document.write("<html><head><meta http-equiv=\'Content-Type\' content=\'text\/html; charset=iso-8859-1\'\/><title>My eLeader Program&trade;<\/title><link href=\'http:\/\/myeleader.com\/css\/style.css\' rel=\'stylesheet\' type=\'text\/css\'\/><\/head><script language=\'javascript\' src=\'http:\/\/myeleader.com\/scripts\/validation.js\'><\/script><script>function validateForm(){if(document.form1.namount.value==\'\'){alert(\'Please enter contribution amount\');document.form1.namount.focus();return false}else if (!isnumeric(document.form1.namount.value)){alert(\'Please enter valid amount\');document.form1.namount.focus();return false;}else if (!val_email(document.form1.email.value)){alert(\'Please enter valid email id\');document.form1.email.focus();return false;}}<\/script><body><form name=\'form1\' onsubmit=\'return validateForm();\' method=\'post\' action=\'http:\/\/myeleader.com\/insertData.asp\'><table width=\'186\' border=\'1\' bordercolor=\'#c6c6c6\' align=\'center\' cellpadding=\'0\' cellspacing=\'0\'><tr><td><table  border=\'0\' align=\'center\' cellpadding=\'2\' cellspacing=\'0\' bgcolor=\'#FFFFFF\'><tr><td  colspan=\'2\' align=\'center\' valign=\'top\'><img src=\'http:\/\/myeleader.com\/images\/laGopwidgetImg.jpg\'\/><\/td><\/tr><tr><td width=\'1%\'><\/td><td class=\'dh_black11px\'>First Name <\/td><\/tr><tr><td width=\'1%\'><\/td><td ><input name=\'firstname\' type=\'text\' class=\'dh_Txtbox\' size=\'29\' maxlength=\'50\' \/><\/td><\/tr><tr><td width=\'1%\'><\/td><td  class=\'dh_black11px\'>Last Name <\/td><\/tr><tr><td width=\'1%\'><\/td><td ><input name=\'lastname\' type=\'text\' class=\'dh_Txtbox\' size=\'29\' maxlength=\'50\'\/><\/td><\/tr><tr>  <td width=\'1%\'><\/td><td  class=\'dh_black11px\'>Amount <\/td><\/tr><tr><td width=\'1%\'><\/td><td ><input name=\'namount\' type=\'text\' class=\'dh_Txtbox\' size=\'29\' maxlength=\'12\'\/><\/td><\/tr><tr><td width=\'1%\'><\/td><td  class=\'dh_black11px\'>Email<\/td><\/tr><tr><td width=\'1%\'><\/td><td ><input name=\'email\' type=\'text\' class=\'dh_Txtbox\' size=\'29\' maxlength=\'75\'\/><\/td><\/tr><tr><td colspan=\'2\' align=\'center\'><input type=\'image\' src=\'http:\/\/myeleader.com\/images\/contButton.gif\' title=\'Contribute Now\'\/><\/td><\/tr><\/table><\/tr><\/td><tr><td><table width=\'185\' height=\'35\' border=\'0\' align=\'center\' cellpadding=\'0\' cellspacing=\'0\' bordercolor=\'#adadad\'><tr><td class=\'txtFooter\' align=\'center\'>Paid for by Republican Party of Los Angeles County<\/td><\/tr><\/table><\/td><\/tr><\/table><input type=\'hidden\' name=\'guideLeader\' value=\'585D59\'><\/form><\/body><\/html>");