//javascript access to form

document.write("<table border='1' cellpadding='10' cellspacing='0' bgcolor='#FFFFCC' width='450'>");
document.write("<tr><td>");
document.write("<font face='arial,helvetica,verdana'  size='1'>");
document.write("<center><font size='2'><b>Customer Priority Form</b></font></center><br>"); 
document.write("<form name='contact' method='POST' action='/cgi-bin/formmail.pl'>");
document.write("<input type=hidden name='recipient' value='jbeatty@fairwaydairy.com'>");
document.write("<input type=hidden name='subject' value='URGENT: Fairway Dairy and Ingredients Customer Priority Form'>");
document.write("<input type=hidden name='required' value='name,email,comments'>");
document.write("<input type=hidden name='redirect' value='http://www.fairwaydairy.com/thanks3.htm'>");
document.write("<b>What is this concerning?</b><br>");
document.write("<input type='radio' name='Concerning' value='Product Sales'>Product Sales<br>");
document.write("<input type='radio' name='Concerning' value='Product Purchase'>Product Purchase<br>");
document.write("<input type='radio' name='Concerning' value='Product Shipping'>Product Shipping<br>");
document.write("<input type='radio' name='Concerning' value='Other'>Other");
document.write("<p>");
document.write("<b>Name: </b><br><input type='text' name='name' value=' ' size='20'><br>");
document.write("<b>Email: </b><br><input type='text' name='email' value=' ' size='20'><br>");
document.write("<b>Comments:</b><br><textarea name='comments' value=' ' cols='35' rows='5'></textarea>");
document.write("<p>"); 
document.write("<center><b><input type='submit' value='Send'></b>&nbsp;  &nbsp;");
document.write("<input type='reset' name='clear' value='Clear'></center>");
document.write("</form>");
document.write("</font>");
document.write("</td></tr></table>");