document.write("<form action=\"http://www.harbourtownbonaire.com/mailinglist.asp?taal=us\" method=\"post\" enctype=\"application/x-www-form-urlencoded\" name=\"mailing\">\n<table width=\"350\" border=\"0\" cellspacing=\"0\" cellpadding=\"2\">\n<tr>\n<td>Name:</td><td><input type=\"text\" name=\"naam\"></td></tr>\n<tr>\n<td>Emailaddress</td><td><input type=\"text\" name=\"emailadres\"></td>\n</tr>\n<tr>\n<td>&nbsp;</td><td><input name=\"subscr\" type=\"radio\" value=\"on\" checked> subscribe &nbsp; &nbsp; <input type=\"radio\" name=\"subscr\" value=\"off\"> unsubscribe</td>\n</tr>\n<tr>\n<td>&nbsp;</td><td><input type=\"submit\" name=\"Submit\" value=\"Send\"></td>\n</tr>\n</table>\n</form>\n");