<!-- Begin ---------------JS-WHOLESALE-ACCOUNT-SETUP ----------------------------
document.write('<DIV ALIGN="CENTER">');
document.write('<table CLASS="forms" border="0" cellpadding="0" cellspacing="0">'); 
document.write('<tr valign="top"><td>'); 
document.write('<BR><H1>Account Setup</H1> '); 
document.write('</TD>'); 
document.write('</TR></TABLE>'); 

document.write('<table CLASS="forms" border="0" cellpadding="0" cellspacing="0">'); 
document.write('<tr valign="top">');
document.write('<form method="POST" action="http://www.tdott.com/cgi-bin/formmail.pl">'); 
document.write('<input type=hidden name="recipient" value="tdott-wholesale-setup@tdott.com">'); 
document.write('<input type=hidden name="subject" value="TdotT - Account SetUp">');
document.write('<input type=hidden name="redirect" value="http://www.tdott.com/GENERAL/account-setup-done-job-deposit.html">'); 
document.write('<input type="hidden" name="required" value="found,referred,name,bus_name,bus_number,website,telephone,street,city,prov-state,country,zip, email,email2,trade_ref1,trade_ref2,trade_ref3,product-interest,questions">'); 
document.write('<TD>How did you find us?</td>');
document.write('<td><select name="found">'); 
document.write('<option value="Please Select">Please Select</option>'); 
document.write('<option value="Related Website">Related Website</option>'); 
document.write('<option value="Search Engine">Search Engine</option>');
document.write('<option value="Forum Board">Forum Board</option>');
document.write('<option value="Blog">Blog</option>');
document.write('<option value="Trade Show">Trade Show</option>');
document.write('<option value="Word Of Mouth">Word of Mouth</option>');
document.write('<option value="News Magazine">News Magazine</option>');
document.write('<option value="Radio-TV-Video">Radio-TV-Video</option>');
document.write('<option value="Other">Other</option>');
document.write('</select>'); 
document.write('</td></tr>');
document.write('<tr>');  
document.write('<td>Who Referred You to us?</TD><td><input type="text" size="30" name="referred"><BR><SMALL>Name of Person or Website.</SMALL>'); 
document.write('</TD></tr>'); 
document.write('<tr><td>Your Name:</TD><td><input type="text" size="30" name="name">'); 
document.write('</TD></tr>'); 
document.write('<tr><td>Your Business Name:</TD><td><input type="text" size="30" name="bus_name">'); 
document.write('</TD></tr>'); 
document.write('<tr><td>Tax/Business #:</TD><td><input type="text" size="30" name="bus_number">'); 
document.write('</TD></tr>'); 
document.write('<tr><td>Your Website:</TD><td><input type="text" size="30" name="website">'); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Telephone #:</TD><td><input type="text" size="15" name="telephone">'); 
document.write('</TD></tr>'); 
document.write('<tr VALIGN="TOP">'); 
document.write('<td>Address:</TD> <td><input type="text" size="30" name="street"> : <small>Street</small><br><input type="text" size="20" name="city"> : <small>City/Town</small><br><input type="text" size="20" name="prov-state"> : <small>Prov/State</small><br><input type="text" size="20" name="country"> : <small>Country</small><br><input type="text" size="10" name="zip"> : <small>Zip Code</small>');  
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Email Address:</TD><td><input type="text" size="30" name="email">');  
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Confirm Email Address:</TD><td><input type="text" size="30" name="email2"> '); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>3 Trade References<br>Name & Tel.#:</TD> <td>1. <input type="text" size="30" name="trade_ref1"><br>2. <input type="text" size="30" name="trade_ref2"><br>3. <input type="text" size="30" name="trade_ref3">');  
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>What products<br>are you interested in buying?'); 
document.write('</TD>'); 
document.write('<td><TEXTAREA NAME="product-interest" ROWS=4 COLS=20></TEXTAREA>'); 
document.write('</TD></tr>'); 
document.write('<tr>'); 
document.write('<td>Do you need a Quote?<BR><BR>If yes, please provide details. <BR>If No, type in NO.'); 
document.write('</TD>'); 
document.write('<td><TEXTAREA NAME="questions" ROWS=6 COLS=20></TEXTAREA>'); 
document.write('</TD></tr>'); 
document.write('</TD></tr>'); 
document.write('<tr><td>-</TD>'); 
document.write('<td>'); 
document.write('<input type="submit" value="SetUp Account">'); 
document.write('</TD>'); 
document.write('</form>'); 
document.write('</TR></table>'); 
document.write('</DIV>');
// End -------------------------------------------------------------------------- -->





