document.write('<form method="post" action="http://www.theloftcompany.co.uk/tlcfm.php" name="SampleForm">');
document.write('<div id="sideform">');
document.write('<input type="hidden" name="env_report" value="REMOTE_HOST,REMOTE_ADDR,HTTP_USER_AGENT,AUTH_TYPE,REMOTE_USER">');
document.write('<input type="hidden" name="recipients" value="info@theloftcompany.co.uk" />');
document.write('<input type="hidden" name="required" value="email:Your email address is missing,realname:Your name is missing,enquiry:Your enquiry is missing,telephone:Your telephone number is missing" />');
document.write('<input type="hidden" name="subject" value="The Loft Company Enquiry Form" />');
document.write('<input type="hidden" name="good_url" value="http://www.theloftcompany.co.uk/thanks.htm" /> ');
document.write('<div class="formThis">Name <span class="required">*</span> </div><div class="formPart"><input type="text" name="realname" class="textbox" /></div>');
document.write('<div class="formThis">Address </div><div class="formPart"><input type="text" name="address1" class="textbox" value=""></div>');
document.write('<div class="formThis">Post Code </div><div class="formPart"><input type="text" name="postcode" class="textbox" value=""></div>');
document.write('<div class="formThis">Telephone <span class="required">*</span> </div><div class="formPart"><input type="text" name="telephone" class="textbox" value=""></div>');
document.write('<div class="formThis">Email <span class="required">*</span> </div><div class="formPart"><input type="text" name="email" class="textbox" value=""></div>');
document.write('<div class="formThis">Enquiry: <span class="required">*</span> </div><div class="formPart"><textarea name="enquiry" class="textbox" rows="3"></textarea></div>');
document.write('<div class="formThis" style="width:210px; text-align:right;"><input name="Submit" type="submit" class="textbox" onClick="MM_validateForm(\'realname\',\'\',\'R\',\'email\',\'\',\'R\',\'enquiry\',\'\',\'R\');return document.MM_returnValue" value="Submit"> &nbsp; * = Required</div></div>');
document.write('</form>');
document.write('<div id="trustmarks"><p><strong>A Loft Company You Can Trust.</strong></p><img src="images/trustmarks.jpg" width="220" height="140" alt="Trust Marks" /></div>');