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=\"1044853882\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"bookshelf\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_9677aae6e7d2e6f8758c7df9aeb8c172\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"inlineBookshelf-main\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from,name\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><font face=\"Arial\" size=\"3\"><strong>Don't Miss Out...Sign Up Now!</strong></font><br /><br /></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>Title:</td><td><input type=\"text\" name=\"custom Title\" value=\"\" size=\"20\"></td></tr><tr><td>School-Library-Company:</td><td><input type=\"text\" name=\"custom School-Library-Company\" value=\"\" size=\"20\"></td></tr><tr><td>Address Line 1:</td><td><input type=\"text\" name=\"custom Address Line 1\" value=\"\" size=\"20\"></td></tr><tr><td>Address Line 2:</td><td><input type=\"text\" name=\"custom Address Line 2\" value=\"\" size=\"20\"></td></tr><tr><td>City:</td><td><input type=\"text\" name=\"custom City\" value=\"\" size=\"20\"></td></tr><tr><td>State-Province:</td><td><input type=\"text\" name=\"custom State-Province\" value=\"\" size=\"20\"></td></tr><tr><td>Zip-Postal Code:</td><td><input type=\"text\" name=\"custom Zip-Postal Code\" value=\"\" size=\"20\"></td></tr><tr><td>Country:</td><td><input type=\"text\" name=\"custom Country\" value=\"\" size=\"20\"></td></tr><tr><td colspan=\"2\" align=\"left\">I Am a(n):</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom I Am A\" value=\"Teacher-Educator\"> Teacher-Educator</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom I Am A\" value=\"Librarian-Media Specialist\"> Librarian-Media Specialist</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom I Am A\" value=\"Comics Retailer\"> Comics Retailer</td></tr><tr><td colspan=\"2\"><input type=\"radio\" name=\"custom I Am A\" value=\"Other\"> Other</td></tr>    <tr><td colspan=2><center><strong><font face=\"Arial\" size=\"3\">* - Indicates a required field</font>.</strong><br></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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