document.write("    <!-- Web Form Generator 2.0 -->    <center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\" target=\"_new\">    <input type=\"hidden\" name=\"meta_web_form_id\" value=\"1849911101\">    <input type=\"hidden\" name=\"meta_split_id\" value=\"\">    <input type=\"hidden\" name=\"unit\" value=\"9daymotivator\">    <input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_e09b7a39a1e23c734bdb3e5cf086c059\">    <input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\">    <input type=\"hidden\" name=\"meta_adtracking\" value=\"25 motiv freestuff\">    <input type=\"hidden\" name=\"meta_message\" value=\"1\">    <input type=\"hidden\" name=\"meta_required\" value=\"name,from\">    <input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\">    <table>    <tr><td colspan=2><center><div align=\"center\"><strong><font color=\"#cc0000\">I Want to Get Motivated!</font></strong></div><div align=\"center\"><strong><font color=\"#cc0000\" size=\"2\">Send Me Your 9-Day Motivational E-Course</font></strong></div><div align=\"center\"><font color=\"#000000\" size=\"1\">(A confirmation email will be sent to you immediately. <br>Open it and click&nbsp;the link provided to complete your approval for contact.)</font></div><div align=\"center\"><font size=\"1\">*I WILL NEVER SELL OR SHARE YOUR INFORMATION*</font></div></center></td></tr><tr><td>First name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Last name:</td><td><input type=\"text\" name=\"custom Last\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Where do you live?:</td><td><input type=\"text\" name=\"custom City_State\" value=\"\" size=\"20\"></td></tr><tr><td>Phone # (optional):</td><td><input type=\"text\" name=\"custom Phone\" value=\"\" size=\"20\"></td></tr><tr><td>How did you find my website?:</td><td><input type=\"text\" name=\"custom Referral\" value=\"\" size=\"20\"></td></tr><tr><td>I want motivation to...:</td><td><input type=\"text\" name=\"custom Reason\" value=\"\" size=\"20\"></td></tr>        <tr><td colspan=2><center></center></td></tr>    <tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Push for Instant Motivation!\"></td></tr>    </table>    </form>        </center>");

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