// Common form top
document.write('<form action="http://www.gefoodalert.org/ext/procExtVolunteer.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>');
}
// volunteer form fields
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Websites where you can link to us</font><br><input type="text" name="linkableWebsites" value="" size="60" maxlength="255"></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Are you a</font>  ');
document.write('<select name="VIPInfo" size="1">');
document.write('<option value="unspecified">Select One</option>');
document.write('<option value="Health Professional">Health Professional</option>');
document.write('<option value="Chef">Chef</option>');
document.write('<option value="Academic">Academic</option>');
document.write('<option value="Scientist">Scientist</option>');
document.write('<option value="Farmer">Farmer</option>');
document.write('<option value="Elected Official">Elected Official</option>');
document.write('<option value="Religious Leader">Religious Leader</option>');
document.write('<option value="Business Leader">Business Leader</option>');
document.write('<option value="other">other</option>');
document.write('</select></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Do you represent an organization that would like to sign-on to this campaign?</font></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Name of Organization</font><br><input type="text" name="orgName" value="" size="40" maxlength="255"></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Phone Number</font><br><input type="text" name="orgPhone" value="" size="40" maxlength="255"></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Will you help out in person?<br><input type="radio" name="helpInPerson" value="Rallies"> Rallies  &nbsp;&nbsp; <input type="radio" name="helpInPerson" value="Signature Gatherings"> Signature Gatherings</font></td></tr>');
document.write('<tr><td colspan="2"><font face="Arial,sans-serif" size="2">Would you contribute money to this campaign?<br><input type="radio" name="contributeMoney" value="1"> Yes &nbsp;&nbsp; <input type="radio" name="contributeMoney" value="0"> No</font></td></tr>');

// common form bottom
document.write('<tr><td colspan="2" align="center"><br><input type="submit" name="submit" value="Sign Up!" onclick="return(valFrmFlds());"></td></tr>');
document.write('</table>');
document.write('</form>');