Contact form

Dear visitors,

please use this form to send us your messages. We will take care of the matter immediately.

Please understand that any anonymous messages will be deleted at once.

Reference:Ref.:

</fieldset>
<fieldset style="WIDTH: 509px; HEIGHT: 728px"><legend>Your details</legend><label for="Mitteilung">Your details:</label><textarea style="WIDTH: 20.29em; HEIGHT: 154px" name="Mitteilung" rows="10" cols="34"/>
<fieldset style="WIDTH: 468px; HEIGHT: 264px"><legend>Ihre Daten</legend><label for="Firma">Company</label> <input id="Firma" maxlength="100" size="40" name="Firma"/><br>
<label for="Anrede">Title</label> <select size="1" name="Anrede">
<option value="Please select" selected="selected">Please select</option>
<option value="Herr">Herr</option>
<option value="Frau">Frau</option>
</select><br>
<label for="Vorname">First name*</label> <input id="Vorname" maxlength="100" size="40" name="Vorname"/><br>
<label for="Nachname">Sur name*</label> <input id="Nachname" maxlength="100" size="40" name="Nachname"/><br>
<label for="Strasse">Street / house no.*</label> <input id="Strasse" maxlength="100" size="40" name="Strasse"/><br>
<label for="PLZ">Postcode* /Town / part of town*</label> <input id="PLZ" maxlength="5" size="5" name="PLZ"/> <input id="Ort" maxlength="100" size="42" name="Ort"/><br>
<label for="Telefon">Telephone*</label> <input id="Telefon" maxlength="100" size="40" name="Telefon"/><br>
<label for="Mobil">Mobil phone</label> <input id="Mobil" maxlength="100" size="40" name="Mobil"/><br>
<label for="FAX">Telefax</label> <input id="FAX" maxlength="100" size="40" name="FAX"/><br>
<label for="Email">Email*</label> <input id="Email" maxlength="100" size="40" name="Email"/></fieldset>
<fieldset style="WIDTH: 468px; HEIGHT: 107px"><legend>Answer by</legend>
<div class="KontaktFormCbx"><label for="EMail">Email</label><input type="checkbox" value="Antwort per E-Mail" name="AntwortEMail"/><br>
<label for="Fax">Telefax</label><input type="checkbox" value="Antwort per Fax" name="AntwortFax"/><br>
<label for="Telefon">Telephone</label><input type="checkbox" value="Antwort per Telefon" name="AntwortTelefon"/><br>
<label for="Brief">Letter</label><input type="checkbox" value="Antwort per Brief" name="AntwortBrief"/></div>
</fieldset>
<div class="KontaktFormTxt">
<p>All fields marked with * are required fields; in order to gain access, please complete all fields.</p>
<p><br>
 </p>
<p><input class="AnfrageSenden" type="submit" value="Send enquiry"/>  <input class="FelderLoeschen" type="reset" value="delete contents" name="Reset"/></p>
<p> </p>
</div>
</fieldset>
</div>
</form>
</div>
</div>
</div>


          </div>
          <div id="ie_clearing">    </div>
        </div>
      </div>
      <div id="footer">

