{include file="stahlblau/header.tpl"}

<div class="outter-wrapper">
<div class="wrapper ad-padx2 clearfix">
<script type="text/javascript">
<!--
function insert(aTag, eTag) {
  var input = document.forms[\'neu\'].elements[\'cont\'];
  input.focus();
  /* für Internet Explorer */
  if(typeof document.selection != \'undefined\') {
    /* Einfügen des Formatierungscodes */
    var range = document.selection.createRange();
    var insText = range.text;
    range.text = aTag + insText + eTag;
    /* Anpassen der Cursorposition */
    range = document.selection.createRange();
    if (insText.length == 0) {
      range.move(\'character\', -eTag.length);
    } else {
      range.moveStart(\'character\', aTag.length + insText.length + eTag.length);      
    }
    range.select();
  }
  /* für neuere auf Gecko basierende Browser */
  else if(typeof input.selectionStart != \'undefined\')
  {
    /* Einfügen des Formatierungscodes */
    var start = input.selectionStart;
    var end = input.selectionEnd;
    var insText = input.value.substring(start, end);
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    /* Anpassen der Cursorposition */
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  {
    /* Abfrage der Einfügeposition */
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    if(pos > input.value.length) {
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    var insText = prompt("Bitte geben Sie den zu formatierenden Text ein:");
    input.value = input.value.substr(0, pos) + aTag + insText + eTag + input.value.substr(pos);
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}
//-->
</script>

<script type="text/javascript">
function captcha(sid){
	var pas = new Image();
	var heuri = new Date();
	pas.src="captcha/captcha.php?x="+heuri.getTime()+sid;
	document.getElementById("captcha").src=pas.src;
}
</script>
<h1>Kontakt</h1>

<form action="" method="post" name="neu">
<input type="hidden" name="_token" value="68c92b1432065">
<input type="hidden" name="send" value="1">
<div class="row">
<div class="col-md-offset-2 col-md-2 col-xs-12">Ihr Name:</div><div class="col-md-5 col-xs-12"><input type="text" value="" name="name" class="form-control"></div></div>
<div class="row">    
<div class="col-md-offset-2 col-md-2 col-xs-12">Ihre E-Mail-Adresse:</div><div class="col-md-5 col-xs-12"><input type="text" name="mail" value="" class="form-control"></div></div>
<div class="row">
<div class="col-md-offset-2 col-md-2 col-xs-12">Ihre Telefonnummer:<div class="small"><i>(Optional)</i></div></div><div class="col-md-5 col-xs-12"><input type="text" name="tel" value=""  class="form-control"></div></div>    

<div class="row">   
<div class="col-md-offset-2 col-md-2 col-xs-12">Nachricht an:</div><div class="col-md-5 col-xs-12">
<select class="form-control" name="an"><option value="">Bitte w&auml;hlen</option><option value="8">Mike Hempel (Rugby)</option><option value="7">Andrea Gro&szlig;e (Gymnastik)</option><option value="6">Anne Albrecht (Tauchsport)</option><option value="5">Tischtennis (Lutz Buntins)</option><option value="2">Billard (Helga Blawid)</option></select>
</div></div><br>    
    

<div class="row">   
<div class="col-md-offset-2 col-md-2 col-xs-12">Ihre Nachricht:</div>
<div class="col-md-5 col-xs-12"><textarea name="cont" class="form-control" style="height:250px;"></textarea></div></div>';

<div class="row">   
<div class="col-md-offset-2 col-md-2 col-xs-12">Sicherheitscode:</div><div class="col-md-5 col-xs-12">
<div style="float:left"><img src="captcha/captcha.php" alt="Captcha" width=150 height=50 id="captcha"/></div>
 
<div style="float:left;font-size:12px;padding-left:10px"><div style="margin-top:5px;margin-bottom:2px;"><input type="text" style="width:100px;padding:4px;font-size:17px;" name="code">
<a href="javascript:captcha('');">Neuer Code?</a></div>
Bitte nebenstehende Buchstaben abtippen.</div>
</div></div>
<br>    
<div align="center"><button type="submit" class="btn btn-info">Senden</button></div></form>
    
    
</div></div>
	  
{include file="stahlblau/footer.tpl"}