document.write("<style>\n.h2 {\n    font-size: 20px;\n    letter-spacing: -1px;\n    margin: 0 0 15px;\n    padding: 0;\n}\n\n.form {\n\twidth: 400px;\n}\n\n.label {\n\t font: 13px\/1.25 \"Trebuchet MS\",Arial,sans-serif;\n    color: #68727B;\n    display: block;\n    font-size: 11px;\n    padding-bottom: 2px;\n    text-transform: uppercase;\n}\n\n\n.input {\n\twidth: 95%;\n    background: url(\"http:\/\/v3.jvnotifypro.com\/assets\/img\/input-bg.png\") repeat-x scroll 0 0 #FFFFFF;\n    border: 1px solid #C0C0C0;\n    border-radius: 5px 5px 5px 5px;\n    color: #000000;\n    font-family: \"Lucida Sans Unicode\",\"Lucida Grande\",\"Arial\",sans-serif;\n    font-size: 14px;\n    padding: 7px;\n}\n\ninput:-moz-read-write, textarea:-moz-read-write {\n    -moz-user-modify: read-write !important;\n}\n\ninput {\n    -moz-appearance: textfield;\n    -moz-user-select: text;\n    background-color: -moz-field;\n    border: 2px inset threedface;\n    color: -moz-fieldtext;\n    cursor: text;\n    font: -moz-field;\n    letter-spacing: normal;\n    line-height: normal !important;\n    padding: 1px 0;\n    text-align: start;\n    text-indent: 0;\n    text-rendering: optimizelegibility;\n    text-shadow: none;\n    text-transform: none;\n    word-spacing: normal;\n}\n\n.submit_button {\n    background: url(\"http:\/\/v3.jvnotifypro.com\/assets\/img\/loginbuttonbg.png\") repeat-x scroll 0 0 #339CDF;\n    border: 1px solid #339CDF;\n    box-shadow: none;\n    color: #FFFFFF;\n    cursor: pointer;\n    margin: 4px 12px 0 0;\n    padding: 7px 10px 8px;\n    text-shadow: 0 -1px #278DB8;\n    width: auto;\n    font-size: 13px;\n     border-radius: 5px 5px 5px 5px;\n}\n<\/style>\n\n<form action=\"http:\/\/v3.jvnotifypro.com\/account\/signup\" method=\"post\" target=\"_blank\" class=\"form\">\n\t<h2 class=\"h2\">Become A Partner<\/h2>\n\t<p>\n\t<label for=\"accountName\" class=\"label\">First Name<\/label>\n\t\t<input type=\"text\" id=\"fname\" value=\"\" name=\"fname\" maxlength=\"320\" tabindex=\"1\" class=\"input\"\/>\n\t\t<\/p>\n\n\t<p>\n\t<label for=\"accountName\" class=\"label\">Last Name<\/label>\n\t\t<input type=\"text\" id=\"lname\" value=\"\" name=\"lname\" maxlength=\"320\" tabindex=\"2\" class=\"input\"\/>\n\t\t<\/p>\n\t\t\n\t<p>\n\t<label for=\"accountName\" class=\"label\">E-mail Address<\/label>\n\t\t<input type=\"text\" id=\"email\" value=\"\" name=\"email\" maxlength=\"320\" tabindex=\"3\" class=\"input\"\/><\/p>\n\t\n\t<p><label for=\"password\" class=\"label\">Password<\/label>\n\t\t<input type=\"password\" id=\"password\" name=\"password\" maxlength=\"16\" tabindex=\"4\" autocomplete=\"off\" class=\"input\"\/><\/p>\n\n\t<p><label for=\"password\" class=\"label\">Confirm Password<\/label>\n\t\t<input type=\"password\" id=\"password_confirm\" name=\"password_confirm\" maxlength=\"16\" tabindex=\"5\" autocomplete=\"off\" class=\"input\"\/><\/p>\n\n\n\t<p style=\"text-align: right; margin-right: 10px;\">\n\t\t<input class=\"submit_button \" type=\"submit\" name=\"submit\" id=\"submit\" value=\"Become A Partner\" \/>\n\n\t<\/p>\n\n  \n<\/form>")