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=\"831774225\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"benbusaff\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.bentoncom.com/ezGaffcode.php\" id=\"redirect_415f8c8eaf2f6214931f68a2bab7bd85\"><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=\"from,custom nick,custom passwd\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"1\"><table><tr><td colspan=2><center><font size=\"1\">You should <b>*NOT*</b> use the same <font size=\"3\"><strong>password</strong></font> as your Clickbank account.<br>This password is for you to access your affiliate stats and resources and is<br>DIFFERENT from Clickbank's</font></center></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>ClickBankID:</td><td><input type=\"text\" name=\"custom nick\" value=\"\" size=\"20\"></td></tr><tr><td>Country:</td><td><input type=\"text\" name=\"custom country\" value=\"\" size=\"20\"></td></tr><tr><td>Website:</td><td><input type=\"text\" name=\"custom website\" value=\"\" size=\"20\"></td></tr><tr><td>Password:</td><td><input type=\"text\" name=\"custom passwd\" 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=\"Submit\"></td></tr></table></form></center>");

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