<td width="9%"><label class="Stil2">
<input type="radio" name="bin" value="Schülerin" id="bin" />
Schülerie</label></td>
<td width="10%" class="Stil2"><label>
<input type="radio" name="bin" value="Abiturientin" />
Abiturientin</label></td>
<td width="12%" class="Stil2"><label>
<input type="radio" name="bin" value="Auszubildende" />
Auszubildende</label></td>
<td width="10%" class="Stil2"><label>
<input type="radio" name="bin" value="Studentin" />
Studentin</label></td>
<td width="11%" class="Stil2"><label>
<input type="radio" name="bin" value="Arbeitend" />
</label>
Arbeitend</td>
<td width="32%" class="Stil2"><input type="radio" name="bin" value="nichts von allem :-)" />
nichts von allem :-)</td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr>
<td scope="row"><p class="Stil1">Bitte gib die folgenden Angaben zu Deiner Person ein</p>
</td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="27" scope="row"><span class="Stil2">Alter:</span></td>
<td width="84%"><input name="alter" type="text" class="name_input" id="alter" size="4" /></td>
</tr>
<tr>
<td height="27" class="Stil2" scope="row">Körpergröße:</td>
<td><input name="cm" type="text" class="name_input" id="cm" size="10" />
<span class="Stil2">cm</span></td>
</tr>
<tr>
<td height="27" scope="row"><span class="Stil2">Gewicht:</span></td>
<td><input name="gewicht" type="text" class="name_input" id="gewicht" size="4" />
<span class="Stil2">kg</span></td>
</tr>
<tr>
<td height="27" scope="row"><span class="Stil2">Haarfarbe:</span></td>
<td><select name="haarfarbe" class="name_input" id="haarfarbe">
<option value="">-- Bitte wähle --</option>
<option value="Blond">Blond</option>
<option value="Braun">Braun</option>
<option value="Schwarz">Schwarz</option>
<option value="Rot">Rot</option>
<option value="Grau">Grau</option>
<option value="Weiß">Weiß</option>
</select>
</td>
</tr>
<tr>
<td height="27" scope="row"><span class="Stil2">Augenfarbe: </span></td>
<td><select name="augenfarbe" class="name_input" id="augenfarbe">
<option value="">-- Bitte wähle --</option>
<option value="Blau">Blau</option>
<option value="Braun">Braun</option>
<option value="Schwarz">Schwarz</option>
<option value="Grün">Grün</option>
<option value="Grau">Grau</option>
<option value="Violett">Violett</option>
</select>
</td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr>
<td scope="row"><p class="Stil1">Hier kannst Du zwei Fotos von Dir hochladen:</p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="27" scope="row"><span class="Stil2">Porträt:</span></td>
<td width="84%"><input name="bild1" type="file" class="name_input" id="bild1" size="50" /></td>
</tr>
<tr>
<td height="27" class="Stil2" scope="row">Ganzkörper:</td>
<td><input name="bild2" type="file" class="name_input" id="bild2" size="50" /></td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr>
<td scope="row"><p class="Stil1">Wie hast Du XXX gefunden</p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="27" class="Stil2" scope="row">Bitte hier wählen : </td>
<td width="9%"><label class="Stil2">
<input type="radio" name="gefunden" value="Flyer" />
Flyer</label></td>
<td width="10%" class="Stil2"><label>
<input type="radio" name="gefunden" value="Empfehlung" />
Empfehlung</label></td>
<td width="15%" class="Stil2"><label>
<input type="radio" name="gefunden" value="Zeitungswerbung" />
Zeitungswerbung</label></td>
<td width="50%" class="Stil2"><label>
<input type="radio" name="gefunden" value="Suchmaschine" />
</label>
Suchmaschine</td>
</tr>
<tr>
<td height="27" class="Stil2" scope="row">Sonstiges:</td>
<td colspan="4"><input name="sonstiges" type="text" class="name_input" id="sonstiges" size="70" /></td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr>
<td scope="row"><p class="Stil1">Wie hast Du XXX</p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="27" class="Stil2" scope="row">Bitte hier wählen : </td>
<td width="9%"><label class="Stil2">
<input type="radio" name="erfahren" value="hier" />
hier</label></td>
<td width="15%" class="Stil2"><label>
<input type="radio" name="erfahren" value="von einer Freundin" />
von einer Freundin</label></td>
<td width="60%" class="Stil2"><label>
<input type="radio" name="erfahren" value="durch XXX" />
</label>
durch XXX</td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr>
<td scope="row"><p class="Stil1">...und zu guter letzt hätten wir gern noch gewusst...</p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="27" class="Stil2" scope="row"><p>...was unterscheidet Dich von anderen,</p>
<p>XXX/p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="50" class="Stil2" scope="row"><p>
<textarea name="unterschied" cols="100" rows="5" class="name_input" id="unterschied"></textarea>
</p>
</td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td width="16%" height="50" class="Stil2" scope="row"><p><img id="luck" src="/img/glueck.jpg" alt="Wir wünschen dir ganz viel Glück" width="657" height="52" /></p></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td scope="row"><input id="the_submit" name="Submit" type="submit" class="name_input" value="Jetzt abschicken" /></td>
</tr>
</table>
<br />
<table width="100%" border="0">
<tr></tr>
<tr>
<td scope="row"><hr /></td>
</tr>
</table>
<table width="100%" border="0">
<tr>
<td class="Stil1 Stil3" scope="row">XXX<br />
Copyright © 2003 [XXX]. Alle Rechte vorbehalten.<br />
Geändert am: 21.09.07</td>
</tr>
</table>
</form>
</body>
</html>