Code:
<center>
<form name="frm" action="#" method="post" target="_blank">
<div style="font-size: 12px; font-family: Tahoma;">Ihre Domain:<br />
<input type="text" maxlength="255" name="user" /> <select name="domain" onChange="this.form.action=this.options[this.selectedIndex].value;document.frm.uname.value=document.frm.user.value;">
<option value="#">Wählen Sie ihren Server:</option>
<option value="http://admin.hephaistos.xxx.de" id="Hephaistos.xxx.de">Hephaistos.xxx.de</option>
<option value="http://admin.zeus.xxx.de" id="Zeus.xxx.de">Zeus.xxx.de</option>
</select> <input type="hidden" name="uname" value="#" /></div>
<div style="font-size: 12px; font-family: Tahoma;"><strong>Ihr Passwort:</strong><br />
<input type="password" maxlength="255" name="upass" /><br />
<div style="font-size: 12px; font-family: Tahoma;"><input type="submit" tabindex="3" value=" Anmelden " name="Submit" /></div>
</div>
</form>
</center>
So hab ichs z.B.