document.writeln('		<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">');
document.writeln('<style type="text/css">');
document.writeln('			<!--');
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document.writeln('		<form method="post" name="form1" enctype="multipart/form-data" action="http://www.sitemason.com/form/ieOweI">');
document.writeln('<input type="hidden" name="referer" value="http://www.belmont.edu/uc/current_student_info/uc_orientation.html">');
document.writeln('<input type="hidden" name="form__current_page" value="1">		<table id="sitemason_ieOweI" class="sitemason_form" border="0" cellspacing="0" cellpadding="0" style="width:525px;" align="center">			<tr>');
document.writeln('					<td class="sitemason_body">');
document.writeln('		');
document.writeln('		<div>');
document.writeln('  <h2 class="sitemason_header" style="width:96%; border-style:none; padding-top:1px; padding-bottom:1px; padding-right:5px; padding-left:5px; margin-top:6px; margin-bottom:6px; margin-right:8px; margin-left:8px; ">');
document.writeln('    <a name="Adult_Degree_Programs"></a><p style="text-align: left;"><span style="font-size: large;"><strong>Adult Degree Programs</strong><br />');
document.writeln('<strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</strong>&nbsp; &gt;&gt; Orientation Registration</span><strong><u><br />');
document.writeln('</u></strong><strong><u><br />');
document.writeln('</u></strong></p>');
document.writeln('<p style="text-align: center;"><u><strong><br />');
document.writeln('</strong></u></p></h2>');
document.writeln('  <div class="sitemason_body" style="text-align:left; border-style:none; ">');
document.writeln('    <div><span style="color: rgb(102, 0, 0);"><em><strong>*&nbsp; Denotes a required field</strong></em></span><br clear="all">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:250px; float:left;">');
document.writeln('      <label class="label" for="orientationdate"><b>*Select Orientation Based on Beginning Term:</label>');
document.writeln('    </div>');
document.writeln('    <div class="value" align="left" style="float:left; ">');
document.writeln('      <select name="orientationdate">');
document.writeln('        <option value="Spring 1 January 12th 2010">Spring 1 January 12th 2010</option>');
document.writeln('        <option value="Date Selection" selected>Select Date Below:</option>');
document.writeln('      </select>');
document.writeln('    </div>');
document.writeln('    <input type="hidden" name="fieldname">');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:300px; float:left;">');
document.writeln('      <label class="label" for="How_Many"><b>* How many people will be attending?</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:50px; " name="How_Many">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="Name">* <b>Full Name</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:200px; " name="Name">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="Address">* <b>Address</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:200px; " name="Address">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="City">* <b>City</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:100px; " name="City">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:60px; float:left;">');
document.writeln('      <label class="label" for="State">* <b>State</b></label>');
document.writeln('    </div>');
document.writeln('    <div class="value" align="left" style="float:left; ">');
document.writeln('      <select name="State">');
document.writeln('        <option value="AL">AL</option>');
document.writeln('        <option value="AK">AK</option>');
document.writeln('        <option value="AZ">AZ</option>');
document.writeln('        <option value="AR">AR</option>');
document.writeln('        <option value="CA">CA</option>');
document.writeln('        <option value="CO">CO</option>');
document.writeln('        <option value="CT">CT</option>');
document.writeln('        <option value="DE">DE</option>');
document.writeln('        <option value="DC">DC</option>');
document.writeln('        <option value="FL">FL</option>');
document.writeln('        <option value="GA">GA</option>');
document.writeln('        <option value="HI">HI</option>');
document.writeln('        <option value="ID">ID</option>');
document.writeln('        <option value="IL">IL</option>');
document.writeln('        <option value="IN">IN</option>');
document.writeln('        <option value="IA">IA</option>');
document.writeln('        <option value="KS">KS</option>');
document.writeln('        <option value="KY">KY</option>');
document.writeln('        <option value="LA">LA</option>');
document.writeln('        <option value="ME">ME</option>');
document.writeln('        <option value="MD">MD</option>');
document.writeln('        <option value="MA">MA</option>');
document.writeln('        <option value="MI">MI</option>');
document.writeln('        <option value="MN">MN</option>');
document.writeln('        <option value="MS">MS</option>');
document.writeln('        <option value="MO">MO</option>');
document.writeln('        <option value="MT">MT</option>');
document.writeln('        <option value="NE">NE</option>');
document.writeln('        <option value="NV">NV</option>');
document.writeln('        <option value="NH">NH</option>');
document.writeln('        <option value="NJ">NJ</option>');
document.writeln('        <option value="NM">NM</option>');
document.writeln('        <option value="NY">NY</option>');
document.writeln('        <option value="NC">NC</option>');
document.writeln('        <option value="ND">ND</option>');
document.writeln('        <option value="OH">OH</option>');
document.writeln('        <option value="OK">OK</option>');
document.writeln('        <option value="OR">OR</option>');
document.writeln('        <option value="PA">PA</option>');
document.writeln('        <option value="RI">RI</option>');
document.writeln('        <option value="SC">SC</option>');
document.writeln('        <option value="SD">SD</option>');
document.writeln('        <option value="TN" selected>TN</option>');
document.writeln('        <option value="TX">TX</option>');
document.writeln('        <option value="UT">UT</option>');
document.writeln('        <option value="VT">VT</option>');
document.writeln('        <option value="VA">VA</option>');
document.writeln('        <option value="WA">WA</option>');
document.writeln('        <option value="WV">WV</option>');
document.writeln('        <option value="WI">WI</option>');
document.writeln('        <option value="WY">WY</option>');
document.writeln('      </select>');
document.writeln('    </div>');
document.writeln('    <input type="hidden" name="fieldname">');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:50px; float:left;">');
document.writeln('      <label class="label" for="Zip">*<b> Zip</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:50px; " name="Zip">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="Day_Phone">* <b>Day Phone</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:100px; " name="Day_Phone">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="Eve_Phone"><b>Evening Phone</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:100px; " name="Eve_Phone">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="float:left; ">');
document.writeln('    <div style="text-align:left; width:100px; float:left;">');
document.writeln('      <label class="label" for="Email">*<b> Email Address</b></label>');
document.writeln('    </div>');
document.writeln('    <div align="left" class="value" style="float:left; ">');
document.writeln('      <input type="text" style="width:200px; " name="Email">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('  <div class="sitemason_body" style="text-align:left; border-style:none; margin-bottom:14px; ">');
document.writeln('    <div><u><strong><br />');
document.writeln('Special Notes:</strong></u><br />');
document.writeln('<span style="color: rgb(102, 0, 0);">We will be providing light refreshments for your convenience.&nbsp;&nbsp;<br />');
document.writeln('<br />');
document.writeln('Spouses and friends&nbsp;are welcome to come if you wish.&nbsp;&nbsp;<br />');
document.writeln('<br />');
document.writeln('You will receive an email with directions a few days before the event.<br />');
document.writeln('<br />');
document.writeln('Please call us with any questions at 615-460-5401.&nbsp;&nbsp;<br />');
document.writeln('We look forward to&nbsp;seeing you!</span><br clear="all">');
document.writeln('    </div>');
document.writeln('  </div>');
document.writeln('  <div class="sitemason_body" align="center" style="text-align:center; ">');
document.writeln('    <input type="submit" name="submit" value="Submit">');
document.writeln('  </div>');
document.writeln('  <br clear="all">');
document.writeln('</div>');
document.writeln('');
document.writeln('				</td>');
document.writeln('			</tr>');
document.writeln('			</table>');
document.writeln('		</form>');
