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document.write('      <td class="p"><font class="p" color="#311d57" face="Helvetica" size="2">Deine Website-URL:</font></td>');
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document.write('      <td class="p"><font class="p" color="#311d57" face="Helvetica" size="2">Thema deiner Seite:</font></td>');
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document.write('          <option value="0">Ayumi Hamasaki');
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document.write('          <option value="1">J-Pop');
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document.write('          <option value="2">Musik');
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document.write('      <td class="p"><font class="p" color="#311d57" face="Helvetica" size="2">Ich bewerbe mich als</font></td>');
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document.write('          <option value="0">Regular Affiliate');
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document.write('          <option value="1">Top Affiliate');
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document.write('      <td class="p"><font class="p" color="#311d57" face="Helvetica" size="2">Bemerkungen:</font></td>');
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document.write('        <input type="hidden" name="action" value="send_mail">');
document.write('        <input type="hidden" name="entry" value="145594">');
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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