document.writeln('<table width=\"100%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\">')
document.writeln('<form name=\"myform\" action=\"/plus/form.asp\" method=\"post\"> ')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\">')
document.writeln('<input type=\"hidden\" value=\"1\" name=\"id\">')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">您的姓名：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:400px\" name=\"KS_ndxm\" value=\"\"><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">您的电话：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:400px\" name=\"KS_nddh\" value=\"\"><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">您的邮箱：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:400px\" name=\"KS_ndyx\" value=\"\">  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">反映问题：</td>')
document.writeln('  <td><textarea style=\"width:400px;height:100px\" rows=\"5\" name=\"KS_fywt\"></textarea><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln('<tr class=\"tdbg\"><td class=\"lefttdbg\" align=\"right\">验证码：</td><td><input name=\"Verifycode\" type=\"text\" name=\"textbox\" size=5><IMG style=\"cursor:pointer\" src=\"/plus/verifycode.asp\" onClick=\"this.src=\'/plus/verifycode.asp?n=\'+ Math.random();\" align=\"absmiddle\"></td></tr>')
document.writeln('<tr><td colspan=\"2\" class=\"subtdbg\" align=\"center\"><input type=\"submit\" value=\"确认提交\" name=\"submit1\"></td></tr>')
document.writeln('</form>')
document.writeln('</table>')
document.writeln('')