Informatieformulier

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="3" width=140 BGCOLOR="#000000" TEXT="#F7F7FF" bgproperties="fixed" background="0728cc00dvldtc.gif"> <div> <A HREF="index.htm" TARGET="_top" TITLE="DanceMasters van Opstal"><U><B>Home</B></U></A></div> <bR> <bR> <bR> </td> <td valign="top" height=110 BGCOLOR="#000000" TEXT="#F7F7FF" bgproperties="fixed" background="0b000730dvldtc.jpg"> <bR> <bR> <div> </div> </td> <td valign="top" rowspan="3" width=140 BGCOLOR="#000000" TEXT="#F7F7FF" bgproperties="fixed" background="0768cc00dvldtc.gif"> <bR> <bR> <bR> <bR> <bR> <bR> <div> <A HREF="contact.htm" TARGET="_top" TITLE="Contact"><U><B>terug</B></U></A></div> </td> </tr><tr> <td valign="top" height=290 BGCOLOR="#FFFFFF" TEXT="#080000"> <bR> <div> <B>Informatieformulier</B></div> <bR> <div> <B><IMG SRC="6008a130.jpg" border=0 width="650" height="19" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <bR> <div> Na invulling en verzenden komt dit bericht terecht in uw Postvak uit. </div> <div> Open Outlook om het bericht te versturen.</div> <div> U krijgt zo spoedig mogelijk antwoord.</div> <bR> <div> <B>Dit formulier kunt u niet versturen vanaf een hotmail-adres.</B></div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Times New Roman" >Stel u vraag dan a.u.b. via ons e-mailadres:</FONT><B> </B><A HREF="mailto:info@dansvanopstal.nl" TARGET="_top" TITLE="mailto:info@dansvanopstal.nl"><U><B>info@dansvanopstal.nl</B></U></A></div> <bR> <div>  <form method="POST"enctype="text/plain" action="mailto:riadekock@dansvanopstal.nl"> <table border="0" width="100%"> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Naam:</td> <td width="83%" valign="top"><input type="text" name="Naam" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Adres:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="text" name="Adres" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Postcode:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="text" name="Postcode" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Woonplaats:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="text" name="Woonplaats" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Telefoonnummer:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="text" name="Telefoonnummer" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Email-adres:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="text" name="Email-adres" size="30" style="border: 1 solid #000000"></td> </tr> <tr> <td width="27%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Ik wil informatie over?</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Beginnerscursus" name="Ik wil informatie over">Beginnerscursus</p> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Volledige cursus stijldansen" name="Ik wil informatie over">Volledige cursus stijldansen</p> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Swing Solution" name="Ik wil informatie over">Swing Solution</p> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Streetdance + showdance" name="Ik wil informatie over">Streetdance + showdance</p> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Kidswing" name="Ik wil informatie over">Kidswing</p> <p style="margin-top: 1; margin-bottom: 1"><input type="radio" value="Sfeerclub" name="Ik wil informatie over">Sfeerclub</p> </tr> <tr> <td width="17%" valign="top"> <p style="margin-top: 1; margin-bottom: 1">Bericht:</td> <td width="83%" valign="top"> <p style="margin-top: 1; margin-bottom: 1"><textarea rows="5" name="Bericht" cols="42" style="color: #000000; border: 1 solid #000000"></textarea></p> </td> </tr> </table> <p style="margin-top: 1; margin-bottom: 1"><input type="submit" value="Verzenden" style="color: #000000; border: 1 solid #000000"><input type="reset" value="opnieuw...." name="B2" style="color: #000000; border: 1 solid #000000"></p> </form>  </div> <bR> <bR> <bR> <bR> <bR> </td> </tr><tr> <td valign="top" height=80 BGCOLOR="#660000" TEXT="#F7F7FF" bgproperties="fixed" background="07800500dvldxa.gif"> <div> <A HREF="cursussen.htm" TARGET="_top" TITLE="Cursussen"><U>Cursussen</U></A>   |   <A HREF="agenda.htm" TARGET="_top" TITLE="Agenda"><U>Agenda</U></A>   |   <A HREF="theatershow_2010.htm" TARGET="_top" TITLE="Theatershow 2010"><U>Theatershow 2010</U></A>   |   <A HREF="nieuws.htm" TARGET="_top" TITLE="Nieuws"><U>Nieuws</U></A>   |   <A HREF="wedstrijden.htm" TARGET="_top" TITLE="Wedstrijden"><U>Wedstrijden</U></A>   |   <A HREF="dans_van_het_jaar.htm" TARGET="_top" TITLE="Dans van het Jaar"><U>Dans van het Jaar</U></A>   |   <A HREF="fotoalbum.htm" TARGET="_top" TITLE="Fotoalbum"><U>Fotoalbum</U></A>   |   <A HREF="feesten_en_partijen.htm" TARGET="_top" TITLE="Feesten en Partijen"><U>Feesten en Partijen</U></A>   |   <A HREF="historie.htm" TARGET="_top" TITLE="Historie"><U>Historie</U></A>   |   <A HREF="contact.htm" TARGET="_top" TITLE="Contact"><U>Contact</U></A>   |   <A HREF="links.htm" TARGET="_top" TITLE="Links"><U>Links</U></A>   |   <A HREF="webdesign.htm" TARGET="_top" TITLE="Webdesign"><U>Webdesign</U></A>   |   <A HREF="disclaimer.htm" TARGET="_top" TITLE="Disclaimer"><U>Disclaimer</U></A>   |   <A HREF="site_overzicht.htm" TARGET="_top" TITLE="Site overzicht"><U>Site overzicht</U></A></div> <bR> <div> Copyright © 2008 - DanceMasters van Opstal - All rights reserved</div> <div>                                                                                </div> <bR> </td> </tr></table></body>