<html>
<head>
<title>Kontakt</title>
<meta name="Webm" content="R">
<script language="JavaScript" src="JS_Kontakt.js">
</script>
<noscript></noscript>
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<body text="#000000" bgcolor="#FFFFFF" link="#EEEEEE" alink="#EEEEEE" vlink="#EEEEEE">
<a name="Top"></a>
<form name="anfragen" action="mailto:text@gmx.de" method="post" enctype="text/plain" onsubmit="return check()">
<table border="0" align="center" width="700">
<tr>
<td width="30%" align="center">
<img src="Bilder/Laptop.jpg" width="250" height="216" border="0" alt="">
</td>
<td align="center">
<b>
bla Gmbh <br>
<br>
<p>
Tel. 0 <br>
Fax. 0 <br>
E-Mail: Info@bla.de
</b>
</td>
<td width="30%" align="center">
<img src="Bilder/Kontaktperson.jpg" width="144" height="212" border="0" alt="">
</td>
</tr>
<tr>
<td colspan="4" align="center" height="40">
<img src="./Bilder/Line.gif" width="700" height="1" border="0">
</td>
</tr>
</table>
<table border="0" align="center" width="700">
<tr>
<td width="115px">
Herr/Frau
</td>
<td>
<select name="anrede" size="1">
<option value="Herr">Herr</option>
<option value="Frau">Frau</option>
</select>
</td>
</tr>
<tr>
<td>Vorname
</td>
<td>
<input type="Text" name="Vorname" size="15" maxlength="15" style="cursor:text">
</td>
<td>Name
</td>
<td>
<input type="Text" name="Name" size="26" maxlength="26">
</td>
</tr>
<tr>
<td>Strasse, Nr.
</td>
<td>
<input type="Text" name="Strasse" size="30" maxlength="30">
<input type="Text" name="Nummer" size="4" maxlength="4">
</td>
<td>PLZ, Ort
</td>
<td>
<input type="Text" name="Plz" size="5" maxlength="5">
<input type="Text" name="Ort" size="16" maxlength="26">
</td>
</tr>
<tr>
<td>E-Mail
</td>
<td>
<input type="Text" name="Email" size="39" maxlength="40">
</td>
<td>Fax
</td>
<td>
<input type="Text" name="FaxVorwahl" size="6" maxlength="10">
/
<input type="Text" name="FaxNr" size="10" maxlength="20">
</td>
</tr>
<tr>
<td>Telefon / Mittags
</td>
<td>
<input type="Text" name="TelMittagsVorwahl" size="6" maxlength="15">
/
<input type="Text" name="TelMittags" size="10" maxlength="15">
</td>
<td>Von / bis Uhrzeit
</td>
<td>
<select name="VonbisMittag" size="1">
<option>6:00</option>
<option>6:30</option>
<option>7:00</option>
<option>7:30</option>
<option selected>8:00</option>
<option>8:30</option>
<option>9:00</option>
<option>9:30</option>
<option>10:00</option>
<option>10:30</option>
<option>11:00</option>
<option>11:30</option>
<option>12:00</option>
<option>12:30</option>
<option>13:00</option>
<option>13:30</option>
<option>14:00</option>
<option>14:30</option>
<option>15:00</option>
<option>15:30</option>
<option>16:00</option>
</select>
-
<select name="VonbisMittag" size="1">
<option>6:00</option>
<option>6:30</option>
<option>7:00</option>
<option>7:30</option>
<option>8:00</option>
<option>8:30</option>
<option>9:00</option>
<option>9:30</option>
<option>10:00</option>
<option>10:30</option>
<option>11:00</option>
<option>11:30</option>
<option>12:00</option>
<option>12:30</option>
<option selected>13:00</option>
<option>13:30</option>
<option>14:00</option>
<option>14:30</option>
<option>15:00</option>
<option>15:30</option>
<option>16:00</option>
</select>
</td>
</tr>
<tr>
<td>Telefon / Abends
</td>
<td>
<input type="Text" name="TelAbendsVorwahl" size="6" maxlength="15">
/
<input type="Text" name="TelAbends" size="10" maxlength="15">
</td>
<td>Von / bis Uhrzeit
</td>
<td>
<select name="VonbisAbends" size="1">
<option>13:00</option>
<option>13:30</option>
<option>14:00</option>
<option>14:30</option>
<option selected>15:00</option>
<option>15:30</option>
<option>16:00</option>
<option>16:30</option>
<option>17:00</option>
<option>17:30</option>
<option>18:00</option>
<option>18:30</option>
<option>19:00</option>
<option>19:30</option>
<option>20:00</option>
<option>20:30</option>
<option>21:00</option>
<option>21:30</option>
<option>22:00</option>
</select>
-
<select name="VonbisAbends" size="1">
<option>13:00</option>
<option>13:30</option>
<option>14:00</option>
<option>14:30</option>
<option>15:00</option>
<option>15:30</option>
<option>16:00</option>
<option>16:30</option>
<option>17:00</option>
<option>17:30</option>
<option>18:00</option>
<option>18:30</option>
<option>19:00</option>
<option>19:30</option>
<option selected>20:00</option>
<option>20:30</option>
<option>21:00</option>
<option>21:30</option>
<option>22:00</option>
</select>
</td>
</tr>
<tr>
<td colspan="4" align="center" height="40">
<img src="./Bilder/Line530.gif" width="530" height="1" border="0">
</td>
</tr>
</table> <!--Ende Table Adressformular-->
<p>
<table border="0" align="center" width="530">
<tr>
<td width="10">
<input type="Checkbox" name="sanitaer" value="v">
</td>
<td width="50%">
Sanitär/Bad/WC/Dusche, etc.
