FormOut = '	<form name="subscribe" method="post" action="/php/form_subscribe.php">'
	+ '	<input type="hidden" name="Mailing_List_Subscription_Form_Specifier" value="true">'
	+ '	<input type="hidden" name="valid_math_answer" value="16">'
	+ '	<table align="center" bgcolor="#17689d" border="0" cellpadding="1" cellspacing="0">'
	+ '	  <tbody>'
	+ '	    <tr>'
	+ '	      <td>'
	+ '	        <table bgcolor="#ffffff" border="0" cellpadding="4" cellspacing="0" width="100%">'
	+ '	          <tbody>'
	+ '	            <tr align="center">'
	+ '	              <td class="small" bgcolor="#17689d"><img src="/images/subscribe_header.gif" width="110" height="13"></td>'
	+ '	            </tr>'
	+ '	            <tr align="center">'
	+ '	              <td class="small"><font color="#000000" face="Arial" size="1">Enter your email for regular<br>'
	+ '	                discounts and updates:</font></td>'
	+ '	            </tr>'
	+ '	            <tr>'
	+ '	              <td class="small" align="center">'
	+ '	                <table border="0" cellpadding="3" cellspacing="0">'
	+ '	                  <tbody>'
	+ '	                    <tr>'
	+ '	                      <td><input name="SUBSCRIBE_Email" value size="15" type="text"></td>'
	+ '	                      <td><input src="/images/search_go.gif" name="Search" value="Submit" type="image" width="22" height="22"></td>'
	+ '	                    </tr>'
	+ '	                    <tr>'
	+ '			      <td style="font-family: Arial; font-size: 11px" align="right">9 + 7 =&nbsp;<input type="text" name="SUBSCRIBE_Math_Answer" size=3></td>'
	+ '	                      <td>&nbsp;</td>'
	+ '	                    </tr>'
	+ '	                  </tbody>'
	+ '	                </table>'
	+ '	              </td>'
	+ '	            </tr>'
	+ '	          </tbody>'
	+ '	        </table>'
	+ '	      </td>'
	+ '	    </tr>'
	+ '	  </tbody>'
	+ '	</table>'
	+ '	</form>';

document.write(FormOut);