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Vielen Dank.</span></strong></td> </tr> </table> <p class="style18"><br /> <br /> </p> <table align="center" style="width: 618px; height: 727px" cellspacing="0"> <tr> <td class="style194" style="width: 606px" valign="top"> <p class="style195"><strong>Meine persönlichen Daten</strong></p> <table align="center" style="width: 588px"> <tr> <td class="style206" style="width: 95px">Name:</td> <td class="style37" style="width: 493px"> <input name="Name" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">Firma:</td> <td class="style37" style="width: 493px"> <input name="Company" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">Adresse:</td> <td class="style37" style="width: 493px"> <input name="Address" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">PLZ/Ort:</td> <td class="style37" style="width: 493px"> <input name="CityState" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">Land:</td> <td class="style37" style="width: 493px"> <input name="Country" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">Tel.:</td> <td class="style37" style="width: 493px"> <input name="Tel" size="80" type="text" /> </td> </tr> <tr> <td class="style37" style="width: 95px">Fax:</td> <td class="style37" style="width: 493px"> <input name="Fax" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">E-Mail:</td> <td class="style37" style="width: 493px"> <input name="EMail" size="80" type="text" /> </td> </tr> <tr> <td class="style206" style="width: 95px">Branche:</td> <td class="style211" style="width: 493px"> <select name="Branche" size="1" style="width: 516px" tabindex="9"> <option>Branche</option> <option>Kunststoff - Kautschuk</option> <option>Chemie</option> <option>Pharmazie - Life Science</option> <option>Nahrungs- und Genussmittel</option> <option>Reinigungsmittel</option> <option>Baustoffe - Keramik - Glas</option> <option>Engineering - Maschinenbau</option> <option>Institute - Lehranstalten</option> <option>Andere Industrien</option> </select></td> </tr> <tr> <td class="style37" style="width: 95px">Mitteilung:</td> <td class="style211" style="width: 493px"> <textarea cols="80" name="Message" rows="2" style="width: 508px" tabindex="10">Mitteilung: </textarea></td> </tr> </table> <p class="style197">&nbsp;</p> <p class="style197"> <img alt="" height="1" src="../../images/pikt/blue-line-578px.gif" width="578" /></p> <p class="style199"><strong>Bitte senden Sie mir meine persönliche Info-CD</strong></p> <p class="style197">&nbsp;</p> <p class="style198"> <input name="Reset" type="reset" value="Löschen" />&nbsp;&nbsp; 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