document.write("<title>Contact DJ Cruzs Today</title>\n");
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document.write("<form  method=POST action=\"http://cruzs.ca/siteforms/csFormbuilder.cgi\" name=\"form_1\"  >\n");
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document.write("<table width=\"100%\" border=\"0\" cellpadding=\"3\" cellspacing=\"0\">\n");
document.write("<tr>\n");
document.write("  <td class=\"textLabel\" colspan=3><h2>TOLL FREE: 1-866-853-7800 &nbsp;&nbsp; PHONE: 204-339-4330 &nbsp;&nbsp; FAX:204-661-9075</h2></td>\n");
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document.write("<tr>\n");
document.write("  <td class=\"textLabel\" colspan=3>4330 Henderson Hwy.\n");
document.write("    Winnipeg (Manitoba) R3C2E7</td>\n");
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document.write("<tr>\n");
document.write("  <td class=\"textLabel\" colspan=3>Or  fill out the following information and click the submit button. \"*\" indicates mandatory fields.</td>\n");
document.write("</tr><tr><td class=\"textLabel\" colspan=3><hr width=\"100%\" size=\"1\" color=\"black\" align=\"left\"></td></tr><tr><td rowspan=\"2\" align=\"left\" nowrap class=\"textLabel\" ></td><td align=left valign=top nowrap class=\"textLabel\">*First Name\n");
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document.write("  <td align=left valign=top nowrap class=\"textLabel\">*Last Name    </td>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">*Urgency </td>\n");
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document.write("<option>Not Urgent</option>\n");
document.write("<option>Mildly Urgent</option>\n");
document.write("<option>Extremely Urgent</option>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">*Response Required </td>\n");
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document.write("<option>Yes</option>\n");
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document.write("<td nowrap class=\"textLabel\" align=\"left\">Comments/Questions/Concerns</td>\n");
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