Untitled

<HTML>
<HEAD>
<meta http-equiv="Content-Type" content="text/html;charset=utf-8">
</HEAD>
<body BGCOLOR="#ffffff" style="padding:0px; margin:0px; font-size:11px; color:#000000; font-family:Tahoma, Arial;">
<style type="text/css">
input { font-size:11px; color:#000000; font-family:Tahoma, Arial; }
</style>

<%v for_html(txt_welcome/)/><br><br>

<!-- FORMULAR START -->
<form method="post" enctype="multipart/form-data" action="_s.php" name="subscribe_form">
<input type=hidden name=fid value="<%v id_tdat_form/>">
<input type=hidden name=fpw value="<%v tdat_form_pw/>">
<input type=hidden name=mode value=finalsubmit>

<!-- E-MAIL FELD -->
<p style="margin-bottom: 10px;"><strong>E-Mail</strong><br><input style="width:250px;" name="email" value="<%v email/>">
<%s input_error/tdat_nl_subscriber_email><br><font color=red>Bitte geben Sie eine gültige E-Mail Adresse ein.</font></%s></p>

<!-- EMPFÄNGER ATTRIBUTE START -->
<p style="margin-bottom: 10px;"><strong>Anrede</strong>   <input type="radio" name="attribute_XXXXX" value="Sehr geehrter Herr">Herr  <input type="radio" name="attribute_XXXXX" value="Sehr geehrte Frau">Frau
<p style="margin-bottom: 10px;"><strong>Nachname</strong><br><input style="width:250px;" name="attribute_XXXXXX" value=""></p>
<!-- EMPFÄNGER ATTRIBUTE ENDE -->

<!-- ANMELDE BUTTON -->
<input type="submit" value="Anmeldung durchführen">

<!-- FORMULAR ENDE -->
</form>
</BODY>

</HTML>