// Generated by Easy HTML To Any Script Converter
document.writeln("<style>");
document.writeln("<!--");
document.writeln(".phpForms_pgtitle");
document.writeln("{");
document.writeln("    font-family : Arial;");
document.writeln("    font-size   : 18px;");
document.writeln("    color       : #1200d9;");
document.writeln("    font-weight : bold;");
document.writeln("}");
document.writeln(".phpForms_btn");
document.writeln("{");
document.writeln("    border-top-width    : 1px;");
document.writeln("    border-left-width   : 1px;");
document.writeln("    border-bottom-width : 1px;");
document.writeln("    border-right-width  : 1px;");
document.writeln("    border-top-color    : #e4e4e4;");
document.writeln("    border-left-color   : #e4e4e4;");
document.writeln("    border-right-color  : #c1c1c1;");
document.writeln("    border-bottom-color : #c1c1c1;");
document.writeln("    font                : Verdana, Arial, Helvetica, sans-serif;");
document.writeln("    color               : #000000;");
document.writeln("}");
document.writeln("-->");
document.writeln("<\/style>");
document.writeln("");
document.writeln("<script language=\"JavaScript\">");
document.writeln("<!--");
document.writeln("var aIds = Array( \'pg_bab11d1bb6\' );");
document.writeln("var aId  = Array ();");
document.writeln("function ChangePage( to_hide, to_show )");
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document.writeln("function Email( old_res, id, field_title )");
document.writeln("{ ");
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document.writeln("   {");
document.writeln("      var el = document.getElementById( id );");
document.writeln("      if ( typeof(el)==\'object\' && el!=null && el.value!=\'\' )");
document.writeln("      {");
document.writeln("         var re = /^[a-zA-Z0-9_\\.\\-]+@([a-zA-Z0-9][a-zA-Z0-9-]+\\.)+[a-zA-Z]{2,6}$/;");
document.writeln("");
document.writeln("         if (el.value.search(re) != -1 )  return 0;");
document.writeln("         else");
document.writeln("         {");
document.writeln("            alert( \'\"\'+field_title+\'\" must be email\' );");
document.writeln("            return 1;");
document.writeln("         }");
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document.writeln("   return 0;");
document.writeln("}");
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document.writeln("				{");
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document.writeln("				}");
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document.writeln("}");
document.writeln("");
document.writeln("function dFilter (key, textbox, dFilterMask)");
document.writeln("{");
document.writeln("        if (key==96) key=48;");
document.writeln("		if (key==97) key=49;");
document.writeln("		if (key==98) key=50;");
document.writeln("		if (key==99) key=51;");
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document.writeln("		if (key==101) key=53;");
document.writeln("		if (key==102) key=54;");
document.writeln("		if (key==103) key=55;");
document.writeln("		if (key==104) key=56;");
document.writeln("		if (key==105) key=57;");
document.writeln("");
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document.writeln("		");
document.writeln("		if (key==9)");
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document.writeln("		{");
document.writeln("        dFilterNum=dFilterNum+String.fromCharCode(key);");
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document.writeln("");
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document.writeln("");
document.writeln("");
document.writeln("		textbox.value = dFilterFinal;");
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document.writeln("}");
document.writeln("");
document.writeln("function replace(fullString,text,by) {");
document.writeln("");
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document.writeln("");
document.writeln("-->");
document.writeln("<\/script>");
document.writeln("");
document.writeln("<form name=\"frm_17afff6cb7\" id=\"frm_17afff6cb7\" method=\"POST\" enctype=\"multipart/form-data\" action=\"http://www.wizworkz.net/pcrebath_form/index.php\" onSubmit=\"return false;\">");
document.writeln("<input type=\"hidden\" name=\"act\" value=\"idx\">");
document.writeln("<input type=\"hidden\" name=\"code\" value=\"01\">");
document.writeln("<input type=\"hidden\" name=\"fid\" value=\"17afff6cb7\">");
document.writeln("");
document.writeln("<script language=\"JavaScript\">");
document.writeln("<!--");
