Kontaktdaten / Kontaktformular

TESIUM GmbH

Mühlenfeldstraße 1          Telefon: +49 5531 90-3333
37603 Holzminden           Telefax: +49 5531 90-1755

<input type="text" name="firma" id="mailformfirma" size="40" value="Ihre Firmenbezeichnung" />
<input type="text" name="name" id="mailformname" size="20" value="Ihr Name" />
<input type="text" name="email" id="mailformemail" size="40" value="" />
<input type="text" name="Telefon" id="mailformTelefon" size="20" value="" />
<textarea name="nachricht" id="mailformnachricht" cols="40" rows="5"> </textarea>
<input type="checkbox" value="1" name="tv" id="mailformtv" checked="checked" class="csc-mailform-check" />
<input type="submit" name="formtype_mail" id="mailformformtype_mail" value="Absenden" class="csc-mailform-submit" />