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<html>
<head>
<title>Kontaktformular Übersetzungen</title>
</head>
<body>
<form action="kontaktformularverarbeitung01.php" method="post">
<input name="name" size="40"/> Name <br />
<input name="email" size="40"/>E-Mail<br />
<select name="betreff"size="1">Betreff
<option>Rückruf Bitte</option>
<option>Preis Anfrage</option>
<option>Hilfe</option>
<option>Übersetzung</option>
<option>Linktausch</option>
<option>Werbung</option>
<option>Sonstiges</option>
</select><br />
Nachricht: <br />
<textarea name="text" cols="50" rows="10"></textarea>
<br />
<input name="submit" type="submit" value="absenden"/>
</form>
<div style="text-align:center;">
<table border="0" width="100%">
<tr>
<td style="width:50%;"><img src="image/de.jpg" alt="De Fahne"/>
</td>
<td style="width:50%;"><h4>Ich spreche deutsch</h4>
</td>
</tr>
<tr>
<td style="width:50%;"><img src="image/dk.jpg" alt="Dk Fahne"/>
</td>
<td style="width:50%;"><h4>Jeg tale dansk</h4>
</td>
</tr>
<tr>
<td style="width:50%;"><img src="image/gb.jpg" alt="Gb Fahne"/></td>
<td style="width:50%;"><h4>I talk English</h4></td>
</tr>
</table>
</div>
<h4>Sombprasonkplaasaa</h4>
<h4>279/161 Moo 12 </h4>
<h4>Jomtien Beach Road</h4>
<h4>20260 Nongprue.Cholburi</h4>
<h4>Tel.:(+66)(0)879.19.78.09</h4>
<h4>Fax and Voicebox:</h4>
<h4>Skype:Tomlinde1</h4>
<p style="text-align:center;font-size:16px;">
E-mail:<a href="mailto:Info@toms-web-design.de">an Tom Lindemann</a></p>
</body>
</html>