document.writeln("function CheckPagebab11d1bb6()");
document.writeln("{");
document.writeln("   var nResult = 0;");
document.writeln("      nResult += NotEmpty( nResult, \'fld_8371d26403\',\'Name\' );");
document.writeln("   nResult += Email( nResult, \'fld_bb30dcbe8c\',\'Email\' );");
document.writeln("   nResult += NotEmpty( nResult, \'fld_456b1c8bd6\',\'Message\' );");
document.writeln("");
document.writeln("   if ( nResult == 0 )");
document.writeln("   {  ");
document.writeln("      ");
document.writeln("      if (1)");
document.writeln("      {");
document.writeln("         var el = document.getElementById( \'frm_17afff6cb7\' );");
document.writeln("         if ( typeof(el)==\'object\' && el != null ) el.submit();");
document.writeln("      }");
document.writeln("      else ChangePage( 0, 1 );");
document.writeln("   }");
document.writeln("}");
document.writeln("-->");
document.writeln("<\/script>");
document.writeln("");
document.writeln("");
document.writeln("     <!-- Page -->");
document.writeln("     <table id=\"pg_bab11d1bb6\" border=\"0\" cellpadding=\"2\" cellspacing=\"1\" width=\"460\" bgcolor=\"#efefef\" class=\"phpForms_main\" style=\"display:;border: solid 1px #777777;\">");
document.writeln("");
document.writeln("");
document.writeln("    <tr>");
document.writeln("          <td width=\"30%\" align=\"left\" bgcolor=\"#cdcdcd\" valign=\"top\">");
document.writeln("             <span style=\"\">Name<\/span> <font color=\'red\'>*<\/font>");
document.writeln("          <\/td>");
document.writeln("          <td width=\"70%\" align=\"left\" bgcolor=\"#cdcdcd\">");
document.writeln("             <input type=\"text\" name=\"fld_8371d26403\"   id=\"fld_8371d26403\" value=\"\" style=\"width:100%;\">");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("      <tr>");
document.writeln("          <td width=\"30%\" align=\"left\" bgcolor=\"#cdcdcd\" valign=\"top\">");
document.writeln("             <span style=\"\">Email<\/span> <font color=\'red\'>*<\/font>");
document.writeln("          <\/td>");
document.writeln("          <td width=\"70%\" align=\"left\" bgcolor=\"#cdcdcd\">");
document.writeln("             <input type=\"text\" name=\"fld_bb30dcbe8c\"   id=\"fld_bb30dcbe8c\" value=\"\" style=\"width:100%;\">");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("      <tr>");
document.writeln("          <td width=\"30%\" align=\"left\" bgcolor=\"#cdcdcd\" valign=\"top\">");
document.writeln("             <span style=\"\">Phone<\/span>");
document.writeln("          <\/td>");
document.writeln("          <td width=\"70%\" align=\"left\" bgcolor=\"#cdcdcd\">");
document.writeln("             <input type=\"text\" name=\"fld_ab1ee1c43a\"   id=\"fld_ab1ee1c43a\" style=\"width:100%;\" onKeyPress=\"javascript:return dFilter (event.keyCode, this, \'(###) ###-####\');\" onKeyDown=\"javascript:return dFilter (event.keyCode, this, \'(###) ###-####\');\" >");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("      <tr>");
document.writeln("          <td width=\"30%\" align=\"left\" bgcolor=\"#cdcdcd\" valign=\"top\">");
document.writeln("             <span style=\"\">Message<\/span> <font color=\'red\'>*<\/font>");
document.writeln("          <\/td>");
document.writeln("          <td width=\"70%\" align=\"left\" bgcolor=\"#cdcdcd\">");
document.writeln("             <textarea name=\"fld_456b1c8bd6\" id=\"fld_456b1c8bd6\" rows=\"5\" style=\"width:100%;\"><\/textarea>");
document.writeln("");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("");
document.writeln("");
document.writeln("<tr>");
document.writeln("          <td colspan=\"2\" align=\"center\" class=\"phpForms_main\">");
document.writeln("            ");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("<tr>");
document.writeln("          <td colspan=\"2\" align=\"center\" class=\"phpForms_main\">");
document.writeln("");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("      <tr>");
document.writeln("          <!-- Buttons -->");
document.writeln("          <td colspan=\"2\" align=\"center\" class=\"phpForms_main\">");
document.writeln("<input type=\"button\" id=\"subbut\" value=\"Submit\" onClick=\'CheckPagebab11d1bb6();\' style=\"width:30%; background-color : #a2a2a2\" class=\"phpForms_btn\">");
document.writeln("");
document.writeln("          <\/td>");
document.writeln("      <\/tr>");
document.writeln("");
document.writeln("     <\/table>");
document.writeln("     <!-- /Page -->");
document.writeln("");
document.writeln("");
document.writeln("<\/form>");