// JavaScript Document

document.write("<table width='260' height='130' border='0' cellspacing='0' cellpadding='1' style='display:none;position:absolute;top:10px;left:10px;empty-cells:hide' id='v1771264780047017v181'>");document.write("<tr><td style='background: #062F91'>");document.write("<table width='100%' height='100%' border='0' cellspacing='0' cellpadding='0'>");document.write("<tr height='1'><td>");document.write("<table width='100%' border='0' cellspacing='1' cellpadding='0' style='background: #3C76B2; color: #FFFFFF; cursor: default'><tr style='font-family: Arial, sans-serif; font-size: 11pt; font-weight: bold'><td>Sign Up For Our E-Newsletter");document.write("<td style='width: 20px; cursor: pointer;' onclick='javascript:v1771264780047017v183();'>-");document.write("<td style='width: 20px; cursor: pointer;' onclick='javascript:v1771264780047017v184();'>X");document.write("</table>");document.write("<tr><td>");document.write("<table width='100%' height='100%' id='v1771264780047017v185' border='0' cellpadding='0' cellspacing='0' bgcolor='#FFFFFF'>");document.write("<tr>");document.write("<td>");document.write("<p><style>\r\n.link,\r\n.signupframe {\r\n	color: #000000;\r\n	font-family: Arial, Helvetica, sans-serif;\r\n	}\r\n	.link {\r\n		text-decoration: none;\r\n		}\r\n	.signupframe {\r\n		border: 1px solid #FFFFFF;\r\n		background: #ffffff;\r\n		}\r\n</style>\r\n<form method=post action=\"https://app.icontact.com/icp/signup.php\" name=\"icpsignup\" id=\"icpsignup271\" accept-charset=\"UTF-8\" onSubmit=\"return verifyRequired271();\" >\r\n<input type=hidden name=redirect value=\"http://www.greatplainslaboratory.com/home/eng/thankyou_event_list.asp\" />\r\n<input type=hidden name=errorredirect value=\"http://www.icontact.com/www/signup/error.html\" />\r\n\r\n<div id=\"SignUp\">\r\n<table width=\"23%\" class=\"signupframe\" border=\"0\" cellspacing=\"0\" cellpadding=\"5\" align=\"center\">\r\n	<tr>\r\n      <td width=\"38%\" align=left valign=top><font size=\"2\">E-mail</font>\r\n              <input type=text name=\"fields_email\" />\r\n        </span></td>\r\n      </tr>\r\n	<tr>\r\n	  <td valign=top align=right><div align=\"left\"><span class=\"style32\"><font size=\"2\">State\r\n	    <input name=\"fields_state2\" type=\"text\" size=\"2\" maxlength=\"3\" />\r\n	      <span class=\"style47\"><br/>Use N/A outside U.S.</span></font></span></div></td>\r\n	  </tr>\r\n	<tr>\r\n      <td Width=\"38%\" valign=top align=right><div align=\"left\"><font size=\"2\">Country\r\n            <select name=\"select\">\r\n              <option></option>\r\n              <option value=\"United States\" selected=\"selected\">United States</option>\r\n              <option value=\"Canada\">Canada</option>\r\n              <option value=\"England\">England</option>\r\n              <option value=\"India\">India</option>\r\n              <option value=\"Australia\">Australia</option>\r\n              <option value=\"Hong Kong\">Hong Kong</option>\r\n              <option value=\"Sweden\">Sweden</option>\r\n              <option value=\"France\">France</option>\r\n              <option value=\"Egypt\">Egypt</option>\r\n              <option value=\"Germany\">Germany</option>\r\n              <option value=\"Italy\">Italy</option>\r\n              <option value=\"Other\">Other</option>\r\n            </select>\r\n      </font></div></td>\r\n      </tr>\r\n	<tr>\r\n	  <td align=right valign=top><div align=\"left\"><font size=\"2\">Are you a physician or healthcare practioner?<br/>Check here</font>\r\n	      <input type=\"checkbox\" id=\"fields_physician\" name=\"fields_physician\" />\r\n	    </div></td>\r\n	  </tr>\r\n	<tr>\r\n      <td align=right valign=top><div align=\"center\">\r\n        <input type=\"submit\" name=\"Submit\" value=\"Submit\" />\r\n      </div></td>\r\n      </tr>\r\n    <input type=hidden name=\"listid\" value=\"28456\">\r\n    <input type=hidden name=\"specialid:28456\" value=\"7UZO\">\r\n\r\n    <input type=hidden name=clientid value=\"589775\">\r\n    <input type=hidden name=formid value=\"271\">\r\n    <input type=hidden name=reallistid value=\"1\">\r\n    <input type=hidden name=doubleopt value=\"1\">\r\n    </table>\r\n</div>\r\n</form>\r\n<script type=\"text/javascript\">\r\n\r\nvar icpForm271 = document.getElementById('icpsignup271');\r\n\r\nif (document.location.protocol === \"https:\")\r\n\r\n	icpForm271.action = \"https://app.icontact.com/icp/signup.php\";\r\nfunction verifyRequired271() {\r\n  if (icpForm271[\"fields_email\"].value == \"\") {\r\n    icpForm271[\"fields_email\"].focus();\r\n    alert(\"The Email field is required.\");\r\n    return false;\r\n  }\r\n  if (icpForm271[\"fields_state\"].value == \"\") {\r\n    icpForm271[\"fields_state\"].focus();\r\n    alert(\"The State field is required.\");\r\n    return false;\r\n  }\r\n\r\n\r\nreturn true;\r\n}\r\n</script>\r\n</p>\r\n\r\n    </div>");document.write("</table></table></table>"); 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