<![CDATA[
<body bgcolor="#FFFFFF" text="#000000">
Online Form<br>
<br>
For More Information, please fill out the following form:
<form name="citrusmotivate" method="post" action="/cgi-bin/nmsformmail.pl">
<input type=hidden name="subject" value="Citrus Motivate Kontakt">
<input type=hidden name="redirect"
value="http://www.citrusdirect.de/sitemap/motivate_formreturn.htm">
<input type=hidden name="recipient" value="pa@citrusdirect.de">
<table width="100%" border="0" cellpadding="3">
<tr>
<td width="6%" class="citrus">
<div align="right">Name:</div>
</td>
<td width="94%">
<input type="text" name="name" size="40">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Address:</div>
</td>
<td width="94%">
<input type="text" name="address" size="40">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">City:</div>
</td>
<td width="94%">
<input type="text" name="city" size="40">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Zip (PLZ):</div>
</td>
<td width="94%">
<input type="text" name="zip" size="20">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Country:</div>
</td>
<td width="94%">
<input type="text" name="country" size="40">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Telephone:</div>
</td>
<td width="94%">
<input type="text" name="telephone" size="20">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Email:</div>
</td>
<td width="94%">
<input type="text" name="email" size="30">
</td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Course:</div>
</td>
<td width="94%">
<input type="checkbox" name="business_motivation" value="checkbox">
<span class="citrus">Business Motivation</span> <br>
<input type="checkbox" name="critical_thinking" value="checkbox">
<span class="citrus">Critical Thinking<br>
<input type="checkbox" name="business_basics" value="checkbox">
Business Basics<br>
<input type="checkbox" name="discussion_groups" value="checkbox">
Discussion Groups</span></td>
</tr>
<tr>
<td width="6%" class="citrus">
<div align="right">Date:</div>
</td>
<td width="94%">
<input type="text" name="date" size="20">
</td>
</tr>
<tr>
<td width="6%" class="citrus"> </td>
<td width="94%">
<input type="submit" name="Submit" value="Send">
</td>
</tr>
</table>
</form>
</body>
]]>