document.write("<form  method=POST action=\"http://www.mediamessiah.com/cgi-scr"+"ipt/csFormbuilder/csFormbuilder.cgi\" name=\"form_190\"  >\n");
document.write("<input type=hidden name=form-id value=\"190\">\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/GirlOfSummer2017.css\">\n");
document.write("<table border=\"0\" cellspacing=\"0\" cellpadding=\"3\">\n");
document.write("<tr><td class=\"textLabel\" colspan=2>Models registration form (for model use only)</td></tr><tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Email:</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Email\"  size=\"50\"  ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 0--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Twitter Username</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"twitter\"  size=\"50\"   maxlength=\"50\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 1--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td class=\"textLabel\" colspan=2>Would you like to submit a 2 minute promotional video for the Summer Camp webcast? The 5 best submissions win necklaces + ALL participants advance directly to the Girl Of Summer SEMI FINALS + receive advanced nomination for CAMMY AWARDS! If you select YES, you will receive further instructions via e-mail.</td></tr><tr><td nowrap class=\"textLabel\" align=\"left\"  valign=\"top\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Will you make the video submission? </td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td 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=\"summercamp\" value=\"YES PLEASE! I'll submit a video to advance directly to Semi Finals &amp; to get an advanced Cammy Awards nomination!\" ></td><td class=\"textLabel\">YES PLEASE! I'll submit a video to advance directly to Semi Finals &amp; to get an advanced Cammy Awards nomination!</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"summercamp\" value=\"No Thanks. I'll take the long route and hope for the best.\" ></td><td class=\"textLabel\">No Thanks. I'll take the long route and hope for the best.</td></tr>\n");
document.write("</table>\n");
document.write("</td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 2--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\"  valign=\"top\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*What regional CAMMY AWARDS title should you be considered for? </td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td 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=\"regional\" value=\"None! I'm NOT a cam model\" ></td><td class=\"textLabel\">None! I'm NOT a cam model</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"regional\" value=\"United States\" ></td><td class=\"textLabel\">United States</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"regional\" value=\"Canada\" ></td><td class=\"textLabel\">Canada</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"regional\" value=\"International (all others)\" ></td><td class=\"textLabel\">International (all others)</td></tr>\n");
document.write("</table>\n");
document.write("</td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 3--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Which Cammy Awards 2018 title would you like to be nominated for? </td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><select name=\"whichaward\"  size=\"1\"   onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\">\n");
document.write("<option value=\"\">-= Select =-</option>\n");
document.write("<option>None! I'm NOT a cam model</option>\n");
document.write("<option>Crossover Performer Of The Year</option>\n");
document.write("<option>Cam Girl Rookie Of The Year</option>\n");
document.write("<option>Cam Girl Duo Of The Year (2 girls)</option>\n");
document.write("<option>Cam Couple Of The Year (boy/girl)</option>\n");
document.write("<option>Pornstar Live Performer Of The Year</option>\n");
document.write("<option>Alternative Performer Of The Year</option>\n");
document.write("<option>Curvaceous Performer Of The Year</option>\n");
document.write("<option>Cosplay Performer Of The Year</option>\n");
document.write("<option>Fetish Performer Of The Year</option>\n");
document.write("<option>MILF Performer Of The Year</option>\n");
document.write("<option>Most Creative Cam Girl</option>\n");
document.write("<option>4:20 Model Of The Year</option>\n");
document.write("<option>Gamer Girl Of The Year</option>\n");
document.write("<option>Best Body</option>\n");
document.write("<option>Best Butt</option>\n");
document.write("<option>Best Boobs</option>\n");
document.write("<option>Best Smile</option>\n");
document.write("</select>&nbsp;</td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 4--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\"  valign=\"top\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Would you like to be included on ballot for DIVA / BOSS contests & 2018 Princess Of The Year? </td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td 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=\"princess\" value=\"YES\" ></td><td class=\"textLabel\">YES</td></tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"princess\" value=\"NO\" ></td><td class=\"textLabel\">NO</td></tr>\n");
document.write("</table>\n");
document.write("</td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 5--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"right\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"right\">NFL fan? Enter your fav NFL team to be included free in the MissSuperSunday.com 2017-18 contest! (optional)</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"misssupersunday\"  size=\"40\"   maxlength=\"40\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 6--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"right\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"right\">Hockey fan? Enter your fav NHL team to be included free in the MissPuckBunny.com 2018 contest! (optional)</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"misspuckbunny\"  size=\"40\"   maxlength=\"40\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 7--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"right\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"right\">Game of Thrones fan? Enter your fav character to be included free in the QueenOfCams.com 2017 contest! (optional)</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"queenofcams\"  size=\"40\"   maxlength=\"40\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 8--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td class=\"textLabel\" colspan=2>When is your Cammiversary? A.K.A. The anniversary of the date you started camming! Please include yours so we know what day to celebrate! Leave blank if you are NOT a cam model or don't like receiving gifts.</td></tr><tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">What is your Cammiversary date? Use format: MM/DD/YYYY</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"cammiversary\"  size=\"40\"   maxlength=\"40\" ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 9--></td></tr>\n");
document.write("<tr><td class=\"textLabel\" colspan=2><hr width=\"100%\"   align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\">Verify Authentication Code:</td>\n");
document.write("</tr>\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><img id=\"Verification_img\" align=absmiddle border=0 width=59 height=15 src=\"\"><input type=hidden id=\"Verification_sid\" name=\"Verification_sid\" value=\"\"> <scr"+"ipt language=javascr"+"ipt src=\"http://www.mediamessiah.com/cgi-scr"+"ipt/csFormbuilder/vimage.cgi?command=g&f=Verification\"></scr"+"ipt>&nbsp;<input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Verification\"  ></td>\n");
document.write("</tr>\n");
document.write("</table> <!-- tr ph 10--></td></tr>\n");
document.write("<tr><td colspan=2 align=\"left\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=button value=\"Back\" onClick=\"history.back();\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=submit value=\"Submit\"></td></tr>\n");
document.write("</table>\n");
document.write("</form>\n");