document.writeln('<div id=fdiv>\n\n<p style=\"color:red;\">* = required field<\/p>\n<form method=\"post\" action=\"/feedback.php?form=dealer_form\" target=\"_irs\" onsubmit=\"return _fbcheck(this)\">\n<table style=\"font-size: 1em\">\n<tr><td><b>Company Name<\/b><font color=\"red\">*<\/font><\/td><td><input name=\"n\" size=\"50\" value=\"\"><\/td><\/tr>\n<tr><td><b>Business Nature<\/b><\/td><td><input name=\"b\" size=\"50\"><\/td><\/tr>\n<tr><td><b>Contact Person<\/b><font color=\"red\">*<\/font><\/td><td><input name=\"c\" size=\"50\" value=\"\"><\/td><\/tr>\n<tr><td><b>Address<\/b><\/td><td><input name=\"ad1\" size=\"50\"><\/td><\/tr>\n<tr><td><\/td><td><input name=\"ad2\" size=\"50\"><\/td><\/tr>\n<tr><td><b>Postcode<\/b><\/td><td><input name=\"pc\" size=\"30\"><\/td><\/tr>\n<tr><td><b>Country<\/b><\/td><td><input name=\"cy\" size=\"30\"><\/td><\/tr>\n<tr><td><b>Phone No.<\/b><font color=\"red\">*<\/font><\/td><td><input name=\"t\" size=\"30\" value=\"\"><\/td><\/tr>\n<tr><td><b>Fax No.<\/b><\/td><td><input name=\"fx\" size=\"30\"><\/td><\/tr>\n<tr><td><b>Mobile No.<\/b><\/td><td><input name=\"mb\" size=\"30\"><\/td><\/tr>\n<tr><td><b>Email<\/b><font color=\"red\">*<\/font><\/td><td><input name=\"e\" size=\"30\" value=\"\"><\/td><\/tr>\n<tr><td><b>website<\/b><\/td><td><input name=\"p\" size=\"50\"><\/td><\/tr>\n<tr><td colspan=\"2\" align=\"center\"><input value=\"Send\" type=\"submit\"><\/td><\/tr>\n<\/table>\n\n<script type=\"text/javascript\">\nfunction _fbcheck(f) { \nif (f.n.value==\"\") { alert(\"Please enter your Company Name\"); f.n.focus(); return false; }\nif (f.c.value==\"\") { alert(\"Please enter your Name\"); f.c.focus(); return false; } \nif (f.t.value==\"\") { alert(\"Please enter your Contact No\"); f.t.focus(); return false; } \nif (f.e.value==\"\") { alert(\"Please enter your Email Address\"); f.e.focus(); return false; } \nreturn true; }\n<\/script>\n\n\n\n\n\n\n<script type=\"text/javascript\">\nfunction _fbcheck(f) { \nif (f.n.value==\"\") { alert(\"Please enter your Company Name\"); f.n.focus(); return false; }\nif (f.c.value==\"\") { alert(\"Please enter your Name\"); f.c.focus(); return false; } \nif (f.t.value==\"\") { alert(\"Please enter your Contact No\"); f.t.focus(); return false; } \nif (f.e.value==\"\") { alert(\"Please enter your Email Address\"); f.e.focus(); return false; } \nreturn true; }\n<\/script>\n</div><div style="display:none"><iframe width=1 height=1 name=_irs></iframe></div>');