document.write('<form name="form1" method="post" action="/members/subscribe" id="form1"><p>Are you human test: What is 9 + 1 <input type="text" size="2" name="data[q][answer]" /></p><input type="text" value="Name" name="data[Member][name]" onclick="javascript: this.value=\'\';" class="txtfield" /> <input type="text" value="Email" name="data[Member][email]" onclick="javascript: this.value=\'\';" class="txtfield" /> <input type="submit" value="submit" name="Submit" class="submit" /></form>');