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=\"452404462\">    <input type=\"hidden\" name=\"meta_split_id\" value=\"\">    <input type=\"hidden\" name=\"unit\" value=\"energizeworks\">    <input type=\"hidden\" name=\"redirect\" value=\"http://lighttravels.com/Energize/verification.htm\" id=\"redirect_95ec5110e52babd563c8ad6d8f882bbb\">    <input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\">    <input type=\"hidden\" name=\"meta_adtracking\" value=\"Energize Subscribers\">    <input type=\"hidden\" name=\"meta_message\" value=\"1\">    <input type=\"hidden\" name=\"meta_required\" value=\"from,custom FirstName,custom Lastname,custom Permission to Be Repatterned\">    <input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\">    <table>    <tr><td colspan=2><center><font color=\"#006633\" size=\"5\"><div align=\"center\"><font face=\"Arial\" color=\"#004020\" size=\"4\">SUBSCRIBE to Energize! <br>- for free <br></font><strong><img height=\"101\" alt=\"\" src=\"file:///d:/My%20Documents/My%20Webs_/Light%20Travels/images/signupg.gif\" width=\"77\" border=\"0\"></strong><font color=\"#004020\"><em><strong>&nbsp; <br></strong></em></font><font size=\"3\"><font color=\"#000000\"><font face=\"Arial\">Please complete the form below and press the submit button.&nbsp; <br></font><font face=\"Arial\">The Program Includes&nbsp;4 full Group Proxy Repatternings&nbsp;held on the solstices and equinoxes</font><strong><em>.</em></strong></font></font></div></font></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=\"custom FirstName\" value=\"\" size=\"20\"></td></tr><tr><td>Last Name:</td><td><input type=\"text\" name=\"custom Lastname\" value=\"\" size=\"20\"></td></tr><tr><td>Telephone:</td><td><input type=\"text\" name=\"custom Telephone\" value=\"\" size=\"20\"></td></tr><tr><td>What is Your Experience with Holographic Repatterning To Date?:</td><td><select name=\"custom Experience with HR\"><option value=\"Please Select One\">Please Select One</option><option value=\"Heard about it from a friend\">Heard about it from a friend</option><option value=\"Just found this on the web\">Just found this on the web</option><option value=\"Have had a session with a practitioner\">Have had a session with a practitioner</option><option value=\"I am a  Holographic Repatterning Student\">I am a  Holographic Repatterning Student</option><option value=\"I am a Holographic Repatterning Practitioner or Teacher\">I am a Holographic Repatterning Practitioner or Teacher</option></select></td></tr><tr><td>Do You Believe? :</td><td><select name=\"custom Believe\"><option value=\"Select One\">Select One</option><option value=\"Do You Believe in Long Distance Healing?\">Do You Believe in Long Distance Healing?</option><option value=\"I am cynical but willing to try.\">I am cynical but willing to try.</option><option value=\"I believe but have never tried it.\">I believe but have never tried it.</option><option value=\"I might believe but need proof.\">I might believe but need proof.</option><option value=\"I totally believe and have had results with other programs!\">I totally believe and have had results with other programs!</option></select></td></tr><tr><td>Where do you need Resonance Repatterning in Your Life? :</td><td><select name=\"custom Area Needed\"><option value=\"Select One\">Select One</option><option value=\"Relationships or family\">Relationships or family</option><option value=\"Finances-Job - Career\">Finances-Job - Career</option><option value=\"Health\">Health</option><option value=\"A recent change or transition in my life\">A recent change or transition in my life</option><option value=\"My business - sales - corporate planning\">My business - sales - corporate planning</option><option value=\"Major Life Events - marriage - children - retirement\">Major Life Events - marriage - children - retirement</option><option value=\"More than one of the above categories!\">More than one of the above categories!</option><option value=\"Don't know\">Don't know</option></select></td></tr><tr><td valign=\"top\">Do You Have a Question for Carolyn? :</td><td><textarea name=\"custom Question for Carolyn\" rows=\"8\" cols=\"40\"></textarea></td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Permission to Be Repatterned\" checked> Yes - please proxy me into Energize! - the daily mini-group proxy healing session. </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>");

        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=LKxMLAwsLGxM";