<div id="Social_Media">
<a href="https://twitter.com/GemLeRo" rel="external noopener" target="_blank" title="St. Leon-Rot auf Twitter"><img alt="twitter.com/GemLeRo" src="/pb/site/st-leon-rot/resourceCached/10.2.2.2/img/social/icon_twitter.png"></a><a href="http://www.facebook.com/pages/Gemeindeverwaltung-St-Leon-Rot/214678745209146" rel="external noopener" target="_blank" title="St. Leon-Rot auf Facebook"><img alt="www.facebook.com/pages/Gemeindeverwaltung-St-Leon-Rot/214678745209146" src="/pb/site/st-leon-rot/resourceCached/10.2.2.2/img/social/icon_facebook.png"></a>
</div>
<div id="bottom_links">
<div class="optionalesDiv bottomSlot">
<div class="composedcontent-dvv-row subcolumns" id="row_1077399">
  <div id="id1077400" class="c33l">
    <div class="subcl">
      <div class="composedcontent-dvv-column2 subrows" id="col_1077400">
        <div id="id1077401">
          <div>
            <div class="composedcontent-dvv-box boxborder block_1077401" id="cc_1077401">
              <div id="boxid1077402" class="boxChild">
                <h3 class="basecontent-dvv-sub-heading-3">Information</h3>
              </div>
              <div id="boxid1077403" class="boxChild">
                <div class="basecontent-list align_left">
                  <ul><li><a class="internerLink" href="/pb/,Len/760600.html" rel="internal" title="Notruf">Notruf</a></li></ul>
                </div>
              </div>
              <div id="boxid1077404" class="boxChild">
                <div class="basecontent-list align_left">
                  <ul><li><a class="internerLink" href="/pb/,Len/757487.html" rel="internal">Routenplaner</a></li></ul>
                </div>
              </div><br class="clearDvv">
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div id="id1077405" class="c33l">
    <div class="subc">
      <div class="composedcontent-dvv-column2 subrows" id="col_1077405">
        <div id="id1077406">
          <div>
            <div class="composedcontent-dvv-box boxborder block_1077406 contact" id="cc_1077406">
              <div id="boxid1077407" class="boxChild">
                <h3 class="basecontent-dvv-sub-heading-3">Kontakt</h3>
              </div>
              <div id="boxid1077408" class="boxChild">
                <p class="basecontent-line-break-text">Telefon: 06227 / 53 80<br>Telefax: 06227 / 53 82 68<br><br><a class="mailLink neuFensterLink" href="mailto:gemeinde@st-leon-rot.de" target="_blank" title="E-Mail an die Gemeinde">E-Mail schreiben</a><br><a class="internerLink" href="/pb/,Len/759709.html" rel="internal" title="Sichere Kommunikation mit der Gemeindeverwaltung">Sichere Kommunikation</a></p>

</div><br class="clearDvv">
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div id="id1077409" class="c33r">
    <div class="subcr">
      <div class="composedcontent-dvv-column2 subrows" id="col_1077409">
        <div id="id1077410">
          <div>
            <div class="composedcontent-dvv-box boxborder block_1077410" id="cc_1077410">
              <div id="boxid1077411" class="boxChild">
                <h3 class="basecontent-dvv-sub-heading-3">Ortsplan</h3>
              </div>
              <div id="boxid1077412" class="boxChild">
                <p class="basecontent-line-break-text">Sie kennen sich in St. Leon-Rot nicht aus?<br><br><a class="internerLink neuFensterLink" href="/pb/,Lde/760608.html" rel="internal" target="_blank" title="zum Ortsplan von St. Leon-Rot">Hier geht's zum Ortsplan</a></p>

</div><br class="clearDvv">
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
</div>
</div>
</div>
<div class="subcolumns-bottom">
<div class="flinks-bottom">
    <div class="my_funktionslinks">
  <a href="/pb/site/st-leon-rot/node/2198477/index.html" title="Datenschutzerklärung">Datenschutzerklärung</a> | <a href="/pb/site/st-leon-rot/node/760581/index.html" title="Impressum">Impressum</a>
    </div>
</div> 
</div> 
<div class="copyright noprint">
© 2013 Sankt Leon-Rot 
</div>
<div class="PageServices noprint">
</div>

      </div>
	</div>
  </div>
<script src="/pb/site/st-leon-rot/data/760590/Len/tracking/tracking.js" type="text/javascript"></script>
<script src="/common/js/piwik055.js" type="text/javascript"></script>
<noscript><img alt="" border="0" src="https://statistik.kivbf.de/piwik/piwik.php?idsite=51&action_name=Englisch%20/%20Topleiste%20/%20contact%20form"></noscript>
</body>
</html>