   document.write("<!-- Web Form Generator 2.0 --><center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\"><input type=\"hidden\" name=\"meta_web_form_id\" value=\"111696094\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"clientwebapp\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.foreclosure-home-buying-secrets.com/thankyouapplication.html\" id=\"redirect_7c3e4255c78a1902152cfde628ee6856\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"zrgwebapp\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"name,custom Last,from,custom Street Address,custom City,custom State,custom Postal Code,custom Primary Phone Number,custom Secondary Phone Number,custom residence\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><div align=\"center\"><div align=\"center\"><h1><font size=\"5\" face=\"Verdana\">New Client Application</font></h1></div></div><div align=\"center\"><div align=\"center\"><font size=\"5\">Zwick Realty Group</font></div></div><div align=\"center\">Total Realty Corp.</div><div align=\"center\"><hr style=\"width: 100%;\" align=\"center\"><br>&nbsp;<div align=\"center\">&nbsp;</div></div></center></td></tr><tr><td>First Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Last  Name:</td><td><input type=\"text\" name=\"custom Last\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Street Address:</td><td><input type=\"text\" name=\"custom Street Address\" value=\"\" size=\"20\"></td></tr><tr><td>Addl Street Address:</td><td><input type=\"text\" name=\"custom Addl Street 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><input type=\"text\" name=\"custom State\" value=\"\" size=\"20\"></td></tr><tr><td>Postal Code:</td><td><input type=\"text\" name=\"custom Postal Code\" value=\"\" size=\"20\"></td></tr><tr><td>Primary Phone #:</td><td><input type=\"text\" name=\"custom Primary Phone Number\" value=\"\" size=\"20\"></td></tr><tr><td>Best Time to Call:</td><td><select name=\"custom test\"><option value=\"Morning\">Morning</option><option value=\"Afternoon\">Afternoon</option><option value=\"Evening\">Evening</option></select></td></tr><tr><td>Secondary Phone #:</td><td><input type=\"text\" name=\"custom Secondary Phone Number\" value=\"\" size=\"20\"></td></tr><tr><td>Fax #:</td><td><input type=\"text\" name=\"custom Fax\" value=\"\" size=\"20\"></td></tr><tr><td>What type of property are you interested in purchasing:</td><td><select name=\"custom residence\"><option value=\"Primary Residence\">Primary Residence</option><option value=\"Investment\">Investment</option><option value=\"Secondary Residence\">Secondary Residence</option><option value=\"For a Family Member\">For a Family Member</option><option value=\"Other\">Other</option></select></td></tr><tr><td>What is your time frame:</td><td><select name=\"custom time frame\"><option value=\"Now\">Now</option><option value=\"Next 3 months\">Next 3 months</option><option value=\"3-6 months\">3-6 months</option><option value=\"6-9 months\">6-9 months</option><option value=\"9-12 months\">9-12 months</option><option value=\"Over 12 months\">Over 12 months</option></select></td></tr><tr><td>Are you pre-approved with a lender:</td><td><select name=\"custom lender\"><option value=\"Yes\">Yes</option><option value=\"No\">No</option><option value=\"Don't need it-cash deal\">Don't need it-cash deal</option></select></td></tr><tr><td>Have you owned a home anytime in the last 3 years:</td><td><select name=\"custom last 3 years\"><option value=\"No\">No</option><option value=\"Yes\">Yes</option></select></td></tr><tr><td valign=\"top\">Any further comments:</td><td><textarea name=\"custom comments\" rows=\"10\" cols=\"30\"></textarea></td></tr>    <tr><td colspan=2><center><div align=\"center\"><div class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\"><font size=\"3\" face=\"Arial\">We will contact you as soon as we review your completed application. </font><em><font size=\"2\" face=\"Arial\"><br></font></em></div><div class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\"><em><font size=\"2\" face=\"Arial\">&nbsp;</font></em></div><div class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\"><em><font size=\"2\" face=\"Arial\">Zwick Realty Group and Total Realty Corp. respect			your privacy and will not share your information with any outside			third parties.</font></em></div><p class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\">			&nbsp;</p><p class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\">			&nbsp;</p><p class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\"><em><strong><font size=\"2\" face=\"Arial\"><a href=\"http://www.foreclosurehomebuyingsecrets.com/freereport/exampleapplication.pdf\"><br></a></font></strong></em></p><p class=\"MsoNormal\" style=\"margin: 0pt 30px; text-align: left;\" align=\"center\">&nbsp;</p></div></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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