document.write("<form method=\"post\" action=\"https://ymlp.com/subscribe.php?id=gjwyqjjgmgw\">\n<table cellpadding=\"5\" cellspacing=\"0\" align=\"center\" border=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Geben Sie Ihre E-Mailadresse ein, um unseren Newsletter zu erhalten</span></td>\n</tr>\n<tr>\n<td style=\"padding: 3px;\" valign=\"top\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">E-Mailadresse:</span></td>\n<td style=\"padding: 3px;\" valign=\"top\"><input size=\"20\" name=\"YMP0\" type=\"text\" style=\"color: #000000;\" /></td>\n</tr>\n<tr>\n<td style=\"padding: 3px;\" valign=\"top\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Vorname:</span></td>\n<td style=\"padding: 3px;\" valign=\"top\"><input size=\"20\" name=\"YMP1\" type=\"text\" style=\"color: #000000;\" /></td>\n</tr>\n<tr>\n<td style=\"padding: 3px;\" valign=\"top\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Name:</span></td>\n<td style=\"padding: 3px;\" valign=\"top\"><input size=\"20\" name=\"YMP2\" type=\"text\" style=\"color: #000000;\" /></td>\n</tr>\n<tr>\n<td style=\"padding: 3px;\" valign=\"top\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Firma:</span></td>\n<td style=\"padding: 3px;\" valign=\"top\"><input size=\"20\" name=\"YMP5\" type=\"text\" style=\"color: #000000;\" /></td>\n</tr>\n<tr>\n<td style=\"padding: 3px;\" valign=\"top\"><span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Telefon:</span></td>\n<td style=\"padding: 3px;\" valign=\"top\"><input size=\"20\" name=\"YMP7\" type=\"text\" style=\"color: #000000;\" /></td>\n</tr>\n<tr>\n<td colspan=\"2\"><input checked=\"checked\" value=\"subscribe\" name=\"action\" type=\"radio\" /> <span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Anmelden</span><input value=\"unsubscribe\" name=\"action\" type=\"radio\" /> <span style=\"font-family: Roboto, Helvetica, Arial, sans-serif; font-weight: 400; font-style: normal; font-size: 15px; line-height: 1.7; letter-spacing: 0; text-transform: inherit; color: #d3d3d3;\">Abmelden</span></td>\n</tr>\n<tr>\n<td colspan=\"2\"><input style=\"color: #000000;\" value=\"Senden\" type=\"submit\" />&nbsp;</td>\n</tr>\n<tr>\n<td colspan=\"2\"><img src=\"http://chiclet.ymlp.com/chiclet_gjwyqjjgmgwrnb.png?id=2014121715584212\" /></td>\n</tr>\n</tbody>\n</table>\n</form>");