Nieuwsbrief

<form method="POST" action="http://www.rusteloosheid.be/kleinebloteliedjes/index.pl"> <table> <tr><td>Naam:</td><td><input type="text" name="title" onFocus="clearText(this)" value="name" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> <tr><td>Email:</td><td><input type="text" name="title" onFocus="clearText(this)" value="email address" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> <tr><td>Adres:</td><td><input type="text" name="title" onFocus="clearText(this)" value="mailing address" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> <tr><td>Postcode:</td><td><input type="text" name="title" onFocus="clearText(this)" value="postcode" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> <tr><td>Staad:</td><td><input type="text" name="title" onFocus="clearText(this)" value="city" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> <tr><td>Land:</td><td><input type="text" name="title" onFocus="clearText(this)" value="country" style="width:150px; line-height:16px; margin:0; padding:0;"></td></tr> </table> </form>

Your address will not be used for anything but mailings from Gerry De Mol. privacy policy