Wasserlauf NRW - Stiftung für Gewässerschutz und Wanderfische

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                 <img src="images/seiten/spenden_head.jpg" >
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                  Füllen Sie das Formular aus.
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                                     <td>
                                     Surname:
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                                     <input type="text" name="Name" size="40">
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<tr>
                                     <td>
                                     Lastname:
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                                     <input type="text" name="Vorname" size="40">
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<tr>
                                     <td>
                                     Organisation:
                                     </td>
                                     <td>
                                     <input type="text" name="Firma" size="40">
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<tr>
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                                     Street/house number:
                                     </td>
                                     <td>
                                     <input type="text" name="Straße" size="40">
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<tr>
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                                     Postcode/zip:
                                     </td>
                                     <td>
                                     <input type="text" name="PLZ" size="40">
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<tr>
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                                     Telephone:
                                     </td>
                                     <td>
                                     <input type="text" name="Telefon" size="40">
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<tr>
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                                     e-mail:
                                     </td>
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                                     <input type="text" name="Email" size="40">
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                                     Mention by name on website:
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                                     <input type="checkbox" name="nennung" value="1">
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                                     <b>Method of Payment</b>
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                                     <td>Direct debit</td>
                                     <td><input type="radio" name="zahlung" value="2" onCLick="bank()" checked></td>
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                                     <td>Bank transfer</td>
                                     <td><input type="radio" name="zahlung" value="1" ></td>
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                                     Account holder:
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                                     <input type="text" name="Kontoinhaber" size="40">
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                                     Account number:
                                     </td>
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                                     <input type="text" name="Kontonummer" size="40">
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                                     Bank details:
                                     </td>
                                     <td>
                                     <input type="text" name="Bank" size="40">
                                     </td>
                                     </tr>

<tr>
                                     <td colspan="2">    <br>
                                     Amount of donation<input type="text" name="spende" size="5"> €<br>
                                     How long should the donation continue? <input type="text" name="dauer" size="1" value="1"> month(s) <br>
                                     
                                     Having made a donation, would you like to be a sponsor? <input type="checkbox" name="foerdermitglied" value="1">
                                     
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                                     <input type="submit" value="Send">
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