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document.writeln('					<tr>');
document.writeln('  <td>');
document.writeln('    <h1 class="sitemason_title">SIGN UP FORM</h1>');
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document.writeln('</tr>			<tr>');
document.writeln('					<td class="sitemason_body">');
document.writeln('		');
document.writeln('		<div>');
document.writeln('  <div class="sitemason_body" style="text-align:left; ">');
document.writeln('    <div>Yes, add me to Jim’s Shooting USA e-mail news list.              *required<br clear="all">');
document.writeln('    </div>');
document.writeln('  </div>');
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document.writeln('      <input type="text" style="width:200px; " name="email">');
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document.writeln('      <label class="label" for="first_name">*First Name</label>');
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document.writeln('      <input type="text" style="width:160px; " name="first_name">');
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document.writeln('      <label class="label" for="last_name">*Last Name</label>');
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document.writeln('      <label class="label" for="address_1">Address</label>');
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document.writeln('    <div style="text-align:right; width:50%; float:left;">');
document.writeln('      <label class="label" for="city">City</label>');
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document.writeln('    <div style="text-align:right; width:50%; float:left;">');
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document.writeln('      <select name="state">');
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document.writeln('        <option value="NY">New York</option>');
document.writeln('        <option value="NC">North Carolina</option>');
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document.writeln('        <option value="OK">Oklahoma</option>');
document.writeln('        <option value="OR">Oregon</option>');
document.writeln('        <option value="PA">Pennsylvania</option>');
document.writeln('        <option value="RI">Rhode Island</option>');
document.writeln('        <option value="SC">South Carolina</option>');
document.writeln('        <option value="SD">South Dakota</option>');
document.writeln('        <option value="TN">Tennessee</option>');
document.writeln('        <option value="TX">Texas</option>');
document.writeln('        <option value="UT">Utah</option>');
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document.writeln('      <label class="label" for="zip_code">Zip Code</label>');
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document.writeln('    <div><br />');
document.writeln('Let me know what you’re most interested in. (Select all that apply)<br clear="all">');
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document.writeln('      <label class="label" for="rifles_and_handguns">Rimfire Shooting (Rifles and Handguns)</label>');
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document.writeln('      <label class="label" for="black_powder_shooting">Black Powder Shooting</label>');
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document.writeln('      <label class="label" for="hunting">Hunting</label>');
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document.writeln('    <div style="text-align:right; width:50%; float:left;">');
document.writeln('      <label class="label" for="reloading">Reloading</label>');
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document.writeln('    <div style="text-align:right; width:50%; float:left;">');
document.writeln('      <label class="label" for="collecting">Collecting</label>');
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document.writeln('      <input type="checkbox" name="collecting" value="Yes"><span class="sitemason_body">Yes</span><input type="hidden" name="collecting">');
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document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="width:100%; margin:0px; float:left; ">');
document.writeln('    <div style="text-align:right; width:50%; float:left;">');
document.writeln('      <label class="label" for="archery">Archery</label>');
document.writeln('    </div>');
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document.writeln('        <input type="checkbox" name="archery" value="Yes">Yes</div>');
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document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="text-align:left; ">');
document.writeln('    <div>Confirmation:  Yes, I want to receive e-mail news from Jim Scoutten and Shooting USA.<br clear="all">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" style="text-align:left; ">');
document.writeln('    <div>Please submit once and wait a moment for a confirmation on your screen.<br clear="all">');
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