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=\"1244428813\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"davidsnape\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_f5b18b5bde2fec4791fba14c1fe95144\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"Image + Name\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><P align=center div=\"center\"><FONT face=Arial size=4>Learn More about Gum Disease from </FONT></P><DIV align=center></DIV><P align=center div=\"center\"><FONT face=Arial size=4>David Snape - Author of: </FONT></P><DIV></DIV><P align=center div=\"center\"><IMG height=269 alt=\"\" src=\"http://www.whatyoushouldknowaboutgumdisease.com/images/book.png\" width=183 border=0></P><DIV></DIV></center></td></tr><tr><td>First Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr>    <tr><td colspan=2><center><DIV align=center>Your email address is safe, It will <STRONG>not</STRONG> be sold or rented to anyone at anytime. </DIV></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Submit\"></td></tr></table></form><img src=\"http://forms.aweber.com/form/ci/?tc=000099&bg=FFFF66&d=zBzsrJyMPoLqpkamTj7MnJws\" style=\"margin-top: 8px;\"></center>");

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