document.write('');
document.write('  <table style="border: 1px solid Black">');
document.write('<form method="post" action="http://19059.formmailer.onetwomax.de/">');
document.write('    <tr>');
document.write('      <td colspan="2"><font face="Arial" size="2"><b>Fragebogen</b></font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td colspan="2"><font face="Arial" size="2">mit * gekennzeichnete Felder müssen ausgefüllt werden</font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Das Preis-Leistungsverhältnis *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id1]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Anmeldung *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id2]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Ausschilderung der Anfahrt *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id3]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Wettkampfstätten *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id6]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Schwimmstrecke *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id5]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Radstrecke *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id7]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Laufstrecke *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id8]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Wechselzonen *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id9]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Wettkampfverpflegung *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id10]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Markierung der Strecken *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id11]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Zielverpflegung *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id12]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Kuchentheke *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id13]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Ergebnisdienst *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id14]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Helferteam beim Schwimmen *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id15]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Helferteam beim Fahrradfahren *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id16]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Helferteam beim Laufen *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id17]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Finishertasse *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id18]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Siegerehrung *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id19]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>T-Shirt</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id20]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Urkunde *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id21]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Die Internetpräsenz *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id22]">');
document.write('          <option value="0">Sehr gut');
document.write('</option>');
document.write('          <option value="1">Gut');
document.write('</option>');
document.write('          <option value="2">Mittelmäßig');
document.write('</option>');
document.write('          <option value="3">Schlecht</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Würdet ihr wiederkommen? *</b></font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <select style=" font-family: Arial;" name="user_input[id23]">');
document.write('          <option value="0">Ja');
document.write('</option>');
document.write('          <option value="1">Nein</option>');
document.write('        </select>');
document.write('      </font></td>');
document.write('    </tr>');
document.write('    <tr>');
document.write('      <td><font face="Arial" size="2"><b>Kommentar<br></b></font><font face="Arial" size="2">Sonstige Bemerkungen und Kommentar zu den neuen Wettkampfstrecken</font></td>');
document.write('      <td><font face="Arial" size="2">');
document.write('        <textarea style=" font-family: Arial;" name="user_input[id24]" style="width:100%" rows="5"></textarea>');
document.write('      </font></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="send_mail">');
document.write('        <input type="hidden" name="entry" value="19059">');
document.write('        <input type="submit" name="submit" value="Abschicken">');
document.write('        <input type="reset" name="reset" value="Zur&uuml;cksetzen">');
document.write('      </td>');
document.write('    </tr>');
document.write('</form>');
document.write('  </table>');
document.write('');