var split_id = 751008368;
   document.write("<center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\"><input type=\"hidden\" name=\"meta_web_form_id\" value=\"846777666\"><input type=\"hidden\" name=\"meta_split_id\" value=\"751008368\"><input type=\"hidden\" name=\"unit\" value=\"theearl-buyers\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.theearlofrealestate.net/thankyou.aspx\" id=\"redirect_fee07611309f8da86a03edf7b99896c3\"><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 Phone - Work\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><span class=\"scopy\">       <font size=\"2\" face=\"Verdana\"><font size=\"1\">Please take a few moments and provide Robert Earl some basic information so that he may begin assisting you in finding the home of your dreams.&nbsp; We will contact you by phone to discuss your specific wants and needs:</font><br></font></span></center></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>First & Last Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Phone - Work or Cell:</td><td><input type=\"text\" name=\"custom Phone - Work\" value=\"\" size=\"20\"></td></tr><tr><td colspan=\"2\" align=\"left\">Type of Home you are considering:</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Single Family Detached\"> Single Family Detached</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Low Rise Condo\"> Low Rise Condo</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Townhouse\"> Townhouse</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom High Rise Condo\"> High Rise Condo</td></tr><tr><td>Locations:</td><td><input type=\"text\" name=\"custom Locations\" value=\"\" size=\"20\"></td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Alexandria City\"> Alexandria City</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Fairfax County\"> Fairfax County</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Loudoun County\"> Loudoun County</td></tr><tr><td colspan=\"2\"><input type=\"checkbox\" name=\"custom Arlington County\"> Arlington County</td></tr><tr><td>How soon would you like to get in your new home:</td><td><input type=\"text\" name=\"custom How soon would you like to get in your new home\" value=\"\" size=\"20\"></td></tr><tr><td>How many bathrooms would best serve your needs:</td><td><input type=\"text\" name=\"custom How many bathrooms would best serve your needs\" value=\"\" size=\"20\"></td></tr><tr><td colspan=\"2\" align=\"left\">Have you been pre approved for a home loan yet:</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom Have you been pre approved for a home loan yet\" value=\"Yes\"> Yes</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom Have you been pre approved for a home loan yet\" value=\"No\"> No</td></tr><tr><td colspan=\"2\" align=\"left\">Are you a first time home buyer:</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom Are you a first time home buyer\" value=\"Yes\"> Yes</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom Are you a first time home buyer\" value=\"No\"> No</td></tr><tr><td>What price homes are you considering:</td><td><input type=\"text\" name=\"custom What price homes are you considering\" value=\"\" size=\"20\"></td></tr><tr><td>Are there any subdivisons in which you have specific interest:</td><td><input type=\"text\" name=\"custom Are there any subdivisons in which you have specific interest\" value=\"\" size=\"20\"></td></tr><tr><td valign=\"top\">How exactly can we assist you when we call back?:</td><td><textarea name=\"custom Are there any other Wants and Needs\" rows=\"3\" cols=\"20\"></textarea></td></tr><tr><td>When is the best time for you to view homes:</td><td><input type=\"text\" name=\"custom When is the best time for you to view homes\" value=\"\" size=\"20\"></td></tr><tr><td colspan=\"2\" align=\"left\">What is your mailing address?:</td></tr><tr><td>Address:</td><td><input type=\"text\" name=\"custom Address\" value=\"\" size=\"20\"></td></tr><tr><td>City:</td><td><input type=\"text\" name=\"custom City\" value=\"\" size=\"20\"></td></tr><tr><td>State:</td><td><select name=\"custom State\"><option value=\" \"> </option><option value=\"AK\">AK</option><option value=\"AL\">AL</option><option value=\"AR\">AR</option><option value=\"AZ\">AZ</option><option value=\"CA\">CA</option><option value=\"CO\">CO</option><option value=\"CT\">CT</option><option value=\"DC\">DC</option><option value=\"DE\">DE</option><option value=\"FL\">FL</option><option value=\"GA\">GA</option><option value=\"HI\">HI</option><option value=\"ID\">ID</option><option value=\"IL\">IL</option><option value=\"IN\">IN</option><option value=\"IA\">IA</option><option value=\"KS\">KS</option><option value=\"KY\">KY</option><option value=\"LA\">LA</option><option value=\"ME\">ME</option><option value=\"MD\">MD</option><option value=\"MA\">MA</option><option value=\"MI\">MI</option><option value=\"MN\">MN</option><option value=\"MS\">MS</option><option value=\"MO\">MO</option><option value=\"MT\">MT</option><option value=\"NE\">NE</option><option value=\"NV\">NV</option><option value=\"NH\">NH</option><option value=\"NJ\">NJ</option><option value=\"NM\">NM</option><option value=\"NY\">NY</option><option value=\"NC\">NC</option><option value=\"ND\">ND</option><option value=\"OH\">OH</option><option value=\"OK\">OK</option><option value=\"OR\">OR</option><option value=\"PA\">PA</option><option value=\"PR\">PR</option><option value=\"RI\">RI</option><option value=\"SC\">SC</option><option value=\"SD\">SD</option><option value=\"TN\">TN</option><option value=\"TX\">TX</option><option value=\"UT\">UT</option><option value=\"VT\">VT</option><option value=\"VA\">VA</option><option value=\"WA\">WA</option><option value=\"WV\">WV</option><option value=\"WI\">WI</option><option value=\"WY\">WY</option></select></td></tr><tr><td>Zip:</td><td><input type=\"text\" name=\"custom Zip\" 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>");

      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=HCxs7OzsbGxs&split_id=" + split_id;

