document.write("    <!-- Web Form Generator 2.0 -->    <center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\" target=\"_new\">    <input type=\"hidden\" name=\"meta_web_form_id\" value=\"1403057843\">    <input type=\"hidden\" name=\"meta_split_id\" value=\"\">    <input type=\"hidden\" name=\"unit\" value=\"msha-email\">    <input type=\"hidden\" name=\"redirect\" value=\"http://www.mshausa.org/ThankYouMSHAeMail.htm\" id=\"redirect_4beb397d670040c6f2d9182ce84e44e6\">    <input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\">    <input type=\"hidden\" name=\"meta_adtracking\" value=\"online\">    <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 align=center><STRONG><FONT color=#cc0000>SUBSCRIBE TO MSHA eMAIL</FONT></STRONG></DIV><DIV align=center>* conference updates</DIV><DIV align=center>*&nbsp;legislative updates</DIV><DIV align=center>*&nbsp;school updates</DIV><DIV align=center>* healthcare updates</DIV><DIV align=center>* private practice updates</DIV></center></td></tr><tr><td>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>Have different work and home emails?</DIV><DIV>Create a new&nbsp;subscription for each.</DIV></center></td></tr>    <tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"SUBSCRIBE NOW\"></td></tr>    </table>    </form>        </center>");

        function setCookie(name, value, expires, path, domain, secure) {
        var curCookie = name + "=" + escape(value) +
        ((expires) ? "; expires=" + expires.toGMTString() : "") +
        ((path) ? "; path=" + path : "") +
        ((domain) ? "; domain=" + domain : "") +
        ((secure) ? "; secure" : "");
        document.cookie = curCookie;
    }

    function getCookie(name) {
        var dc = document.cookie;
        var prefix = name + "=";
        var begin = dc.indexOf("; " + prefix);
        if (begin == -1) {
        begin = dc.indexOf(prefix);
        if (begin != 0) return null;
        } else
        begin += 2;
        var end = document.cookie.indexOf(";", begin);
    if (end == -1)
        end = dc.length;
        return unescape(dc.substring(begin + prefix.length, end));
    }


            unique_track = new Image();
        unique_track.src = "http://forms.aweber.com/form/displays.htm?id=jCwMzAys7BwszA==";