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=\"1613793206\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"guatedirecto\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_8a4e503ad306090ab58242b5c48fe1e8\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"http://www.guatedirecto.com\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"\"><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>Primero tu informacion y despues la de tu compania. </div></center></td></tr><tr><td>Tu Nombre:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Tu Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Compania:</td><td><input type=\"text\" name=\"custom Nombre de la Compania\" value=\"\" size=\"20\"></td></tr><tr><td valign=\"top\">Descripcion:</td><td><textarea name=\"custom Descripcion de la Compania\" rows=\"5\" cols=\"18\"></textarea></td></tr><tr><td>Telefono:</td><td><input type=\"text\" name=\"custom Telefono\" value=\"\" size=\"20\"></td></tr><tr><td>Direcion:</td><td><input type=\"text\" name=\"custom Direcion de la Compania\" value=\"\" size=\"20\"></td></tr><tr><td>Categoria:</td><td><input type=\"text\" name=\"custom Categoria para tu impresa\" value=\"\" size=\"20\"></td></tr><tr><td>Pagina Web:</td><td><input type=\"text\" name=\"custom Pagina Web\" value=\"\" size=\"20\"></td></tr><tr><td>Paquete:</td><td><select name=\"custom Paquete\"><option value=\"Demo (gratis)\" selected>Demo (gratis)</option><option value=\"Basico\">Basico</option><option value=\"Premium\">Premium</option><option value=\"Deluxe\">Deluxe</option></select></td></tr>    <tr><td colspan=2><center><div>Para saber los precios y detalles de paquetes favor de revisar <a href=\"http://guatedirecto.com/?page_id=4959\" title=\"\">esta pagina</a>. Si escoges un paquete pagado te enviaremos la factura al correo electronico con un enlace donde puedes cancelar el pago con tarjeta. </div></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Submit\"></td></tr></table></form></center>");

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