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=\"349499716\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"pocnewsletter\"><input type=\"hidden\" name=\"redirect\" value=\"http://pocusa.info/thankyou.htm\" id=\"redirect_08ba7e90e228a1d77e63d44ce726b101\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"http://pocusa.info/alreadysubscribed.htm\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from,name,custom Last Name,custom City  Town,custom State,custom Zip Code\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><div><font size=\"5\"><span>Fields with an * are required<br></span></font></div></center></td></tr><tr><td>* Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>* First or nick 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>* City / Town:</td><td><input type=\"text\" name=\"custom City  Town\" value=\"\" size=\"20\"></td></tr><tr><td>* State:</td><td><input type=\"text\" name=\"custom State\" value=\"\" size=\"20\"></td></tr><tr><td>* Zip Code:</td><td><input type=\"text\" name=\"custom Zip Code\" value=\"\" size=\"20\"></td></tr><tr><td>Phone # w/area code:</td><td><input type=\"text\" name=\"custom Phone Area  number\" value=\"\" size=\"20\"></td></tr>    <tr><td colspan=2><center><div>Phone numbers used <em><strong>only</strong></em> if we lose your email address.</div><div>We strongly urge you to include yours as we have no other way </div><div>to contact you if your address becomes corrupted or is changed.&nbsp;</div></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Subscribe\"></td></tr></table></form></center>");

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      unique_track = new Image();
      unique_track.src = "http://forms.aweber.com/form/displays.htm?id=zCycLJyc7Ixs";