// common form top
document.write('<form action="http://www.gefoodalert.org/ext/procExtInvite.cfm" method="post" name="ContactForm">');
document.write('<input type="hidden" name="k" size="3">');
document.write('<input type="hidden" name="hostDom" size="3" value="' + document.location.host + '">');
document.write('<table border="0" cellpadding="2" cellspacing="8">');

if(  ( (!qStr) || (qStr.indexOf('gealertk=') == -1) )  &&  (!read_cookie('gealertk', 0))  )
{
	//contact part of form. Show if no query string
	document.write('<tr><td><font face="Arial,sans-serif" size="2">First Name</font><br><input type="text" name="fname" value="" size="29" maxlength="255"></td>');
	document.write('<td><font face="Arial,sans-serif" size="2">Last Name</font><br><input type="text" name="lname" value="" size="29" maxlength="255"></td></tr>');
	document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">E-mail Address</font><br><input type="text" name="emailAdd" value="" size="40" maxlength="255"></td></tr>');
	document.write('<tr><td><font face="Arial,sans-serif" size="2">Street Address</font><br><input type="text" name="streetAdd" value="" size="29" maxlength="255"></td>');
	document.write('<td><font face="Arial,sans-serif" size="2">City</font><br><input type="text" name="city" value="" size="29" maxlength="255"></td></tr>');
	document.write('<tr><td><font face="Arial,sans-serif" size="2">State</font><br><SELECT NAME="state" SIZE=1><option value="Unspecified"></option><OPTION>Alabama</OPTION><OPTION>Alaska</OPTION><OPTION>Arizona</OPTION><OPTION>Arkansas</OPTION><OPTION>California</OPTION><OPTION>Colorado</OPTION><OPTION>Connecticut</OPTION><OPTION>Delaware</OPTION><OPTION>District of Columbia</OPTION><OPTION>Florida</OPTION><OPTION>Georgia</OPTION><OPTION>Hawaii</OPTION><OPTION>Idaho</OPTION><OPTION>Illinois</OPTION><OPTION>Indiana</OPTION><OPTION>Iowa</OPTION><OPTION>Kansas</OPTION><OPTION>Kentucky</OPTION><OPTION>Louisiana</OPTION><OPTION>Maine</OPTION><OPTION>Maryland</OPTION><OPTION>Massachusetts</OPTION><OPTION>Michigan</OPTION><OPTION>Minnesota</OPTION><OPTION>Mississippi</OPTION><OPTION>Missouri</OPTION><OPTION>Montana</OPTION><OPTION>Nebraska</OPTION><OPTION>Nevada</OPTION><OPTION>New Hampshire</OPTION><OPTION>New Jersey</OPTION><OPTION>New Mexico</OPTION><OPTION>New York</OPTION><OPTION>North Carolina</OPTION><OPTION>North Dakota</OPTION><OPTION>Ohio</OPTION><OPTION>Oklahoma</OPTION><OPTION>Oregon</OPTION><OPTION>Pennsylvania</OPTION><OPTION>Rhode Island</OPTION><OPTION>South Carolina</OPTION><OPTION>South Dakota</OPTION><OPTION>Tennessee</OPTION><OPTION>Texas</OPTION><OPTION>Utah</OPTION><OPTION>Vermont</OPTION><OPTION>Virginia</OPTION><OPTION>Washington</OPTION><OPTION>West Virginia</OPTION><OPTION>Wisconsin</OPTION><OPTION>Wyoming</OPTION></SELECT></td>');
	document.write('<td><font face="Arial,sans-serif" size="2">Postal Code</font><br><input type="text" name="zip" value="" size="15" maxlength="255"></td></tr>');
}
// common form bottom
document.write("<tr><td colspan=2><font face='Arial,sans-serif' size=2>Type in your message here:</font><br><textarea cols=53 rows=6 name='invitationTxt' wrap='physical'>Did you know that the Kellogg cereal you eat probably contains Genetically Engineered corn?  Or that your favorite Campbell's soup probably uses Genetically Engineered ingredients?\n\nNeither did I.  That's why I sent a FREE email to those companies and the FDA at http://www.GEFoodAlert.org.\n\nRight now, there are hundreds of products on our grocery store shelves that contain genetically engineered food products - without testing or labeling!  And that's compromising our health and safety.\n\nSo let the FDA and our corporate leaders know that we deserve to know what's in our food, and that it's safe to eat, at http://www.GEFoodAlert.org.\n\nAnd let your other friends know about this campaign too!  Forward my message along to people you know who care about our health and safety!</textarea></td></tr>");
document.write('<tr><td><font face="Arial,sans-serif" size="2">Friend\'s First Name <sup>*</sup></font><br><input type="text" name="inviteFname" value="" size="28" maxlength="255"></td></tr>');
document.write('<tr><td><font face="Arial,sans-serif" size="2">Friend\'s Last Name<sup>*</sup></font><br><input type="text" name="inviteLname" value="" size="28" maxlength="255"></td></tr>');
document.write('<tr><td><font face="Arial,sans-serif" size="2">Friend\'s E-mail Address <sup>*</sup></font><br><input type="text" name="inviteEmailAdd" value="" size="28" maxlength="255"></td></tr>');
document.write('<tr><td colspan="2" align="center"><br><br><input type="submit" name="submit" value="Send My Messages!" onclick="return(valFrmFlds());"></td></tr>');
document.write('</table>');
document.write('</form>');