document.write("</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Why do you like it? Describe it<FONT SIZE=1> (2+ lines)</FONT>:</STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><textarea wrap=\"hard\" name=\"why\" rows=\"2\" cols=\"73\" CLASS=color1></textarea></FONT></TD></TR>");
document.write("<!--TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Favourite Cover Band: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" SIZE=30 NAME=\"cover\" CLASS=color1></FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Favourite Song: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" SIZE=30 NAME=\"song\" CLASS=color1><FONT SIZE=1> (inc. artist)</FONT></FONT></TD></TR-->");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Favourite Type of Music: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><SELECT NAME=\"vote\" CLASS=color1>");
document.write("     <OPTION value=\"\">choose one of these...</OPTION>");
document.write("     <OPTION>commercial (top 40 dance)</OPTION>");
document.write("     <OPTION>party/retro (Micky etc)</OPTION>");
document.write("     <OPTION>r\&b/funk/rap/hip-hop</OPTION>");
document.write("     <OPTION>house</OPTION>");
document.write("     <OPTION>techno</OPTION>");
document.write("     <OPTION>reggae</OPTION>");
document.write("     <OPTION>alternative/indie/grunge</OPTION>");
document.write("     <OPTION>pub (Cold Chisel)</OPTION></SELECT></FONT></TD></TR>");
document.write("<!--TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Favourite Radio Stations: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>(select all that apply) </FONT></FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=CENTER COLSPAN=2>");
document.write("<TABLE><TR><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"tt\" CLASS=color2>Mix FM (ex TT)<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"fox\">Fox FM<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"gol\">Gold 104<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"krk\">K-Rock<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"jjj\">Triple J<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"mmm\">Triple M<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"rrr\">Triple R<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"hit\">Hitz FM<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"kis\">Kiss 90<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"kik\">Kicks FM<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"str\">Street FM<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"pbs\">PBS<BR>");
document.write("</FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"sub\">Sub FM <INPUT TYPE=\"CHECKBOX\" NAME=\"nov\">Nova<BR>");
document.write("<INPUT TYPE=\"CHECKBOX\" NAME=\"oth\">Other: <INPUT TYPE=\"TEXT\" NAME=\"other\" SIZE=19 CLASS=color1><BR>");
document.write("</FONT></TD></TR></TABLE>");
document.write("</TD></TR-->");
document.write("<!--TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Should Smoking be Banned in Clubs?: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"RADIO\" NAME=\"ban\" VALUE=\"b\">Yes <INPUT TYPE=\"RADIO\" NAME=\"ban\" VALUE=\"d\" CLASS=radio>No</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Would you go to a Non-Smoking Club?: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"RADIO\" NAME=\"attend\" VALUE=\"a\">Yes <INPUT TYPE=\"RADIO\" NAME=\"attend\" VALUE=\"n\">No</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Would a Non-Smoking Club work?: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"RADIO\" NAME=\"smokework\" VALUE=\"w\">Yes <INPUT TYPE=\"RADIO\" NAME=\"smokework\" VALUE=\"n\">No</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Do you smoke?: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"RADIO\" NAME=\"smoker\" VALUE=\"s\">Yes <INPUT TYPE=\"RADIO\" NAME=\"smoker\" VALUE=\"c\">No</FONT></TD></TR-->");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Where did you hear about MAX MOOSE?: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" SIZE=44 NAME=\"found\" CLASS=color1></FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>What did you think of MAX MOOSE/<BR>What should we add/improve?</STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><textarea wrap=\"hard\" name=\"think\" rows=\"2\" cols=\"45\" CLASS=color1></textarea></FONT></TD></TR>");
document.write("<!--TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>What new features would you<BR>like to see on MAX MOOSE?</STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><textarea wrap=\"physical\" name=\"improve\" rows=\"2\" cols=\"45\" CLASS=color1></textarea></FONT></TD></TR-->");
document.write("<TR VALIGN=TOP><TD ALIGN=CENTER COLSPAN=2><HR WIDTH=60% COLOR=BLUE><FONT SIZE=4 FACE=\"Tahoma,ARIAL\" COLOR=#00FF88><B>Details</B></FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Suburb: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" NAME=\"suburb\" CLASS=color1></FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>State: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><SELECT NAME=\"state\" CLASS=color1>");
document.write("     <OPTION value=\"\">choose one</OPTION>");
document.write("     <OPTION value=\"v\">Vic</OPTION>");
document.write("     <OPTION>NSW</OPTION>");
document.write("     <OPTION>ACT</OPTION>");
document.write("     <OPTION>SA</OPTION>");
document.write("     <OPTION>Tas</OPTION>");
document.write("     <OPTION>Qld</OPTION>");
document.write("     <OPTION>WA</OPTION>");
document.write("     <OPTION>NT</OPTION>");
document.write("     <OPTION>Outside Oz</OPTION></SELECT></FONT></TD></TR>");
document.write("<!--STRONG>State: </STRONG></FONT><INPUT TYPE=\"RADIO\" NAME=\"state\" VALUE=\"Vic\">Vic<INPUT TYPE=\"RADIO\" NAME=\"state\" VALUE=\"others\">Other, please specify: <INPUT TYPE=\"TEXT\" NAME=\"others\"><BR>");
document.write("<FONT COLOR=#0088ff><STRONG>Postcode: </STRONG><INPUT TYPE=\"TEXT\" SIZE=5 NAME=\"postcode\"><BR-->");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Birthdate: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" SIZE=3 NAME=\"day\" CLASS=color1><INPUT TYPE=\"TEXT\" SIZE=3 NAME=\"month\" CLASS=color1><INPUT TYPE=\"TEXT\" SIZE=6 NAME=\"year\" CLASS=color1> (D/M/Y)</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Sex: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"RADIO\" NAME=\"sex\" VALUE=\"m\">Male<INPUT TYPE=\"RADIO\" NAME=\"sex\" VALUE=\"f\">Female</FONT></TD></TR>");
document.write("<TR VALIGN=TOP><TD ALIGN=RIGHT><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2 COLOR=#0088ff><STRONG>Name: </STRONG></FONT></TD><TD><FONT FACE=\"TAHOMA,ARIAL\" SIZE=2><INPUT TYPE=\"TEXT\" NAME=\"name\" CLASS=color1></FONT></TD></TR>");
document.write("<!--STRONG>Surname: </STRONG><INPUT TYPE=\"TEXT\" NAME=\"surname\"><BR>");
document.write("<STRONG>Number \& Street: </STRONG><INPUT TYPE=\"TEXT\" NAME=\"street\"><BR-->");
document.write("</TABLE>");
document.write("<HR WIDTH=60% COLOR=BLUE>");
document.write("<CENTER>");
document.write("Thank-you<BR>");