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document.write('<form method="post" action="http://125194.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td colspan="2"><font size="2">Weblink eintragen:</font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2"><font size="2">Hier kannst Du uns einen interessanten Link melden.</font></td>');
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document.write('    <tr>');
document.write('      <td><font size="1">Name *</font></td>');
document.write('      <td>');
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document.write('      <td><font size="1">Webseite</font></td>');
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document.write('      <td><font size="1">E-Mail</font></td>');
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document.write('    <tr>');
document.write('      <td><font size="1">Auswahl</font></td>');
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document.write('          <option value="0">Freiwilligefeuerwehr');
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document.write('          <option value="1">Berufsfeuerwehr');
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document.write('          <option value="2">Jugendfeuerwehr');
document.write('</option>');
document.write('          <option value="3">Links aus Liebengrün');
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document.write('          <option value="4">Link aus der Region');
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document.write('          <option value="5">Sonstige Links</option>');
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document.write('    <tr>');
document.write('      <td><font size="1">Bundesland</font></td>');
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document.write('      <td><font size="1">Beschreibung</font></td>');
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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="125194">');
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>');
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document.write('</form>');
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