document.write("<form method=\"post\" accept-charset=\"utf-8\" action=\"spamcheck.php\">")
document.write(" <p class=\"dark\" style=\"line-height: 14px;\">CONTACT US</p>")
document.write("Your Name:<br />")
document.write("<input name=\"name\" value=\"\" style=\"width: 170px; height: 18px;\" type=\"text\" /> <br />")
document.write("Your eMail:<br />")
document.write("<input name=\"email\" value=\"\" style=\"width: 170px; height: 18px;\" type=\"text\" /> <br />")
document.write("Remarks:<br />")
document.write("<textarea cols=\"40\" rows=\"4\" name=\"comment\" style=\"width: 170px; height: 60px;\"></textarea> <br />")
document.write("<input value=\"SEND\" style=\"position: relative; top: -4px; width: 85px;\" type=\"submit\" /> <input value=\"RESET\" style=\"position: relative; top: -4px; width: 85px;\" type=\"reset\" /><input name=\"key\" value=\"nRhCnXWg\" type=\"hidden\" />")
document.write("<span style=\"z-index: -1; position: relative; top: -70px;\">Please leave blank:<br />")
document.write("<input name=\"website\" value=\"\" style=\"width: 100px; height: 10px;\" type=\"text\" /> <br /></span></form>")