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document.write('    <tr>');
document.write('      <td align="center" colspan="2"><font color="#FF8000">Creepy Crawly Newsletter Anmeldung</font></td>');
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document.write('    <tr>');
document.write('      <td align="center" colspan="2"><font color="#FF8000">!!! KOSTENLOS !!!</font></td>');
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document.write('    <tr>');
document.write('      <td align="right"><font color="#FF8000"><i>E-Mail *</i></font></td>');
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document.write('      <td align="right"><font color="#FF8000"><i>Name *</i></font></td>');
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document.write('        <input style=" border: 1px solid #FF8000; color: #000000;" type="text" name="user_input[id4]" value="" size="20">');
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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="34888">');
document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('      </td>');
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document.write('    <tr>');
document.write('      <td colspan="2" align="center"><font size="-2">Powered by <a href="http://www.onetwomax.de" target="_blank">OneTwoMax</a> Newsletter Script</font></td>');
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