<td width="500"><table width="500" border="0" cellspacing="5" cellpadding="0">
<tr>
<td colspan="2"><table width="100%" border="0" cellspacing="0" cellpadding="0">
<tr>
<td><form action="formular_script.php" method="post" name="formular" id="formular">
<table width="100%" border="0" cellspacing="5" cellpadding="0">
<tr>
<td> </td>
<td align="left"><span class="arial_16">
<label>
<input type="radio" name="Geschlecht" id="radio" value="Herr" />
</label>
</span>
<label><span class="verdana_14">Herr </span></label>
<span class="arial_16">
<label>
<input name="Geschlecht" type="radio" id="radio2" value="Frau" checked="checked" />
</label>
</span>
<label><span class="verdana_14"> Frau </span></label></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">Name*</span></td>
<td align="left"><span class="arial_16">
<input name="Name" type="text"id="Name" onblur="MM_validateForm('Name','','R','Email','','NisEmail');return document.MM_returnValue" size="30" />
</span></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">Vorname</span></td>
<td align="left"><span class="arial_16">
<input name="Vorname" type="text"id="Vorname" size="30" />
</span></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">Adresse</span></td>
<td align="left"><span class="arial_16">
<input name="Adresse" type="text" id="Adresse" size="30" />
</span></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">PLZ / Wohnort</span></td>
<td align="left"><span class="arial_16">
<input name="Wohnort" type="text" id="Wohnort" size="30" />
</span></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">Telefon</span></td>
<td align="left"><span class="arial_16">
<input name="Telefon" type="text" id="Telefon" size="25" />
</span></td>
</tr>
<tr>
<td width="180" align="left"><span class="verdana_14">E-Mail*</span></td>
<td align="left"><span class="arial_16">
<input name="Email" type="text"id="Email" value="@" size="30" />
</span></td>
</tr>
<tr>
<td width="180" align="left" valign="top" class="verdana_14">Nachricht</td>
<td width="235" align="left"><span class="arial_16">
<textarea name="Bemerkungen" cols="30" id="Bemerkungen"></textarea>
</span></td>
</tr>
<tr>
<td valign="top" class="arial_16"> </td>
<td align="left"><span class="verdana_14">*erforderliche Felder</span></td>
</tr>
<tr>
<td height="25" colspan="2" align="center" class="klein"> </td>
</tr>
<tr align="right">
<td height="25" colspan="2" align="center" class="klein"><span class="verdana_copyright_12"> Ihre Angaben werden vertraulich behandelt und nicht an Dritte weitergegeben. </span></td>
</tr>
<tr align="center">
<td height="25" colspan="2"><span class="arial_16">
<input name="Submit" type="submit" onclick="MM_validateForm('Name','','R','Email','','NisEmail');return document.MM_returnValue" value="Anfrage absenden" />
</span></td>
</tr>
</table>
</form></td>
</tr>
</table></td>