Reinhard Theimer - Anfrage

<body bgcolor="#C0C0C0" text="#000000" link="#0000EE" vlink="#551A8B"> <table border="0" cellpadding="0" cellspacing="0" style="page-break-before: always"> <tr> <td valign="bottom" width="100%"><p align="center"><img src="img/bkopf.gif" alt="Reinhard Theimer" width="500" height="50" name="Grafik1"></p> </td> <td rowspan="2"><a href="index.htm" target="_top"><font color="#0000EE"><img src="img/icon.gif" alt="Zurück" border="1" hspace="25" width="87" height="85" name="Grafik2"></font></a></td> </tr> <tr> <td><p align="center"><a href="weg.htm" target="_top"><font color="#330033" size="5"><em><b>Kontakt</b></em></font></a><font size="5"><em> </em></font><font size="3">· </font><a href="about.htm" target="_top"><font color="#330033" size="3"><b>Über uns</b></font></a><font size="3">· </font><a href="produkt/index.htm" target="_top"><font color="#330033" size="3"><b>Unsere Produkte</b></font></a><font size="3">· </font><a href="offers.htm" target="_top"><font color="#330033" size="3"><b>Sonderangebote</b></font></a><font size="3">· </font><a href="service.htm" target="_top"><font color="#330033" size="3"><b>Service</b></font></a></p> </td> </tr> </table> <p> </p> <table border="0" width="100%"> <tr> <td width="100%" bgcolor="#FFFF00"><font color="#800080" size="5">Bitte benutzen Sie ab sofort unseren </font><a href="form/warenkorb.htm" target="warenkorb"><font color="#800080" size="6"><strong>Warenkorb</strong></font></a><font color="#800080" size="6"><strong> </strong></font><font color="#800080" size="5">für Bestellung und Anfrage. </font><p><font color="#800080" size="3"><strong>Wenn Ihr Browser Java unterstützt, werden Ihnen dort Preise und Frachtkonditionen von Serienprodukten sofort angezeigt.</strong></font></p> </td> </tr> </table> <p><font color="#000000" size="5">nur für Browser ohne Java sinnvoll:</font></p> <table border="0" cellpadding="2" cellspacing="5" width="80%"> <tr> <td><a name="anfang"></a><font size="6">Anfrage: </font></td> <td width="15%"><a href="mailbest.htm" target="_top">Bestellung</a></td> <td><a href="pemail.htm" target="_top"><font size="4">zurück </font></a></td> </tr> </table> <form action="http://www.nettz.de/Formular-Chef/Formular-Chef.cgi" method="post" enctype="multipart/form-data" name="Anfrage"> <input type="hidden" name="antwortseite_template" value="http://www.theimer-leitern.de/form/anfan.html"><input type="hidden" name="betreff" value="Anf##AUFRUFE##"><input type="hidden" name="email_check" value="1"><input type="hidden" name="email_template" value="http://www.theimer-leitern.de/form/anfem.txt"><input type="hidden" name="empfaenger" value="webform@theimer-leitern.de"><input type="hidden" name="fehler_template" value="http://www.theimer-leitern.de/form/anfer.html"><input type="hidden" name="kopie_an_absender_template" value="http://www.theimer-leitern.de/form/anfea.html"><input type="hidden" name="pflicht" value="Ansprechpartner,Land,Name,PLZ,absender"><table border="0" cellpadding="2" cellspacing="0" width="671"> <COL WIDTH="60"> <tr> <td><font color="#FF0000"><strong>Rote Felder müssen ausgefüllt werden </strong></font></td> </tr> <tr> <td><table border="0" cellpadding="2" cellspacing="0" width="671"> <tr> <td width="60">Anrede</td> <td width="309"><input type="text" size="16" name="Anrede"></td> <td width="134">Telefon</td> <td width="152"><input type="text" size="16" name="Telefon"></td> </tr> <tr> <td width="60"><font color="#FF0000">Name</font></td> <td width="309"><input type="text" size="35" name="Name"></td> <td width="134">Fax</td> <td width="152"><input type="text" size="16" name="Fax"></td> </tr> <tr> <td width="60">Firma</td> <td width="309"><input type="text" size="35" name="Firma"></td> <td width="134"><font color="#FF0000">E-Mail</font></td> <td width="152"><input type="text" size="16" name="absender"></td> </tr> <tr> <td width="60">Anschrift</td> <td width="309"><input type="text" size="35" name="Anschrift"></td> <td width="134"><font color="#FF0000">Ansprechpartner </font></td> <td width="152"><input type="text" size="16" name="Ansprechpartner"></td> </tr> <tr> <td width="60"><font color="#FF0000">PLZ</font></td> <td width="309"><input type="text" size="16" name="PLZ"></td> <td width="134"><font color="#FF0000">ich bin:</font></td> <td width="152"><select name="Kunde" size="1"> <option selected>Privatkunde </option> <option>Kommune / Behörde </option> <option>Handwerksbetrieb </option> <option>Baufirma </option> <option>Industriebetrieb </option> <option>Einzelhadel </option> <option>Großhandel </option> <option>Sonst. Gewerbe</option> </select></td> </tr> <tr> <td width="60">Ort</td> <td width="309"><input type="text" size="36" name="Ort"></td> <td width="134"> </td> <td width="152"> </td> </tr> <tr> <td width="60"><font color="#FF0000">Land</font></td> <td width="309"><input type="text" size="36" name="Land" value="D"></td> <td width="134">Kundennummer</td> <td width="152"><input type="text" size="16" name="Kundennummer"></td> </tr> </table> <p>Bitte geben Sie als Händler oder Gewerbetreibender ihre Kundennummer an, wenn Sie mehr als eine Leiter bestellen möchten! Haben Sie noch keine, dann fragen Sie bitte auch gleich <a href="mailkond.htm" target="_new">hier </a>Ihre Konditionen an! </p> <table border="0" cellpadding="2" cellspacing="5"> <tr> <td>alternativ</td> <td width="80">Menge</td> <td width="100">Bestellnummer </td> <td colspan="2" width="200">Bezeichnung / Sonderwunsch</td> </tr> <tr> <td> </td> <td width="80"><input type="text" size="10" name="M_1"></td> <td width="100"><input type="text" size="10" name="N_1"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_1"></td> </tr> <tr> <td><input type="checkbox" name="A_2" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_2"></td> <td width="100"><input type="text" size="10" name="N_2"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_2"></td> </tr> <tr> <td><input type="checkbox" name="A_3" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_3"></td> <td width="100"><input type="text" size="10" name="N_3"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_3"></td> </tr> <tr> <td><input type="checkbox" name="A_4" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_4"></td> <td width="100"><input type="text" size="10" name="N_4"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_4"></td> </tr> <tr> <td><input type="checkbox" name="A_5" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_5"></td> <td width="100"><input type="text" size="10" name="N_5"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_5"></td> </tr> <tr> <td><input type="checkbox" name="A_6" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_6"></td> <td width="100"><input type="text" size="10" name="N_6"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_6"></td> </tr> <tr> <td><input type="checkbox" name="A_7" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_7"></td> <td width="100"><input type="text" size="10" name="N_7"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_7"></td> </tr> <tr> <td><input type="checkbox" name="A_8" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_8"></td> <td width="100"><input type="text" size="10" name="N_8"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_8"></td> </tr> <tr> <td><input type="checkbox" name="A_9" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_9"></td> <td width="100"><input type="text" size="10" name="N_9"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_9"></td> </tr> <tr> <td><input type="checkbox" name="A_10" value="Alternativ"></td> <td width="80"><input type="text" size="10" name="M_10"></td> <td width="100"><input type="text" size="10" name="N_10"></td> <td colspan="2" width="200"><input type="text" size="35" name="B_10"></td> </tr> </table> <p>Bitte wählen Sie alternativ, wenn Sie den Artikel an Stelle dessen in der Zeile drüber möchten. ( Wichtig wegen Fracht und ggf. Rabatt )</p> <p>Gewünschter Liefertermin: <input type="text" size="51" name="Liefertermin"></p> <p>Sonstiges:</p> <p><textarea name="Text" rows="5" cols="65"></textarea> </p> <p align="center">Wie sind Sie auf unsere Website aufmerksam geworden? <br> <select name="kontakt" size="1"> <option>Prospekte / Korrespondenz</option> <option>Link von einer anderen Website</option> <option>Suchmaschine</option> <option>Branchenverzeichniss</option> <option>sonstiges</option> </select> welche(s) / wie? <input type="text" size="13" name="kontaktwie"></p> </td> </tr> </table> <div align="center"><center><table border="0" cellpadding="2" cellspacing="0" width="80%"> <tr> <td width="200"><p align="center"><input type="submit" name="OK" value="Anfrage so abschicken"></p> </td> <td width="150"><p align="center"> <a href="#anfang">Zum Anfang der Seite</a></p> </td> <td width="200"><p align="center"><input type="reset" name="B2" value="Zurücksetzen"></p> </td> </tr> </table> </center></div> </form> <p> </p> <p> </p> </body>