document.write("<form  method=POST action=\"http://www.mediamessiah.com/cgi-scr"+"ipt/csFormbuilder/csFormbuilder.cgi\" name=\"form_1\"  >\n");
document.write("<input type=hidden name=form-id value=\"1\">\n");
document.write("<input type=hidden name=command value=\"mailform\">\n");
document.write("<link rel=\"stylesheet\" type=\"text/css\" href=\"http://www.mediamessiah.com/cgi-scr"+"ipt/csFormbuilder/forms/contact.css\">\n");
document.write("<table border=\"0\" cellspacing=\"0\" cellpadding=\"3\">\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"right\" >E-Mail:</td><td align=left valign=top nowrap class=\"textLabel\"><input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"return\"  > <!-- tr ph 0--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"right\"  valign=\"top\" >Subject: </td><td align=left valign=top nowrap class=\"textLabel\"><table border=0 cellspacing=2 cellpadding=0><tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"subject\" value=\"feedback\" ></td><td class=\"textLabel\">feedback</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"subject\" value=\"general question\" ></td><td class=\"textLabel\">general question</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"subject\" value=\"premium service question\" ></td><td class=\"textLabel\">premium service question</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"subject\" value=\"\"></td><td class=\"textLabel\">Other: <input type=text name=\"subject\"  ></td></tr>\n");
document.write("</table>\n");
document.write(" <!-- tr ph 1--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"right\" >Message:</td><td align=left valign=top nowrap class=\"textLabel\"><input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"main\"  size=\"35\"  > <!-- tr ph 2--></td></tr>\n");
document.write("<tr><td colspan=2 align=\"left\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=submit value=\"Submit\"></td></tr>\n");
document.write("</table>\n");
document.write("</form>\n");