document.writeln('<form method="post" action="http://www.realtyproductions.com/mail_new.php">');
document.writeln('      <input type="hidden" name="mailto" value="' + mailto + '"/>');
document.writeln('      <input type="hidden" name="subject" value="' + subject + '"/>');
document.writeln('      <input type="hidden" name="follow_link" value="' + follow_link + '"/>');
document.writeln('      <input type="hidden" name="follow_link_text" value="' + follow_link_text + '"/>');
if (typeof(referer) != "undefined")
	document.writeln('            <input type="hidden" name="http_referer" value="' + referer + '"/>');
document.writeln('');
document.writeln('      <table border="0" width="75%">');
document.writeln('              <tr>');
document.writeln('                      <td align="right">Name: </td><td colspan="3"><input type="text" name="Name" size="40"/></td>');
document.writeln('              </tr>');
document.writeln('              <tr>');
document.writeln('                      <td align="right">Email: </td><td colspan="3"><input type="text" name="Email" size="40"/></td>');
document.writeln('              </tr>');
if (form_type == 1)
{
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Your property address: </td><td colspan="3"><input type="text" name="Property_address" size="40"/></td>');
	document.writeln('              </tr>');
}
document.writeln('              <tr>');
document.writeln('                      <td align="right">Business Phone: </td><td><input type="text" name="Business_phone" size="15"/> </td><td colspan="2">(e.g. 888-888-8888)</td>');
document.writeln('              </tr>');
document.writeln('              <tr>');
document.writeln('                      <td align="right">Cell: </td><td><input type="text" name="Cell" size="15"/> </td><td colspan="2">(e.g. 888-888-8888)</td>');
document.writeln('              </tr>');
document.writeln('              <tr>');
document.writeln('                      <td align="right">Best time to reach you: </td><td colspan="3"><input type="text" name="Best_time_to_reach_you" size="30"/></td>');
document.writeln('              </tr>');
if (form_type == 1)
{
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Would you like to receive my newsletter? </td><td colspan="3"><select name="Receive_newsletter"><option name="yes" selected>Yes</option><option name="no">No</option></select></td>');
	document.writeln('              </tr>');
}
else if (form_type == 2)
{
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Add me to your mailing list? </td><td colspan="3"><select name="Add_to_mailing_list"><option name="yes" selected>Yes</option><option name="no">No</option></select></td>');
	document.writeln('              </tr>');
}
else if (form_type == 4)
{
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Type of home desired: </td><td colspan="3"><input type="text" name="Type_of_home_desired" size="30"/></td>');
	document.writeln('              </tr>');
	document.writeln('              <tr>');
	document.writeln('                      <td align="right"># Bedrooms: </td><td colspan="3"><select name="Number_bedrooms"><option name="1">1</option><option name="2">2</option><option name="3" selected>3</option><option name="4">4</option><option name="5">5</option><option name="> 5">&gt; 5</option></select></td>');
	document.writeln('              </tr>');
	document.writeln('              <tr>');
	document.writeln('                      <td align="right"># Bathrooms: </td><td colspan="3"><select name="Number_bathrooms"><option name="1">1</option><option name="2" selected>2</option><option name="3">3</option><option name="4">4</option><option name="5">5</option><option name="> 5">&gt; 5</option></select></td>');
	document.writeln('              </tr>');
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Desired location(s): </td><td colspan="3"><input type="text" name="Desired_location(s)" size="50"/></td>');
	document.writeln('              </tr>');
	document.writeln('              <tr>');
	document.writeln('                      <td align="right">Price range: </td><td colspan="3"><select name="Price_range"><option name="< $100,000">&lt; $100,000</option><option name="$100,000 to $150,000" selected>$100,000 to $150,000</option><option name="$150,001 to $250,000">$150,001 to $250,000</option><option name="> $250,000">&gt; $250,000</option></select></td>');
	document.writeln('              </tr>');
}
document.writeln('              <tr>');
document.writeln('                      <td align="right">Comments: </td><td colspan="3"><textarea name="Comments" rows="5" cols="46"></textarea></td>');
document.writeln('              </tr>');
document.writeln('              <tr>');
document.writeln('                      <td align="right">Type the characters you see to the right: </td><td width=1%><input type="text" name="security_code" size="15"/></td><td align="left" width=1%><img src="http://www.realtyproductions.com/CaptchaSecurityImages.php?width=150&height=40&characters=6"/></td><td><a href="javascript:this.location.reload()">New image</a></td>');
document.writeln('              </tr>');
document.writeln('              <tr>');
document.writeln('                      <td colspan="4" align="center"><br/><input type="reset"> <input type="submit" name="submit" value="Send"/></td>');
document.writeln('              </tr>');
document.writeln('      </table>');
document.writeln('</form>');