function writeJS(){
var str='';
str+=' <div id="col_two">';
str+='    <form action="..\/form-process.php?m=a" method="post" name="loan_form" id="loan_form">';
str+='      <div id="form_box">';
str+='        <p class="label"><span class="w">*  Name :<\/span>';
str+='          <input name="name" type="text" id="name" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">* Address: <\/span>';
str+='          <input name="address" type="text" id="address" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w"> Address1: <\/span>';
str+='          <input name="address_1" type="text" id="address_1" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">* City:<\/span>';
str+='          <input name="city" type="text" id="city" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">County: <\/span>';
str+='          <input name="county" type="text" id="county" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">* Postcode: <\/span>';
str+='          <input name="postcode" type="text" id="postcode" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">* Email: <\/span>';
str+='          <input name="email" type="text" id="email" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w">Telephone Number: <\/span>';
str+='          <input name="telephone" type="text" id="telephone" \/>';
str+='        <\/p>';
str+='        <p class="label"><span class="w"> Mobile Number: <\/span>';
str+='          <input name="mobile" type="text" id="mobile" \/>';
str+='        <\/p>';
str+='		<p class="label"><span class="w">* Property Value: <\/span>';
str+='          <input name="loan_amount" type="text" id="loan_amount" \/>';
str+='        <\/p>';
str+='		<p class="label"><span class="w">* Mortgage Type: <\/span>';
str+='          <select name="mortgage_type" id="mortgage_type">';
str+='		  	<option value="First Time Buyer" id="First-Time-Buyer">First Time Buyer<\/option>';
str+='		  	<option value="Remortgage" id="Remortgage">Remortgage<\/option>';
str+='		  	<option value="Buy To Let" id="Buy-To-Let">Buy To Let<\/option>			';
str+='		  <\/select>';
str+='        <\/p>';
str+='		<p class="label"><span class="w">* Mortgage Amount: <\/span>';
str+='          <input name="mortgage_amount" type="text" id="mortgage_amount" \/>';
str+='        <\/p>';
str+='	  <\/div>';
document.write(str);
}