document.write('<style>\n#flexiform dt { margin: 0px; padding: 0px; float: none; width: auto; text-align: left; font-weight: bold; }\n#flexiform dd { margin: 0px 0px 0px 0px; padding: 0px; float: none; width: auto; }\n\n\n#flexiform dd { padding: 2px; margin-left: 250px; }\n#flexiform dl { overflow: hidden; }\n#flexiform dt\n{\n  font-weight: normal;\n  float: left;\n  clear:  both;\n  width: 28%;\n  clear: left;\n  padding-top:  0.5em;\n  text-align: left;\n}\n\n#form dd { margin-bottom: 0.5em; }\n#flexiform-submit { margin-left: 250px; value:Submit; }\n\n\n</style>\n<div id=\"flexiform\">\n\n  <p><P>WE HAVE A NEW CATALOGUE COMING SOON.</P>\n<P>If you would like a copy of our current catalogue, please fill in the request form. All sections must be completed before a catalogue will be sent.</P></p>\n\n  <form method=\"post\" action=\"http://forms.flexikit.net/public/javascript_collect/3528059\">\n\n    <dl>\n    \n      \n      <dt>\n        Title\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n          \n          \n          \n          \n          <select name=\"results[329][]\" >\n            \n            <option value=\"Mr\">Mr</option>\n            \n            <option value=\"Mrs\">Mrs</option>\n            \n            <option value=\"Miss\">Miss</option>\n            \n            <option value=\"Dr\">Dr</option>\n            \n            \n          </select>\n          \n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        First Name*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[262]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Last Name*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[263]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Job Title*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[264]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Company*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[265]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Type of Company*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n          \n          \n          \n          \n          <select name=\"results[273][]\" >\n            \n            <option value=\"Architect\n\">Architect\n</option>\n            \n            <option value=\"Builder\n\">Builder\n</option>\n            \n            <option value=\"Contractor\n\">Contractor\n</option>\n            \n            <option value=\"Consultant\n\">Consultant\n</option>\n            \n            <option value=\"Interior Designer\n\">Interior Designer\n</option>\n            \n            <option value=\"Hotel/Leisure\n\">Hotel/Leisure\n</option>\n            \n            <option value=\"Lighting Retailer\n\">Lighting Retailer\n</option>\n            \n            <option value=\"Lighting Wholesaler     \">Lighting Wholesaler     </option>\n            \n            \n            <option value=\"\" selected>Other, please specify...</option>\n            \n          </select>\n          \n          <div style=\"margin-left: 1em;\">Other <input type=\"text\" name=\"results[273][]\" value=\"\" /></div>\n          \n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Website Address\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[330]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Telephone*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[266]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Fax No\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[267]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Email*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[268]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Address Line 1*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[269]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Address Line 2\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[332]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Address Line 3\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[333]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Town*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[270]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        County\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[271]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Country*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[331]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Postcode*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <input type=\"text\" name=\"results[272]\" size=\"37\" value=\"\" class=\"flexiform-text\" />\n          \n        \n        \n      </dd>\n    \n      \n      <dt>\n        Area of Interest*\n        <div style=\"color: #777; font-weight: normal; font-size: 98%;\"></div>\n      </dt>\n      <dd>\n        \n        \n        \n          <textarea name=\"results[274]\" rows=\"3\" cols=\"30\" /></textarea>\n        \n        \n        \n      </dd>\n    \n    </dl>\n\n    <p><input type=\"submit\" value=\"Submit Form\" id=\"flexiform-submit\" /></p>\n  </form>\n\n  <p>* required information</p>\n\n</div>');