Lieblings Twilight Song? *</td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id7]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Ein Tag mit Robert &amp; Kristen, wie sieht sie aus? *</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id11]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Hast du mal von Robert/Kristen geträumt?<br>Was war los? *</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id12]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Warum solltest du Fan des Monats werden? *</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id13]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Bilder von dir! *</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id14]" style="width:100%" rows="5">Hier bitten wir dich 1 oder 2 Bilder zu posten das dich zeigt, wenn du gewählt wirst.</textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Was ist für dich Robert-and-Kristen.de? *</td>');
document.write('      <td>');
document.write('        <textarea name="user_input[id15]" style="width:100%" rows="5"></textarea>');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td>Willst du uns sonst noch was mitteilen?</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 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="166897">');
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>');
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