<html>

<head>

<title>aanvragen</title>

</head>

<body>


<div class="entry">


<form action="malt:jete9@telenet.be" method="POST"


enctype="text/plain" name="email"


onsubmit="return mailMe( this.form )">


<p align="center">Naam:<br>


<input type="text" size="30" name="ingevuld door">


<p align="center">E-mail:<br>


<input type="text" size="30" name="EMAIL ADRES"><br>


Vraag:<font color="#000000" face="Arial"><br>


<textarea name="COMMENTS" rows="8" cols="30" wrap="virtual"></textarea><br>


<input type="submit" value="Verstuur "><input type="reset"


value="Reset"></font></p>


</form>


</body>

</html>