document.write("<!-- Web Form Generator 2.0 --><center><form method=\"post\" action=\"http://clients.xmailpro.com/scripts/addlead.pl\" target=\"_new\"><input type=\"hidden\" name=\"meta_web_form_id\" value=\"78602941\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"eft-mauritius\"><input type=\"hidden\" name=\"redirect\" value=\"http://clients.xmailpro.com/thankyou-coi.htm?m=audio\" id=\"redirect_eeefc97d5f1db351ffface876f9a9b2f\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><DIV align=center>Receive Free healing and info about Reiki classes and Seminars.<BR>Free ebooks when you join. Tell us about your problems or sickness. we will contact you . accept by filling this form.</DIV></center></td></tr><tr><td>Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Address:</td><td><input type=\"text\" name=\"custom Address\" value=\"\" size=\"20\"></td></tr><tr><td>TEL:</td><td><input type=\"text\" name=\"custom TEL\" value=\"\" size=\"20\"></td></tr>    <tr><td colspan=2><center><DIV><SPAN style=\"LINE-HEIGHT: 115%; FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 7.5pt\">Your information will never be rented, traded or sold.<BR><SPAN style=\"TEXT-TRANSFORM: uppercase\">We guarantee your confidentiality.</SPAN></SPAN></DIV></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Submit\"></td></tr></table></form></center>");

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