document.write('<div class="applynow"><div class="theform"><form action="process1.php"><table width="400" border="0" align="center" cellpadding="5" cellspacing="0"><tr><td width="141"><div align="right">Name</div></td><td width="239"><div align="left"><input name="name" type="text" id="name" size="13" /> </div></td></tr><tr><td><div align="right">Email</div></td><td><div align="left"><input name="email" type="text" id="email" size="16" /></div></td></tr><tr><td colspan="2"><div align="center">Search Zip Code<input name="zip" type="text" id="zip" size="5" /></div><div align="left"></div></td></tr><tr><td colspan="2"><div align="center"><input type="submit" name="submit" id="submit" value="Get Me Into A Home!" onclick="javascript_alert_credit()" style="padding:8px; font-size:21px; margin-left: 50px;" /></div></td></tr></table></form></div></div>')