<!-- Start Code dw-Formgenerator -->
<style type="text/css">
.font-big {
font-family:Verdana, sans-serif;
font-size:16px; font-weight:bold;
color:#FFFFFF;
}
.font-small {
font-family:Verdana, sans-serif;
font-size:10px; font-weight:normal;
color:#000000;
}
.table {
background-color:#FFFFFF;
width:90%;
}
.table2 {
background-color:#FFFFFF;
width:100%;
}
.head {
background-color:#83ADDD;
}
.main {
background-color:#ECECEC;
font-family:Verdana, sans-serif;
font-size:12px; font-weight:normal;
color:#000000;
}
.foot {
background-color:#83ADDD;
}
.align {
text-align:left;
}
.textarea {
background-color:#ECECEC;
color:#000000;
font-family : Verdana, Helvetica, sans-serif;
font-size:12px;
font-weight: bold;
border : 1px solid #808080;
}
.input {
background-color:#ECECEC;
color:#000000;
font-family : Verdana, Helvetica, sans-serif;
border : 1px solid #808080;
font-size:12px;
}
.select {
background-color:#ECECEC;
color:#000000;
font-family : Verdana, Helvetica, sans-serif;
font-size:12px;
}
.button {
width: 130px;
}
</style>
<script type="text/javascript">
var tv=-1;
window.onLoad=page_tv();
function VerifyEmailAddress(EmailAddress) {
if (window.RegExp) {
var reg1str = "(@.*@)|(\.\.)|(@\.)|(\.@)|(^\.)";
var reg2str = "^.+\@(\[?)[a-zA-Z0-9\-\.]+\.([a-zA-Z]{2,4}|[0-9]{1,4})(\]?)$";
var reg1 = new RegExp(reg1str);
var reg2 = new RegExp(reg2str);
if (!reg1.test(EmailAddress) && reg2.test(EmailAddress)) {
return true
}else {
return false
}
}else {
if (EmailAddress.indexOf("@") >= 0) {
return true
}else {
return false
}
}
}
function weiter(a,b) {
if (a.getAttribute&&a.value.length==a.getAttribute("maxlength"))
b.focus();
}
function machwech(c) {
if (c.defaultValue==c.value)
c.value="";
}
function page_tv() {
tv++;
window.setTimeout('page_tv()', 1000);
}
function check_form(f,g) {
if (f.elements['Name'].value == '') {
alert("Bitte alle Pflichtfelder ausfu00FCllen! n(Schreibe hier deinen Benutzernamen hin.)");
f.elements['Name'].focus();
return false;
}
if (f.elements['E-Mail Adresse'].value=='') {
alert("Bitte alle Pflichtfelder ausfu00FCllen! n(E-Mail Adresse hier eingeben.)");
f.elements['E-Mail Adresse'].focus();
return false;
}else {
if (!VerifyEmailAddress(f.elements['E-Mail Adresse'].value)) {
alert("Bitte geben Sie eine gu00FCltige E-Mail Adresse ein! n(E-Mail Adresse hier eingeben.)");
f.elements['E-Mail Adresse'].focus();
return false;
}
}
if (f.elements['Passwort'].value == '') {
alert("Bitte alle Pflichtfelder ausfu00FCllen! n(Passwort)");
f.elements['Passwort'].focus();
return false;
}
var chk=false;
for (var i=0;i<f.elements['Geburtsdatum'].length;i++) {
if (f.elements['Geburtsdatum'][i].value=='dd' ||
f.elements['Geburtsdatum'][i].value=='mm' ||
f.elements['Geburtsdatum'][i].value=='yyyy' ||
f.elements['Geburtsdatum'][i].value=='') {
chk=true;
}
}
if (chk) {
alert("Bitte alle Pflichtfelder ausfu00FCllen! n(Bitte dein Geburtsdatum eingeben.)");
f.elements['Geburtsdatum'][0].focus();
return false;
}
if (navigator.appName=="Microsoft Internet Explorer") {
for (i=0;i<f.length;i++) {
var e=f.elements[i];
if (e.type == 'submit' || e.type == 'reset')
e.disabled=true;
}
}
if (f.elements['page_tv']) {
f.elements['page_tv'].value = tv;
}
return true;
}
</script>
<form name="dwmailer" action="http://www.dw-formmailer.de/cgi-bin/dwmailer/dwmailer.pl" enctype="multipart/form-data" method="post" onsubmit="return check_form(this);">
<input type="hidden" name="page_tv" value="" />
<input type="hidden" name="pflicht" value="Name,E-Mail Adresse,Passwort,Geburtsdatum" />
<input type="hidden" name="empfaenger_mail" value="Zl9tdWVuc3Rlcm1hbm5AdC1vbmxpbmUuZGU=" />
<input type="hidden" name="language" value="de" />
<input type="hidden" name="page_background_color" value="#FFFFFF" />
<input type="hidden" name="page_font_color" value="#000000" />
<table align="center" class="table" border="0" cellspacing="1" cellpadding="3">
<tr>
<td colspan="2" class="head" height="17" width="100%" align="left"><span class="font-big">Kontaktformular</span></td>
</tr>
<tr>
<td colspan="2" class="main" height="16" width="100%"><span class="font-small">Bitte füllen Sie alle mit * markierten Felder aus. (Pflichtfelder)</span></td>
</tr>
<tr>
<td class="main" width="30%"><div class="align">Schreibe hier deinen Benutzernamen hin.*</div></td>
<td class="main"><input class="input" type="text" name="Name" size="20" maxlength="100" /></td>
</tr>
<tr>
<td class="main" width="30%"><div class="align">E-Mail Adresse hier eingeben.*</div></td>
<td class="main"><input class="input" type="text" name="E-Mail Adresse" size="20" maxlength="100" /></td>
</tr>
<tr>
<td class="main" width="30%"><div class="align">Passwort*</div></td>
<td class="main"><input class="input" type="password" name="Passwort" size="20" maxlength="100" /></td>
</tr>
<tr>
<td class="main" width="30%"><div class="align">Bitte dein Geburtsdatum eingeben.*</div></td>
<td class="main"><input class="input" type="text" id="geburtstagdd" name="Geburtsdatum" onfocus="machwech(this)" onkeyup="weiter(this, document.dwmailer.geburtstagmm)" size="2" maxlength="2" value="dd" /> <input class="input" type="text" id="geburtstagmm" name="Geburtsdatum" onfocus="machwech(this)" onkeyup="weiter(this, document.dwmailer.geburtstagyyyy)" size="2" maxlength="2" value="mm" /> <input class="input" type="text" id="geburtstagyyyy" name="Geburtsdatum" size="4" maxlength="4" value="yyyy" onfocus="machwech(this)" />
</td>
</tr>
<tr><td class="foot" colspan="2" align="center" height="25" width="100%"><input class="button" type="submit" value="Abschicken" /> <input class="button" type="reset" value="Zurücksetzen" /></td></tr>
</table>
</form>
<p align="center"><span style="font-size:9px;font-family:Verdana,sans-serif;"><a href="https://www.dw-formmailer.de" target="_blank">dw-FormGenerator 5.3.2</a></span></p>
<!-- End Code dw-Formgenerator -->
