document.writeln('<iframe src=\"about:blank\" name=\"hidform30\" style=\"display:none\"></iframe>')
document.writeln('<script src=\"/ks_inc/common.js\"></script>')
document.writeln('<script src=\"/ks_inc/form_ck.js\"></script>')
document.writeln('<form name=\"myform\" action=\"/plus/form/form.asp\" onSubmit=\"return(form_c());\"  target=\"hidform30\" method=\"post\"> ')
document.writeln('<table width=\"100%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\">')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\"/>')
document.writeln('<input type=\"hidden\" value=\"30\" name=\"id\"/>')
document.writeln('<input type=\"hidden\" value=\"1\" name=\"m\"/>')
document.writeln('<input type=\"hidden\" value=\"3870\" name=\"d\"/>')
document.writeln('<input type=\"hidden\" value=\"{$ToUserName}\" id=\"tousername\" name=\"tousername\"/>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">您的姓名：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_name\" name=\"KS_name\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"您的姓名|%|KS_name|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">真实姓名</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">联系地址：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_address\" name=\"KS_address\" value=\"\"><span ')
document.writeln('class=\"formstrck\" id=\"联系地址|%|KS_address|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">期刊')
document.writeln('收货地址</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">联系电话：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_tel\" name=\"KS_tel\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"联系电话|%|KS_tel|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">请填写手机号码</span>  ')
document.writeln('</td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">联系QQ：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_qq\" name=\"KS_qq\" value=\"\"><span class=\"formstrck\" id=\"联')
document.writeln('系QQ|%|KS_qq|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">请填写常用QQ号</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">优惠方案：</td>')
document.writeln('  <td><input type=\"radio\" id=\"KS_fangan\" name=\"KS_fangan\" value=\"活动一\">活动一<input type=\"radio\" id=\"KS_fangan\" name=\"KS_fangan\" value=\"活')
document.writeln('动二\">活动二<span class=\"formstrck\" id=\"优惠方案|%|KS_fangan|%|6\" style=\"display:none\"></span><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><span ')
document.writeln('style=\"color:#999\">请输入下图中的字符</span><br/><IMG style=\"cursor:pointer\" src=\"/plus/verifycode.asp\" ')
document.writeln('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('</table>')
document.writeln('</form>')
document.writeln('')