<form action="<?php echo $_SERVER['PHP_SELF']; ?>" method="post">
<table border=0 cellspacing=2 cellpadding=0>
<tr>
<td nowrap align=right>An:</td>
<td> </td>
<td><label>
<select name="adresse">
<option value="ich@web.de">Ich(Webmaster)</option>
<option value="du@web.de">Du</option>
<option value="er@web.de">Er</option>
</select>
</label></td>
</tr>
<tr><td nowrap align=right>Name:</td><td> </td>
<td width=100%><input type="text" name="fromname" size=50 maxlength=120 value="<?php echo $from_name; ?>"></td></tr>
<tr><td nowrap align=right>E-Mail Adresse:</td><td></td>
<td width=100%><input type="text" name="frommail" size=50 maxlength=120 value="<?php echo $from_mail; ?>"></td></tr>
<tr><td nowrap align=right>Betreff:</td><td></td>
<td width=100%><input type="text" name="mailsubject" size=50 maxlength=120 value="<?php echo $mail_subject; ?>"></td></tr>
<tr><td nowrap align=right valign=top>Nachricht:<br><i>(max. 1.000 Zeichen)</i></td><td></td>
<td width=100%><textarea cols="40" rows="10" name="mailtext"><?php echo $mail_text; ?></textarea></td></tr>
<tr>
<td></td>
<td><img src="/rechen-captcha.php"></td>
<td><input type="text" name="sicherheitscode" size="5"></td>
</tr>
<tr><td></td><td></td><td>
<input type="hidden" value="1" name="s">
<input type="submit" value="Nachricht versenden" name="submit">
</td></tr>
</table>
</form>