document.write("<form  method=POST action=\"http://www.mediamessiah.com/cgi-scr"+"ipt/csFormbuilder/csFormbuilder.cgi\" name=\"form_218\"  >\n");
document.write("<input type=hidden name=form-id value=\"218\">\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/CamNite.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 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\">Do you cam on MyFreeCams, Chaturbate, or CamSoda and like to be featured on CAMNiTE? If so please provide a link to your cam room!</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=\"caroom\"  size=\"100\"   maxlength=\"100\" ></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=\"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 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 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=\"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 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 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\" ></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 5--></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");