document.write("<scr"+"ipt language=javascr"+"ipt>\n");
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document.write("<form  method=POST action=\"http://www.myhpws.org/cgi-bin/csFormbuilder/csFormbuilder.cgi\" name=\"form_11\"  >\n");
document.write("<input type=hidden name=form-id value=\"11\">\n");
document.write("<input type=hidden name=command value=\"mailform\">\n");
document.write("<link rel=\"stylesheet\" type=\"text/css\" href=\"http://www.myhpws.org/cgi-scr"+"ipt/csFormbuilder/forms/contactform.css\">\n");
document.write("<table border=\"0\" cellspacing=\"0\" cellpadding=\"3\">\n");
document.write("<tr><td class=\"textLabel\" colspan=2>Please fill out the following information and click the submit button. \"*\" indicates mandatory fields.</td></tr><tr><td class=\"textLabel\" colspan=2><hr width=\"100%\" size=\"1\" color=\"black\" align=\"left\"></td></tr><tr><td nowrap class=\"textLabel\" align=\"left\"  valign=\"top\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Comment topic </td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><table border=0 cellspacing=2 cellpadding=0><tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"comment_topic\" value=\"School\">\n");
document.write("  School</td>\n");
document.write("<td class=\"textLabel\"><div align=\"left\">\n");
document.write("  <p>&nbsp;</p>\n");
document.write("</div></td>\n");
document.write("</tr>\n");
document.write("<tr><td class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=radio name=\"comment_topic\" value=\"Website\">\n");
document.write("  Website</td><td class=\"textLabel\"> <div align=\"left\"></div></td></tr>\n");
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document.write("</tr>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">*First Name</td>\n");
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document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Name\"  size=\"25\"   maxlength=\"50\" ></td>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">*Last Name</td>\n");
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document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"LastName\"  size=\"25\"   maxlength=\"50\" ></td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">*Email</td>\n");
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document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Email\"  size=\"35\"   maxlength=\"100\" ></td>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">*Verify Email</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><input onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Email_Verify\"  size=\"35\"   maxlength=\"100\" ></td>\n");
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document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" ></td><td align=left valign=top nowrap class=\"textLabel\"><table align=left border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n");
document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\" align=\"left\">Comments/Questions/Concerns</td>\n");
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document.write("<tr>\n");
document.write("<td nowrap class=\"textLabel\"><textarea  onfocus=\"className='textFieldFocus'\" name=\"Comments\"  rows=\"5\" cols=\"50\"   maxlength=\"1000\"  ONCHANGE=\"TAMax(this,document.getElementById('Comments_D'),1000);\" ONBLUR=\"TAMax(this,document.getElementById('Comments_D'),1000);className='textField';\" ONKEYUP=\"TAMax(this,document.getElementById('Comments_D'),1000);\"></textarea><br><span id=\"Comments_D\">1000</span>&nbsp;characters remaining.</td>\n");
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document.write("</table> <!-- tr ph 4--></td></tr>\n");
document.write("<tr><td colspan=2 align=\"center\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=submit value=\"Submit\"></td></tr>\n");
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document.write("</form>\n");