<html>
<head>
<title>::GEMAXX TeleCom | Communication Systems::</title>
</head>
<script language="JavaScript">
function check() {
var err="";
var w=window.document.form1;
var ok=false;
for (var t=0; t<12; t++) {
eval('if (w.art'+t+'.checked) {ok=true;}');
}
if (!ok) {
err+="+ Bitte wählen Sie mindestens eine Störungsart aus!\n";
}
if (w.telenr1.value=="" || w.telenr2.value=="") err+="+ Bitte geben Sie eine Telefonnummer ein!\n";
if (w.zielnr1.value=="" || w.zielnr2.value=="") err+="+ Bitte geben Sie eine Ziel-Telefonnummer ein!\n";
if (w.uhrstunde.value=="" || w.uhrminute.value=="") err+="+ Bitte geben Sie eine Uhrzeit ein!\n";
if (w.datumtag.value=="" || w.datumtag.value=="" || w.datumjahr.value=="") err+="+ Bitte geben Sie ein Datum ein!\n";
if (err=="") return true; else {
alert("Bitte füllen Sie das Formular vollständig aus:\n\n"+err);
return false;
}
}
</script>
<style type="text/css">
TD.dark {
font-family:Arial;
font-size:10px;
color:#FFFFFF;
background-color: #666666;
letter-spacing:2px;
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TD.light {
font-family:Arial;
font-size:12px;
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background-color:#F2F2F2;
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font-family:Arial;
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background-color:#E5E5E5
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TD.white {
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font-family:Arial;
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input,textarea {
border: 1px solid #666666;
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input.check {
border: 0px;
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input.button {
border: 0px;
background-color:#D6D6D6;
color:#666666;
font-size:10px;
height:16px;
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</style>
<body marginwidth=0 marginheight=0 topmargin=0 leftmargin=0>
<form name="form" method="post"
action="mailto
stankowiak@hotmail.com?SUBJECT=Störungsmeldung" enctype="text/plain"
onSubmit="return validate_form()">
<table border=0 cellpadding=0 cellspacing=0 width=640>
<tr>
<td colspan=2>
<div align="left">[img]stoer_head_d.jpg[/img]</div>
</td>
</tr>
<tr>
<td width=40 class=white></td>
<td>
<table border=0 cellpadding=0 cellspacing=0 width=600>
<tr>
<td class=dark colspan=2>ART DER STÖRUNG</td>
</tr>
<tr>
<td colspan=2>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td rowspan=23 valign=top width=140 class=light> Zutreffendes
bitte auswählen </td>
<td width=460>
<input type="checkbox" class=check value="1" name="art0"> Immer besetzt (normaler, langsamer Besetztton)
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art1"> Gassenbesetzt (schneller Besetztton)
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art2"> Ansage Deutsche Telekom: "Kein Anschluß unter dieser Nummer".
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art3"> Schlechte Qualität der Verbindung. Knacken und Kratzen in der Leitung.
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art4"> Abbruch der Verbindung während des Gesprächs
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art5"> Zu lange Wartezeit nach dem Wählen bis zum Verbindungsaufbau
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art6"> Das Telefon bleibt stumm
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art7"> Der Gesprächspartner kann mich nicht verstehen- oder umgekehrt
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art8"> Ansage Deutsche Telekom: "Dienst oder Dienstmerkmal nicht möglich"
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art9"> Falsch verbunden
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art10"> Falsche Tarifansage bzw. Minutenansage (bei Calling Cards)
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td>
<input type="checkbox" class=check value="1" name="art11"> Fehlerhafte Guthabenabbuchung (bei Calling Cards)
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td colspan=2 class=dark >IHRE KUNDENDATEN</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Kunden-Nr. </td>
<td>
<input type="text" name="kundennr" style="width:160px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Telefon-Nr. </td>
<td>
<input type="text" name="telenr1" style="width:54px">
<input type="text" name="telenr2" style="width:100px"> <span class=grey>(Vorwahl/Telefonnummer)</span>
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> E-Mail-Adresse </td>
<td>
<input type="text" name="email" style="width:300px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Land </td>
<td>
<input type="text" name="land" style="width:300px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Ziel-Nr. </td>
<td>
<input type="text" name="zielnr1" style="width:54px">
<input type="text" name="zielnr2" style="width:100px"><span class=grey>(Vorwahl/Zielnummer)</span>
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Datum des Anrufs </td>
<td>
<input type="text" name="datumtag" maxlength=2 style="width:24px">
<input type="text" name="datummonat" maxlength=2 style="width:24px">
<input type="text" name="datumjahr" maxlength=4 style="width:38px"><span class=grey>(Tag/Monat/Jahr)</span>
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Uhrzeit des Anrufs </td>
<td>
<input type="text" name="uhrstunde" maxlength=2 style="width:24px">:
<input type="text" name="uhrminute" maxlength=2 style="width:24px"><span class=grey>Uhr</span>
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td valign=top class=light> Anmerkung </td>
<td>
<textarea name="anmerkung" style="width:300px;height:110px"></textarea>
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td colspan=2 class=dark >NUR FÜR CALLING-CARD KUNDEN</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> PIN-Nr. </td>
<td>
<input type="text" name="pin" maxlength=12 style="width:160px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Batch-Nr. </td>
<td>
<input type="text" name="batch" maxlength=20 style="width:160px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Calling-Card-Name </td>
<td>
<input type="text" name="ccname" style="width:300px">
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Gewählt von </td>
<td>
<input type="radio" class=check name="ccvon" value="Festnetz">Festnetz
<input type="radio" class=check name="ccvon" value="Mobilfunk">Mobilfunk
<input type="radio" class=check name="ccvon" value="Telefonzelle">Telefonzelle
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td class=light> Gewählt nach </td>
<td>
<input type="radio" class=check name="ccnach" value="Festnetz">Festnetz
<input type="radio" class=check name="ccnach" value="Mobilfunk">Mobilfunk
<input type="radio" class=check name="ccnach" value="Telefonzelle">Telefonzelle
<input type="radio" class=check name="ccnach" value="Lokal">Lokal
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
<tr>
<td valign=top class=light> Anmerkung </td>
<td>
<textarea name="ccanmerkung" style="width:300px;height:110px"></textarea>
[img]01_group/images/t.gif[/img]
</td>
</tr>
<tr>
<td colspan=2 class=white>[img]01_group/images/t.gif[/img]</td>
</tr>
</table>
</td>
</td>
</table>
<table border=0 cellpadding=0 cellspacing=0 width=640>
<tr>
<td class=white width=40></td>
<td class=white width=140>
<input type="submit" value="Störung melden" onClick="return check()" class=button>
<input type="Hidden" name="formmailer" value="70696">
</td>
<td class=white width=230>
<input type="reset" value="Eingabe löschen" class=button>
</td>
<td class=white width=220 align=right>
<input type="button" value="Fenster schließen" onClick="self.close()" class=button>
</td>
<td class=white width=10></td>
</tr>
</table>
<input type="hidden" name="postback" value="1">
</form>
</body>
</html>