document.write(' <form onsubmit="return formvalidation(this)" method="post" name="subform" action="http://nms.oneclick.ro.networknameservers.com/forms/optIn.asp" target="blank"> '
  + ' <table width="100%" border="0" class="rhp">'
  + '              <tr>'
  + '                <th>Newsletter</th>'
  + '              </tr>'
  + '              <tr>'
  + '                <td height="114">Your name <br />'
  + '                    <input type="text" name="name" value="">'
  + '                    Your email address<br />'
  + '                   <input type="text" name="email" value="">                    '
  + ' 					<input type="hidden" name="idList" value="4"> '
  + '      <INPUT TYPE="image" src="'+ baseUrl + '/images/submit_btn.gif"' 
  + ' style="width:54px; height:21px" /><br />'
  + '      We will keep your info confidentials and not giving to third parties. </td>'
  + '              </tr>'
  + '            </table>'
  + ' </form>');