document.write('<form method="post" action="http://44611.newsletter.onetwomax.de/">');
document.write('  <table bgcolor="#FFCC66" style="border: 1px solid #FF6600">');
document.write('    <tr bgcolor="#FF9933">');
document.write('      <td colspan="2">Art-Shop Newsletter</td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#FF9933">');
document.write('      <td><font face="New Roman"><b>E-Mail *</b></font></td>');
document.write('      <td>');
document.write('        <input type="text" name="email" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#FF9933">');
document.write('      <td colspan="2">mit * gekennzeichnete Felder müssen ausgefüllt werden</td>');
document.write('    </tr>');
document.write('    <tr bgcolor="#FF9933">');
document.write('      <td><font face="New Roman"><b>Name *</b></font></td>');
document.write('      <td>');
document.write('        <input type="text" name="user_input[id4]" value="" size="20">');
document.write('      </td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2" align="center" valign="middle">');
document.write('        <input type="hidden" name="mq" value="\'">');
document.write('        <input type="hidden" name="action" value="add">');
document.write('        <input type="hidden" name="entry" value="44611">');
document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('      </td>');
document.write('    </tr>');
document.write('  </table>');
document.write('</form>');
document.write('');