
document.write("<script type=\"text/javascript\">			function emdTrimstring(s)			{			  return s.replace(\"/^\\s+|\\s+$/\", \"\");			}			function emdValidateEmail(fld)			{				var tfld = emdTrimstring(fld);				var emailFilter = /^[^@]+@[^@.]+\\.[^@]*\\w\\w$/ ;				var illegalChars= /[\\(\\)\\<\\>\\,\\;\\:\\\\\"\\[\\]]/ ;				if (fld == \"\")				{					return false;				}				else if (!emailFilter.test(tfld))				{				   return false;				}				else if (fld.match(illegalChars))				{					return false;				}				return true;			}			function emdCheckRequiredField( fid, name, description,error_message )			{				document.getElementById(\"error_\"+fid).innerHTML = \"\";				if( document.getElementById(name).value == \"\" )				{					if(error_message!=\"\")						document.getElementById(\"error_\"+fid).innerHTML = error_message;					else 	document.getElementById(\"error_\"+fid).innerHTML = description + \" is required!\";					return false;				}else if(name==\"email_address\" && emdValidateEmail(document.emdform.email_address.value) == false){					if(error_message!=\"\")						document.getElementById(\"error_\"+fid).innerHTML = error_message;					else	document.getElementById(\"error_\"+fid).innerHTML = \"Please enter a valid email address!\";					return false;				}				return true;			}			function emdCheckSubmitForm()			{				var em=true;				var ref=document.getElementById(\"sf_ref\");				ref.value=document.referrer;		 if(!emdCheckRequiredField(10,\'first_name\',\'First Name\',\'\'))em=false; if(!emdCheckRequiredField(1,\'email_address\',\'Email Address\',\'\'))em=false;			return em;		}		function _ws_track_views(){		var _ws_track_img=new Image();		_ws_track_img.src=\'https://womsend.com/emd/v/6/1.gif?sf_ref=\'+encodeURIComponent(document.referrer)+\'&ref=\'+encodeURIComponent(document.location);		}		_ws_track_views();		</script>			<a name=\"_ws_form_6_1\"></a>			<form action=\"http://womsend.com/emd/submit_form.php\" method=\"post\" name=\"emdform\" id=\"emdform\" onsubmit=\"return emdCheckSubmitForm();\">			<input type=\"hidden\" name=\"fid\" id=\"fid\" value=\"1\" />			<input type=\"hidden\" name=\"cid\" id=\"cid\" value=\"6\" />			<input type=\"hidden\" name=\"ref\" id=\"sf_ref\" value=\"\" />			<table width=\"390\" height=\"120\" border=\"0\" cellpadding=\"1\" cellspacing=\"1\" style=\"background-color:#e1b73e;color:#000000\">			<tr>				<td colspan=\"2\"></td>			</tr>		<tr>					<td>First Name</td>					<td><input type=\"text\" name=\"first_name\" id=\"first_name\" value=\"\"  onblur=\"emdCheckRequiredField(10,\'first_name\',\'First Name\',\'\');\" /> * <div id=\"error_10\"></div></td></tr><tr>					<td>Email Address</td>					<td><input type=\"text\" name=\"email_address\" id=\"email_address\" value=\"\"  onblur=\"emdCheckRequiredField(1,\'email_address\',\'Email Address\',\'\');\" /> * <div id=\"error_1\"></div></td></tr>				<tr>				<td>&nbsp;</td>				<td><input type=\"submit\" value=\"Subscribe\" /> <br /> * required fields</td>				</tr>				</table>				</form>");
