// JavaScript Document
var FirstName = "newsletter";
var username = "John";
var hostname = "clearlight.com.au";
var spmeml = username + "@" + hostname;
document.write('<form method="POST" name="contact" action="http://mailgate.server-mail.com/cgi-bin/mailgate" onsubmit="return FormCheck();">\
<input type=hidden name="recipient" value="' + spmeml + '">\
<input type=hidden name="subject" value="Email from Clearlight web site">\
<input type=hidden name="redirect" value="http://www.clearlight.com.au/contacts/contactreturns/return' + FirstName + '.htm">\
<table border="0"><tr><td align="right" valign="top"><font size="1" color="black" face="Verdana, Arial, Helvetica, sans-serif">Your Request</font></td><td align="LEFT" valign="TOP">\
<input type=text name="realname" size="46"><br><br>\
<table border="0"><tr><td align="right" valign="top"><font size="1" color="black" face="Verdana, Arial, Helvetica, sans-serif">Your Full Name</font></td><td align="LEFT" valign="TOP">\
<input type=text name="realname" size="46">\
<br><br></td></tr><tr><td align="RIGHT" valign="TOP"><font size="1" color="black" face="Verdana, Arial, Helvetica, sans-serif">Your Email </font></td><td align="LEFT" valign="TOP">\
<input type=text name="email" size="46"><br>\
<br></td></tr><tr><td align="right" valign="top"><font color="black" size="1" face="Verdana, Arial, Helvetica, sans-serif">Your Organisation details</font></td><td align="LEFT" valign="TOP">\
<textarea name= "comments" rows=10 cols=70></textarea>\
</td></tr><tr><td align="right" valign="top">&nbsp;</td><td align="LEFT" valign="TOP"> &nbsp;<br>\
<input name="SUBMIT" type="SUBMIT" id="SUBMIT" value="Send Details">\
</td></tr></table>\
<div id="spmfld"><input type="text" name="spmfldtxt"></div>\
</form>');