document.write("<title>ContactForm</title>\n");
document.write("<scr"+"ipt language=javascr"+"ipt>\n");
document.write("function TAMax( ta, countspan, maxlength ) {\n");
document.write(" if (ta.value.length > maxlength){\n");
document.write(" 	ta.value = ta.value.substring( 0, maxlength );\n");
document.write("  	ta.blur();\n");
document.write("  	ta.focus();\n");
document.write("  	return false;\n");
document.write(" 	}\n");
document.write(" else {\n");
document.write("  	countspan.innerHTML = maxlength - ta.value.length;\n");
document.write(" 	}\n");
document.write("}\n");
document.write("</scr"+"ipt>\n");
document.write("<form  method=POST action=\"http://forms.uia.net/cgi-bin/csFormbuilder/csFormbuilder.cgi\" name=\"form_1144\"  >\n");
document.write("<input type=hidden name=form-id value=\"1144\">\n");
document.write("<input type=hidden name=command value=\"mailform\">\n");
document.write("<link rel=\"stylesheet\" type=\"text/css\" href=\"http://forms.uia.net/cgi-scr"+"ipt/csFormbuilder/forms/AFX_EmailForm.css\">\n");
document.write("<table border=\"0\" cellspacing=\"0\" cellpadding=\"3\">\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" >*Name:</td><td align=left valign=top nowrap class=\"textLabel\"><input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Name\"  size=\"35\"  > <!-- tr ph 0--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" >*Email:</td><td align=left valign=top nowrap class=\"textLabel\"><input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"Email\"  > <!-- tr ph 1--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" >*Confirm Email:</td><td align=left valign=top nowrap class=\"textLabel\"><input  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" type=\"text\" name=\"emailConfirm\"  > <!-- tr ph 2--></td></tr>\n");
document.write("<tr><td nowrap class=\"textLabel\" align=\"left\" >*Please type your message here:</td><td align=left valign=top nowrap class=\"textLabel\"><textarea  onfocus=\"className='textFieldFocus'\" onblur=\"className='textField'\" class=\"textField\" name=\"Message\"  rows=\"5\" cols=\"35\"  ></textarea>   <!-- tr ph 3--></td></tr>\n");
document.write("<tr><td colspan=2 align=\"left\"><input onmouseover=\"className='buttonfieldFocus'\" onmouseout=\"className='buttonfield'\" class=\"buttonfield\" type=submit value=\"Submit\"></td></tr>\n");
document.write("</table>\n");
document.write("</form>\n");
document.write("<scr"+"ipt type=\"text/javascr"+"ipt\">\n");
document.write("jQuery.validator.setDefaults({\n");
document.write("debug: true,\n");
document.write("success: \"valid\"\n");
document.write("});\n");
document.write("</scr"+"ipt>\n");
document.write("  <scr"+"ipt>\n");
document.write("  $(document).ready(function(){\n");
document.write("    $(\"[name=form_1144]\").validate({\n");
document.write("  rules: {\n");
document.write("       Email: {\n");
document.write("         required: true,\n");
document.write("         email: true\n");
document.write("       },\n");
document.write("    emailConfirm: {\n");
document.write("      equalTo: \"[name=Email]\"\n");
document.write("    }\n");
document.write("  },\n");
document.write("   submitHandler: function(form){ \n");
document.write("      form.submit(); \n");
document.write("   },\n");
document.write("   messages: {\n");
document.write("      emailConfirm: \"Emails must match.\"\n");
document.write("   }\n");
document.write("});\n");
document.write("  });\n");
document.write("  </scr"+"ipt>\n");
document.write("<style>\n");
document.write("  #field, label { float: left; font-family: Arial, Helvetica, sans-serif; font-size: small; }\n");
document.write("  label {  width: 10em; }\n");
document.write("br { clear: both; }\n");
document.write("input { margin-left: .5em; float: left; border: 1px solid black; margin-bottom: .5em;  }\n");
document.write("input.submit { float: none; }\n");
document.write("input.error { border: 1px solid red; width: auto; }\n");
document.write("label.error {\n");
document.write("background: url('/images/unchecked.gif') no-repeat;\n");
document.write("padding-left: 16px;\n");
document.write("margin-left: .3em;\n");
document.write("}\n");
document.write("label.valid {\n");
document.write("background: url('/images/checked.gif') no-repeat;\n");
document.write("display: block;\n");
document.write("width: 16px;\n");
document.write("height: 16px;\n");
document.write("}\n");
document.write("</style>\n");