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document.write('      <td><font color="black" face="verdana" size="1">Vorname</font></td>');
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document.write('      <td><font color="black" face="verdana" size="1">E-Mail</font></td>');
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document.write('      <td><font color="black" face="verdana" size="1">Homepage</font></td>');
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document.write('      <td><font color="black" face="verdana" size="1">Elite oder Top?</font></td>');
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document.write('          <option value="0">Bitte auswählen');
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document.write('          <option value="1">Elite-Affiliates');
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document.write('          <option value="2">Top-Affiliates');
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document.write('          <option value="3">Bieber-Elite</option>');
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document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('        <input type="reset" name="reset" value="Zur&uuml;cksetzen">');
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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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