document.write('</form>');document.write('<form method=post onsubmit="return SubmitForm()">');document.write('<TABLE class="" style="WIDTH: 310px; HEIGHT: 88px" cellSpacing=5 cellPadding=5 width=310 align=right bgColor=#f75948 border=0>');document.write('<TBODY>');document.write('<TR>');document.write('<TD colSpan=2><FONT style="FONT-SIZE: 12pt" face=Verdana size=3><STRONG>');document.write('<P align=center><FONT color=#ffffee>Request a Pick-Up</FONT></STRONG></FONT></P></TD></TR>');document.write('<TR>');document.write('<TD vAlign=center align=middle width="75%">');document.write('<TABLE class="" cellSpacing=0 cellPadding=0 width="100%" align=center bgColor=#ffffff border=0>');document.write('<TBODY>');document.write('<TR>');document.write('<TD align="center">');document.write('<input  name=email type="text" value="Enter your e-mail address" size="35" /></TD></TR></TBODY></TABLE></TD>');document.write('<TD width="75%" align=left vAlign=middle>');document.write('<P align=left><U>');document.write('  <input type="submit" name="Submit" value="Submit" OnClick="return SubmitForm()">');document.write('</U></P></TD></TR>');document.write('</TBODY></TABLE>');document.write('</form>');document.write('<form>');submitted = false;function SubmitForm(){if(!submitted){document.forms[1].action='ValidateRequestAPickupForm.aspx?rq=1&email='+document.forms[1].email.value;document.forms[1].submit();submitted=true;}return false;}