</td>
<td width="10">
<input type="Checkbox" name="lueftung" value="v">
</td>
<td width="50%">
Lüftungstechnik
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="solar" value="v">
</td>
<td width="50%">
Solartechnik
</td>
<td width="10">
<input type="Checkbox" name="zisternen" value="v">
</td>
<td width="50%">
Zisternen / Regenwassernutzung
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="schwimmbad" value="v">
</td>
<td width="50%">
Schwimmbadbau
</td>
<td width="10">
<input type="Checkbox" name="wellness" value="v">
</td>
<td width="50%">
Wellness (Whirlpool, Sauna, Dampfbad, etc.)
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="zubehoer" value="v">
</td>
<td width="50%">
Schwimmbadzubehör
</td>
<td width="10">
<input type="Checkbox" name="pflege" value="v">
</td>
<td width="50%">
Schwimmbad - Wartung und Pflege
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="heizung" value="v">
</td>
<td width="50%">
Heizungstechnik
</td>
<td width="10">
<input type="Checkbox" name="bhkw" value="v">
</td>
<td width="50%">
Blockheizkraftwerke (BHKW)
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="wartung" value="v">
</td>
<td width="50%">
Wartung / Notdienst
</td>
<td width="10">
<input type="Checkbox" name="zentralstaub" value="v">
</td>
<td width="50%">
Zentralstaubsauganlage
</td>
</tr>
<tr>
<td width="10">
<input type="Checkbox" name="interesse" value="v">
</td>
<td width="50%">
generelles Interesse / Firmenkooperation
</td>
<td width="10">
<input type="Checkbox" name="sonstiges" value="v">
</td>
<td width="50%">
Sonstiges
</td>
</tr>
<!--Trennlinie-->
<tr>
<td colspan="4" align="center" height="40">
<img src="./Bilder/Line530.gif" width="530" height="1" border="0">
</td>
</tr>
<tr>
<td colspan="4" align="center">
Text / Detailangaben
</td>
</tr>
<tr>
<td colspan="4" align="center">
<textarea name="details" cols="50" rows="8"></textarea>
</td>
</tr>
<!--Trennlinie-->
<tr>
<td colspan="4" align="center" height="40">
<img src="./Bilder/Line530.gif" width="530" height="1" border="0">
</td>
</tr>
<tr>
<td width="5%" align="center">
<input type="Checkbox" name="antwortmail" value="v">
</td>
<td colspan="3">
Ich / Wir möchte(n) eine kurze Antwort per E-Mail oder Fax.
</td>
</tr>
<tr>
<td>
<input type="Checkbox" name="antwortanruf" value="v">
</td>
<td colspan="3">
Ich / Wir benötige(n) mehr Informationen, bitte rufen Sie mich/uns an.
</td>
</tr>
<tr>
<td>
<input type="Checkbox" name="angebot" value="v">
</td>
<td colspan="3">
Es geht um ein unverbindliches Angebot.
</td>
</tr>
<tr height="60">
<td colspan="2" align="right">
<input type="Submit" value="Absenden">
</td>
<td colspan="2">
<input type="reset" value="Zurücksetzen">
</td>
</tr>
<!--Trennlinie-->
<tr>
<td colspan="4" align="center" height="40">
<img src="./Bilder/Line530.gif" width="530" height="1" border="0">
</td>
</tr>
<tr>
<td colspan="4" align="center">
<a href="#Top" style="color:blue">Zurück</a>
</td>
</tr>
</table>
</form>
</body>
</html>