document.write("<!-- Web Form Generator 2.0 --><center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\"><input type=\"hidden\" name=\"meta_web_form_id\" value=\"772546401\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"salmoncdrequest\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.omega-3.us/cdthanks.htm\" id=\"redirect_2a1c5b46fc9e08aa94078c492e5ba6b3\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"name,custom Last Name,from,custom Address,custom Phone\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center></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 Name\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td valign=\"top\">Address:</td><td><textarea name=\"custom Address\" rows=\"6\" cols=\"40\"></textarea></td></tr><tr><td>Phone:</td><td><input type=\"text\" name=\"custom Phone\" value=\"\" size=\"20\"></td></tr><tr><td>How Did You Find Us?:</td><td><select name=\"custom How did you find us\"><option value=\"Alltheweb\">Alltheweb</option><option value=\"AltaVista\">AltaVista</option><option value=\"America Online\">America Online</option><option value=\"AOLFind\">AOLFind</option><option value=\"Ask Jeeves\">Ask Jeeves</option><option value=\"BellaOnline\">BellaOnline</option><option value=\"Excite\">Excite</option><option value=\"Google\">Google</option><option value=\"Infoseek\">Infoseek</option><option value=\"Lycos\">Lycos</option><option value=\"MSN\">MSN</option><option value=\"Web Crawler\">Web Crawler</option><option value=\"Yahoo\">Yahoo</option><option value=\"Friend\">Friend</option><option value=\"Other\">Other</option></select></td></tr><tr><td valign=\"top\">Comments:</td><td><textarea name=\"custom Comments\" rows=\"4\" cols=\"40\"></textarea></td></tr>    <tr><td colspan=2><center></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Send My Free CD\"></td></tr></table></form></center>");

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