document.writeln('<h2>CastorOil Newsletter</h2>');
document.writeln('<ul><p><font size="2.5" face="Palatino Linotype">Don&acute;t Miss It! Get Latest from CastorOil Delivered in Your Mailbox. </font><b>Free!</b></p>');
document.writeln('<form name="email" action="http://castoroil.in/mlist/user/process.php" method="post" class="flogin">');
document.writeln('<table><tr><td colspan="2">Enter your current Email id</td></tr><tr><td colspan="2">');
document.writeln('<input type="text" name="Email" class="txtbox" id="email" size="20"/></td></tr>');
document.writeln('<tr><td colspan="2">Enter your name</td></tr><tr><td colspan="2">');
document.writeln('<input type="text" size="20" name="d[1]" class="txtbox" id="field1" /></td></tr>');
document.writeln('<tr><td colspan="2">Background</td></tr><tr><td colspan="2">');
document.writeln('<input type="text" size="20" name="d[2]" class="txtbox" id="field2" /></td></tr>');
document.writeln('<input type="hidden" name="formSubmitted" value="1" />');
document.writeln('<input type="hidden" name="pommo_signup" value="true" />');
document.writeln('<tr><td colspan="2" align="center"><input name="pommo_signup" type="submit" value="Subscribe"  alt="sign up" class="signup" />');
document.writeln('</td></tr></table></form></ul><br />');