<form action="http://add-ons.homepageforum.de/cgi-bin/formmail.cgi" method="post">
<input type="hidden" name="html_template_url" value="http://members.tripod.de/dflclan/antrag.html">
<input type="hidden" name="email_template_url" value="http://members.tripod.de/dflclan/email.txt">
<input type="hidden" name="betreff" value="Antrag auf mitgliedschaft bei -{DFL}-">
<input type="hidden" name="empfaenger_name" value="MrSpoocy">
<input type="hidden" name="empfaenger_mail" value="MrSpoocy@web.de">
<input type="hidden" name="pflicht" value="testen,Name,Clanname,Alter,Art,absender_mail">
<TABLE border="0" >
<TR>
<TD>Clanname:</TD>
<TD><INPUT NAME="Clanname" value="-{DFL}-" style="COLOR: #00ccff; BACKGROUND-COLOR: #000000" size ="23"></TD></TR>
<TR>
<TD>Name:</TD>
<TD><INPUT NAME="Name" style="COLOR: #00ccff; BACKGROUND-COLOR: #000000" size="23"></TD></TR>
<TR>
<TD>Alter:</TD>
<TD align="right"><select name="Alter" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="8-14" selected>8-14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26-30">26-30</option>
<option value="31-40">31-40</option>
<option value="älter">Älter</option></select></TD></TR>
<TR>
<TD>Geschwindigkeit:</TD>
<TD align="right"><select name="KB" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="14-56 KB Modem" selected>14-54 KB Modem</option>
<option value="ISDN">64 KB ISDN</option>
<option value="2ISDN">128 KB ISDN</option>
<option value="Cable">Cable</option>
<option value="DSL">DSL</option>
<option value="T1">T1</option>
<option value="T3">T3</option></select></TD></TR>
<TR>
<TD>Internet:</TD>
<TD align="right"><select name="Art" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="JA" selected>Flatrate</option>
<option value="NEIN">Viel Geld</option></select></TD></TR>
<TR>
<TD>Hobby:</TD>
<TD><INPUT NAME="hobby" style="COLOR: #00ccff; BACKGROUND-COLOR: #000000" size="23"></TD></TR>
<TR>
<TD>E-Mail:</TD>
<TD><INPUT NAME="absender_mail" style="COLOR: #00ccff; BACKGROUND-COLOR: #000000" size="23"></TD></TR>
<TR>
<TD>ICQ Nummer:</TD>
<TD> <INPUT NAME="icq" style="COLOR: #00ccff; BACKGROUND-COLOR: #000000" size="23"></TD></TR>
</TABLE>
<TABLE border="0" >
<TR>
<TD width="92">Tag zu testen <br> der fähigkeiten:</TD>
<TD width="87" align="left"><select name="testen" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="Montag" selected>Montag</option>
<option value="Dienstag">Dienstag</option>
<option value="Mittwoch">Mittwoch</option>
<option value="Donerstag">Donnerstag</option>
<option value="Freitag">Freitag</option>
<option value="Samstag">Samstag</option>
<option value="Sontag">Sonntag</option>
<option value="Unbekannt">Unbekannt</option></select></TD>
<TD><select name="tt" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="01" selected>01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option></select></TD>
<TD><select name="mm" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="01" selected>01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option></select></TD>
<td><select name="jj" Size=1 style="COLOR: #000000; BACKGROUND-COLOR: #00ccff">
<option value="2000" selected>2000</option>
<option value="2001">2001</option></select></td>
</TR></TABLE></P>
Persönlicher anhang:<br><TEXTAREA style="COLOR: #000000; BACKGROUND-COLOR: #00ccff" name="persönlicher anhang" rows=5 cols=40></TEXTAREA>
<p>
Antrag wird an -{DFL}-MrSpoocy gesendet <input type="submit" value ="Anfrage senden" style ="COLOR: #00ff00; BACKGROUND-COLOR: #000000" value?Abschicken?>
</p>
</FORM>