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=\"648646649\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"triumph-ezine\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou.htm?m=default\" id=\"redirect_4eb53ad4c96932a1d5cd11d759432efa\"><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\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><div style=\"font-family: Arial; text-align: left\"><span style=\"font-weight: bold\"><font size=\"5\">Subscribe Now!</font></span></div> <div style=\"font-family: Arial; text-align: left\"><font size=\"3\">- </font><font style=\"font-family: Arial\" size=\"3\">Get free</font><font size=\"3\"> excerpts from our upcoming book: find out the 6 main reasons that people keep drinking and using, and what you can do today to help<span style=\"font-family: Arial\"></span></font></div><div style=\"font-family: Arial; text-align: left\"><font size=\"3\"><span style=\"font-family: Arial\">- </span>Get helpful addictions news-bytes and information&nbsp;</font></div><div style=\"text-align: left\"></div><div style=\"font-family: Arial\"><font size=\"3\">&nbsp;</font></div></center></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>First Name:</td><td><input type=\"text\" name=\"name\" 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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