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=\"1394227396\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"backpainebook\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_004f80990eeaab7fe35b7103373f401e\"><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><div><h3><font color=\"#ff0000\">Sign up now to be put on the waiting list for our founder's <u>FREE</u> e-book on back pain.</font></h3><div><font color=\"#ff0000\">Written with honesty and insight by a professional writer who has true, first-hand experience with over 35 years of chronic back pain, this e-book promises to be unlike anything you've ever seen or read before.</font></div></div></div></center></td></tr><tr><td>Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr>    <tr><td colspan=2><center><address>(It's not ready yet, but by signing up today you will be among the very first to be informed when it is, and as we hate spam as much as you do, we promise we will not spam you or give or sell your information to anyone else.)</address></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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