document.write('<form method=POST action="http://patkelleyrvpark.com/cgi-bin/FormMail.pl"target="_top">');
document.write('<INPUT TYPE="HIDDEN" NAME="recipient" VALUE="web15_karen@patkelleyrvpark.com">');
document.write('<INPUT TYPE="HIDDEN" NAME="subject"  VALUE="RV Park Registration"> ');
document.write('<INPUT TYPE="HIDDEN" NAME="redirect" VALUE="http://patkelleyrvpark.com/pages/thanks.htm">');
document.write('<INPUT TYPE="HIDDEN" NAME="required" VALUE="email,first_name,last_name,home_address,phone"> ');
document.write('<INPUT TYPE="HIDDEN" NAME="sort" value="through,first_name,last_name,phone_home,email,time_day,service_type,comments">');
document.write('<TABLE BORDER="0" cellpadding="0" cellspacing="0" width="100%">');

document.write('</td><td valign="top" align="25%">First Name<br>');
document.write('<INPUT TYPE="TEXT" NAME="first_name" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Last Name<br>');
document.write('<INPUT TYPE="TEXT" NAME="last_name" SIZE="20" class="shadeform">');


document.write('</TD></TR><TR><TD align="25%">Home Address<br>');
document.write('<INPUT TYPE="TEXT" NAME="home_address" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">City<br>');
document.write('<INPUT TYPE="TEXT" NAME="city" SIZE="20" class="shadeform">');

document.write('</td></tr><tr><td align="25%">State<br>');
document.write('<INPUT TYPE="TEXT" NAME="state" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Zip Code<br>');
document.write('<INPUT TYPE="TEXT" NAME="zip_code" SIZE="20" class="shadeform">');

document.write('</td></tr><tr><td align="25%">Phone<br>');
document.write('<INPUT TYPE="TEXT" NAME="phone" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Fax<br>');
document.write('<INPUT TYPE="TEXT" NAME="fax" SIZE="20" class="shadeform">');

document.write('</td></TR><td align="25%">E-Mail<br>');
document.write('<INPUT TYPE="TEXT" NAME="email" SIZE="20" class="shadeform">');

document.write('</td></TR><td align="25%">Date of Arrival<br>');
document.write('<INPUT TYPE="TEXT" NAME="arrival_date" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Time of Arrival<br>');
document.write('<INPUT TYPE="TEXT" NAME="arrival_time" SIZE="20" class="shadeform">');

document.write('</TD></TR><TR><TD align="25%">Departure Date<br>');
document.write('<INPUT TYPE="TEXT" NAME="departure_date" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Type of RV<br>');
document.write('<INPUT TYPE="TEXT" NAME="rv_type" SIZE="20" class="shadeform">');

document.write('</td></tr><tr><td align="25%">Length of RV<br>');
document.write('<INPUT TYPE="TEXT" NAME="rv_size" SIZE="20" class="shadeform">');

document.write('</td><td valign="top" align="25%">Eletrical Service Required<br>');
document.write('<INPUT TYPE="TEXT" NAME="electrical" SIZE="20" class="shadeform">');

document.write('</td></tr><tr><td align="middle"><br>Questons and/or Comments<br>');
document.write('<TEXTAREA NAME="comments" ROWS="5" COLS="30" wrap="soft" class="textarea"></TEXTAREA><p>');
document.write('<input type=submit value="Submit Information" onmouseover="this.className=\'buttonon\'" onmouseout="this.className=\'button\'" class="button">');
document.write('</FORM>');

document.write('</td></tr></table>');