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Ansprechperson

Dr. Klaudia Hradil

Kontaktformular

<label for="mailformAnrede/Titel">Anrede/Titel:</label>
<input type="text" name="Anrede/Titel" id="mailformAnrede/Titel" size="40" maxlength="40" value="" />
<label for="mailformnachname">Nachname:*</label>
<input type="text" name="nachname" id="mailformnachname" size="40" maxlength="40" value="" />
<label for="mailformvorname">Vorname:*</label>
<input type="text" name="vorname" id="mailformvorname" size="40" maxlength="40" value="" />
<label for="mailformFirma">Firma/Einrichtung:*</label>
<input type="text" name="Firma" id="mailformFirma" size="80" maxlength="80" value="" />
<label for="mailforminst">Institut:</label>
<input type="text" name="inst" id="mailforminst" size="40" maxlength="40" value="" />
<label for="mailformadresse">Adresse 1:</label>
<input type="text" name="adresse" id="mailformadresse" size="40" maxlength="40" value="" />
<label for="mailformadresse">Adresse 2:</label>
<input type="text" name="adresse" id="mailformadresse" size="40" maxlength="40" value="" />
<label for="mailformtelefon">Telefon:*</label>
<input type="text" name="telefon" id="mailformtelefon" size="40" maxlength="40" value="" />
<label for="mailformfax">Fax:</label>
<input type="text" name="fax" id="mailformfax" size="40" maxlength="40" value="" />
<label for="mailformemail">Email:*</label>
<input type="text" name="email" id="mailformemail" size="40" maxlength="40" value="" />
<label for="mailformmessage_text">Ihre Anfrage:*</label>
<textarea name="message_text" id="mailformmessage_text" cols="40" rows="20"> </textarea>
<label for="mailformattachment1">Datei hochladen</label>
<input type="file" name="attachment1" id="mailformattachment1" size="20" />
<input type="submit" name="formtype_mail" id="mailformformtype_mail" value="Senden" class="csc-mailform-submit" />

*) Eingabe erforderlich