document.write('\
			<table width="500" border="0" cellspacing="0" cellpadding="0">\
              <tr>\
                <td><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
              </tr>\
              <tr>\
                <td><table width="500" border="0" cellspacing="0" cellpadding="0">\
                  <tr>\
                    <td colspan="4"><table border="0" cellspacing="0" cellpadding="0">\
                      <tr valign="baseline">\
                        <td>I am applying for:&nbsp;</td>\
                        <td width="224"><form name="form2" method="post" action="jobapplication2.asp">\
                          <select name="select" size="1" class="products">\
                            <option selected>Choose Position</option>\
                            <option>Customer Service Reps</option>\
                            <option>Production Personnel</option>\
                            <option>Restoration</option>\
                            <option>Home Delivery</option>\
                            <option>General/Admin</option>\
                          </select>\
                          </td>\
                      </tr>\
                    </table></td>\
                    </tr>\
                  <tr>\
                    <td colspan="4" valign="top" class="header1"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                    </tr>\
                  <tr>\
                    <td colspan="4" valign="top" class="header1">Contact Information</td>\
                  </tr>\
                  <tr>\
                    <td colspan="4" valign="top" class="header1"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td width="87">Name</td>\
                    <td width="161">\
                      <input name="name" type="text" id="name3" size="15">\
                    </td>\
                    <td width="97">Work Phone </td>\
                    <td width="155">\
                      <input name="wphone" type="text" id="name4" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Address </td>\
                    <td>\
                      <input name="street" type="text" id="street3" size="15">\
                    </td>\
                    <td>Home Phone</td>\
                    <td>\
                      <input name="hphone" type="text" id="hphone" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>City</td>\
                    <td>\
                      <input name="city" type="text" id="street4" size="15">\
                    </td>\
                    <td>Fax</td>\
                    <td>\
                      <input name="fax" type="text" id="fax" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>State</td>\
                    <td><input type="text" name="state" size="2" maxlength="2"></td>\
                    <td>Email</td>\
                    <td>\
                      <input name="email" type="text" id="email" size="15">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Zip Code </td>\
                    <td>\
                      <input name="zip" type="text" id="street6" size="5">\
                    </td>\
                    <td>Voice Mail </td>\
                    <td>\
                      <input name="vmail" type="text" id="vmail" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4">&nbsp;</td>\
                    </tr>\
                  <tr valign="top">\
                    <td colspan="4"><strong class="header1">Academic Achievement</strong></td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Education </td>\
                    <td>\
                      <input name="ed" type="text" id="name5" size="15">\
                    </td>\
                    <td>Degree Obtained</td>\
                    <td>\
                      <input name="degree" type="text" id="name7" size="15">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Certification</td>\
                    <td>\
                      <input name="cert" type="text" id="name6" size="15">\
                    </td>\
                    <td>Year</td>\
                    <td>\
                      <input name="affil" type="text" id="name8" size="15">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Comments</td>\
                    <td colspan="3" rowspan="2">\
                      <textarea name="comments1" cols="64" rows="4" id="comments1"></textarea>\
                    </td>\
                    </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                    </tr>\
                  <tr valign="top">\
                    <td colspan="4">&nbsp;</td>\
                    </tr>\
                  <tr valign="top">\
                    <td colspan="4"><strong class="header1">Work History (Present) </strong></td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Employer</td>\
                    <td>\
                        <input name="employ" type="text" id="name3" size="15">\
                    </td>\
                    <td>Title</td>\
                    <td>\
                        <input name="title" type="text" id="name4" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Hire Date <span class="productssmall"></span></td>\
                    <td>\
                        <input name="hire" type="text" id="street3" size="15">\
                    </td>\
                    <td>To</td>\
                    <td>\
                        <input name="to" type="text" id="to" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Job Duties </td>\
                    <td>\
                        <input name="job" type="text" id="street4" size="15">\
                    </td>\
                    <td>Company Size </td>\
                    <td>\
                        <input name="cosize" type="text" id="cosize" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Comments</td>\
                    <td colspan="3" rowspan="2">\
                        <textarea name="comments2" cols="64" rows="4" id="comments2"></textarea>\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4">&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><strong class="header1">Work History (Prior 1) </strong></td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Employer</td>\
                    <td>\
                        <input name="employ1" type="text" id="name3" size="15">\
                    </td>\
                    <td>Title</td>\
                    <td>\
                        <input name="title1" type="text" id="name4" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Hire Date <span class="productssmall"></span></td>\
                    <td>\
                        <input name="hire1" type="text" id="street3" size="15">\
                    </td>\
                    <td>To</td>\
                    <td>\
                        <input name="to1" type="text" id="to1" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Job Duties </td>\
                    <td>\
                        <input name="job1" type="text" id="street4" size="15">\
                    </td>\
                    <td>Company Size </td>\
                    <td>\
                        <input name="cosize1" type="text" id="cosize1" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Comments</td>\
                    <td colspan="3" rowspan="2">\
                        <textarea name="comments3" cols="64" rows="4" id="comments3"></textarea>\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4">&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><strong class="header1">Work History (Prior 2) </strong></td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Employer</td>\
                    <td>\
                        <input name="employ2" type="text" id="name3" size="15">\
                    </td>\
                    <td>Title</td>\
                    <td>\
                        <input name="title2" type="text" id="name4" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Hire Date <span class="productssmall"></span></td>\
                    <td>\
                        <input name="hire2" type="text" id="street3" size="15">\
                    </td>\
                    <td>To</td>\
                    <td>\
                        <input name="to2" type="text" id="to2" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Job Duties </td>\
                    <td>\
                        <input name="job2" type="text" id="street4" size="15">\
                    </td>\
                    <td>Company Size </td>\
                    <td>\
                        <input name="cosize2" type="text" id="cosize2" size="10">\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>Comments</td>\
                    <td colspan="3" rowspan="2">\
                        <textarea name="comments4" cols="64" rows="4" id="comments4"></textarea>\
                    </td>\
                  </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4">&nbsp;</td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><strong class="header1">Business and Personal Objectives </strong></td>\
                  </tr>\
                  <tr valign="top">\
                    <td colspan="4"><img src="images/line.gif" width="500" height="1" vspace="10"></td>\
                  </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                    <td colspan="3">\
                      <textarea name="comments5" cols="64" rows="4" id="comments5"></textarea>\
                    </td>\
                    </tr>\
                  <tr valign="top">\
                    <td>&nbsp;</td>\
                    <td colspan="3">\
                        <input type="submit" name="Submit" value="Submit">\
                        <input name="Reset" type="submit" id="Reset" value="Reset">\
                    </td>\
					</form>\
                  </tr>\
                </table>                  <p><span class="products"><br>\
                      </span></p></td>\
              </tr>\
            </table>\
');
