document.getElementById( 'request_form_response_div' ).innerHTML	= '';

document.write( '<form action="request_send.php" method="post" target="request_form_frame">' + "\n" );

document.write( '	<table cellspacing="0" cellpadding="0">' + "\n" );
document.write( '		<tr>' );
document.write( '			<td style="text-align:right;">Desired Category:&nbsp;</td>' + "\n" );
document.write( '			<td><input name="category" id="category" value="" size="35" /></td>' + "\n" );
document.write( '		</tr>' + "\n" );
document.write( '		<tr>' );
document.write( '			<td style="text-align:right;">Your Name:&nbsp;</td>' + "\n" );
document.write( '			<td><input name="name" id="name" value="" size="35" /></td>' + "\n" );
document.write( '		</tr>' + "\n" );
document.write( '		<tr>' + "\n" );
document.write( '			<td style="text-align:right;">Your e-Mail Address:&nbsp;</td>' + "\n" );
document.write( '			<td><input name="email" id="email" value="" size="35" /></td>' + "\n" );
document.write( '		</tr>' + "\n" );
document.write( '		<tr>' + "\n" );
document.write( '			<td style="text-align:right;padding-top:4px;" valign="top">Description:&nbsp;</td>' + "\n" );
document.write( '			<td><textarea name="description" id="description" cols="35" rows="8"></textarea></td>' + "\n" );
document.write( '		</tr>' + "\n" );
document.write( '		<tr>' + "\n" );
document.write( '			<td style="text-align:right;" colspan="2"><input type="submit" value="Submit" /></td>' + "\n" );
document.write( '		</tr>' + "\n" );
document.write( '	</table>' + "\n" );

document.write( '</form>' + "\n" );