document.write("<form method=\"post\" action=\"http://ymlp.com/subscribe.php?YMLPID=guyubehgmgs\" target=\"_blank\">\n<table style=\"width: 196px; height: 132px;\" align=\"center\" border=\"0\" cellpadding=\"3\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\"><font size=\"1\" face=\"verdana,geneva\">Repeat club members only!</font></td>\n</tr>\n<tr>\n<td valign=\"top\"><font size=\"1\" face=\"verdana,geneva\">First</font></td>\n<td valign=\"top\"><input name=\"YMP1\" size=\"20\" type=\"text\" /></td>\n</tr>\n<tr>\n<td valign=\"top\"><font size=\"1\" face=\"verdana,geneva\">Last</font></td>\n<td valign=\"top\"><input name=\"YMP2\" size=\"20\" type=\"text\" /></td>\n</tr>\n<tr>\n<td valign=\"top\"><font size=\"1\" face=\"verdana,geneva\">Email</font></td>\n<td valign=\"top\"><input name=\"YMP0\" size=\"20\" type=\"text\" /></td>\n</tr>\n<tr>\n<td colspan=\"2\"><input type=\"submit\" /></td>\n</tr>\n</tbody>\n</table>\n</form>");