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<form method="post" action="http://www.world-of-scripts.net/mailer.php" target="_blank">
<input type="hidden" name="id" value="546063">
<input type="hidden" name="an" value="vrh-seeadler@web.de">
<input type="hidden" name="betreff" value="anmeldung">
<input type="hidden" name="weiterleitung">
<input type="hidden" name="ip" value="1">
<input type="hidden" name="newwin" value="1">
<input type="hidden" name="benoetigt" value="">

<table>
<tr>
<td><font size="1pt" face="Tahoma" color="#f0eeee"><center>Name:</td> 
<td><input type="text" name="Name"></td>
</tr>
<tr>
<td><font size="1pt" face="Tahoma" color="#f0eeee"><center>Pflegepferd:</td>
<td><input type="text" name="pflegepferd"></td>
</tr>
<tr>
<td><font size="1pt" face="Tahoma" color="#f0eeee"><center>Alter:</td>
<td><input type="text" name="Alter"></td>
</tr>
<tr>
<td><font size="1pt" face="Tahoma" color="#f0eeee"><center>E-mail:</td>
<td><input type="text" name="e-mail"></td>
</tr>
</table>
<input type="submit" value="Senden"> <input type="reset" value="Neu"></form>