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<area shape=rect coords="28, 0, 58, 26" href="http://www.edelstahl-waermetauscher.de">
<area shape=rect coords="58, 0, 89, 26" href="http://www.brazed-plate-heat-exchanger.com">
<area shape=rect coords="440, 0, 494, 26" href="kontakt.htm">
<area shape=rect coords="494, 0, 567, 26" href="impressum.htm">
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<div style="width:665px; height:28px; background:url('pic/linie.gif'); ">
<div style="display:inline; background-color:#ffffff; padding-left:15px; padding-right:10px; vertical-align:5px; 
color:#14327b; font-size:16px; font-weight:bold;">Registration: Plate heat 
  exchanger calculation App (single phase)</div>
</div>
</div>
<!-- Ende Titel -->

<!--Main-->
<div style="position:absolute; left:265px; top:210px;">
<div class="main" style="width:650px; color:#003273; line-height:18px;">

<b>Please enter for registration following data (* Required)<br>
</b>The access data will be temporarily valid.<p>&nbsp;</p>

<table width="644" height="365">
<tr>
<td align=left width="101" height="18"></td>
<td width="537" height="18">  <font color="#000066">&nbsp;Mr.<input type=radio name="Anrede" checked value="Herr"> 
Mrs.<input type=radio name="Anrede" value=" Frau"></font></td>
</tr>
<tr>
<td align=left width="101" height="27"><b>Company*:</b></td>
<td width="537" height="27"><font color="#000066"><input type=text size=25 name="firma" title="Company"></font></td>
</tr>
<tr>
<td align=left width="101" height="27"><b>N<font color="#000066">ame*:</font></b></td>
<td width="537" height="27"><font color="#000066"><input type=text size=25 name="vorname" title="First Name"></font></td>
</tr>
<tr>
<td align=left width="101" height="27"><b>First name*:</b></td>
<td width="537" height="27"><font color="#000066"><input type=text size=25 name="absender_name" title="Name"></font></td>
</tr>
<tr>
<td align=left width="101" height="27"><b>E-Mail*:</b></td>
<td width="537" height="27"><font color="#000066"><input type=text size=25 name="absender_mail" title="E-Mail"></font></td>
</tr>
<tr>
<td align=left width="101" height="27">Application:</td>
<td width="537" height="27"><font color="#000066">
<input type=text size=25 name="anwendung" title="Application"></font></td>
</tr>
<tr>
<td align=left width="101" height="27">Fluid 1:</td>
<td width="537" height="27"><font color="#000066">
<input type=text size=25 name="m1" title="Fluid 1"></font></td>
</tr>
<tr>
<td align=left width="101" height="27">Fluid 2:</td>
<td width="537" height="27"><font color="#000066">
<input type=text size=25 name="m2" title="Fluid 2"></font></td>
</tr>
<tr>
<td  colspan=2 width="612" height="13"></td>
</tr>
<td  colspan=2 width="612" height="13"><hr noshade size=1></td>
</tr>
<tr>
<td align=right width="101" height="29">&nbsp;</td>
<td width="537" height="29"><font>
<input type="submit" value="Send" title="" style="color: #000000; font-size:10pt">&nbsp;
</font> </td>
</tr>
<tr>
<td align=right colspan="2" width="612" height="42">
<font color="#000066">&nbsp; </font>
<p align="center"><font color="#000066"><font face="Arial" size="1"><strong>
© 2008. All rights reserved by G. Grande</strong></font> </font>
</p>
</td>
</tr>
</table>


</div>
</div>
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