document.write('<div id=\'slf\'>')
document.write('       <form action="#" method="post" id="slf_form" name="slf_form">');document.write('    <div class="field">');document.write('                        <label for="slf_title">Title *</label>');document.write('                        <select name="title"> <option value="mr" selected="selected">Mr</option> <option value="mrs">Mrs</option> <option value="miss">Miss</option> <option value="dr">Dr</option> <option value="ms">Ms</option></select>');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_forename">First Name *</label>');document.write('                        <input id="slf_forename" name="forename"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_surname">Last Name *</label>');document.write('                        <input id="slf_surname"  name="surname"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_coname">Group Name *</label>');document.write('                        <input id="slf_coname"  name="coname"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_add1">Address *<br/><Br/><Br/></label>');document.write('                        <input id="slf_add1"  name="add1"><br/> ');document.write('                        <input id="slf_add2"  name="add2"><br/>');document.write('                        <input id="slf_add3"  name="add3"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_town">Town *</label>');document.write('                        <input id="slf_town"  name="town"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_county">County *</label>');document.write('                        <input id="slf_county"  name="county"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_postcode">Postcode *</label>');document.write('                        <input id="slf_postcode"  name="postcode"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_tel">Telephone number *</label>');document.write('                        <input id="slf_tel"  name="tel"> ');document.write('                    </div>');document.write('                    <div class="field">');document.write('                        <label for="slf_email">Email *</label>');document.write('                        <input id="slf_email"  name="email"> ');document.write('                    </div>');document.write('                    <input type="hidden" name="lea" value="47" />');document.write('                    <!--div class="field">');document.write('                        <label for="slf_lea">LEA *</label>');document.write('                        <select id="slf_lea" name="lea">                     </select></div-->');document.write('    <div class="field">');document.write('                        Preferred start time and number of young people attending:');document.write('                    </div>');document.write('                    <table>');document.write('<tr><th colspan=\'5\'>Thursday 07 Oct 2010</th></tr><tr><td></td><th>09:30-12:00&nbsp;</th><th>10:30-13:00&nbsp;</th><th>11:30-14:00&nbsp;</th><th>12:30-15:00&nbsp;</th></tr>');document.write('<tr>');document.write('<th>Year 9</th>');document.write('<td><input name=\'sess_49_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_50_1\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_51_1\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_52_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 10</th>');document.write('<td><input name=\'sess_49_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_50_2\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_51_2\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_52_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 11</th>');document.write('<td><input name=\'sess_49_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_50_3\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_51_3\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_52_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 12</th>');document.write('<td><input name=\'sess_49_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_50_4\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_51_4\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_52_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 13</th>');document.write('<td><input name=\'sess_49_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_50_5\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_51_5\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_52_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr><th colspan=\'5\'>Friday 08 Oct 2010</th></tr><tr><td></td><th>09:30-12:00&nbsp;</th><th>10:30-13:00&nbsp;</th><th>11:30-14:00&nbsp;</th><th>12:30-15:00&nbsp;</th></tr>');document.write('<tr>');document.write('<th>Year 9</th>');document.write('<td><input name=\'sess_53_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_54_1\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_55_1\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_56_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 10</th>');document.write('<td><input name=\'sess_53_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_54_2\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_55_2\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_56_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 11</th>');document.write('<td><input name=\'sess_53_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_54_3\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_55_3\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_56_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 12</th>');document.write('<td><input name=\'sess_53_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_54_4\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_55_4\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_56_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 13</th>');document.write('<td><input name=\'sess_53_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_54_5\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_55_5\' type=\'text\' size=\'3 readonly=\'readonly\' value=\'Full\'/></td>');document.write('<td><input name=\'sess_56_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr><th colspan=\'5\'>Saturday 09 Oct 2010</th></tr><tr><td></td><th>10:30-13:00&nbsp;</th><th>11:30-14:00&nbsp;</th><th>12:30-15:00&nbsp;</th><th>13:30-16:00&nbsp;</th></tr>');document.write('<tr>');document.write('<th>Year 9</th>');document.write('<td><input name=\'sess_57_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_58_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_59_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_60_1\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 10</th>');document.write('<td><input name=\'sess_57_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_58_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_59_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_60_2\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 11</th>');document.write('<td><input name=\'sess_57_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_58_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_59_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_60_3\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 12</th>');document.write('<td><input name=\'sess_57_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_58_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_59_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_60_4\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('<tr>');document.write('<th>Year 13</th>');document.write('<td><input name=\'sess_57_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_58_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_59_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('<td><input name=\'sess_60_5\' type=\'text\' size=\'3  value=\'0\'/></td>');document.write('</tr>');document.write('                    </table>');document.write('                    <p>We will try to');document.write('                            meet your requests wherever possible, however, in some cases');document.write('                                    allocated timeslots may have to be varied due to safety');document.write('                                            requirements.</p>');document.write('                          <div class="field">');document.write('<label for="slf_teachers">How many teachers/group helpers');document.write('                                will be attending?</label>');document.write('<input type="text" id="slf_teachers" name="teachers"  value="0" />');document.write('</div>');document.write('                    <div class="field">');document.write('<label for="slf_special">How many');document.write('                                young people with special needs will be attending?</label>');document.write('<input type="text" name="special" id="slf_special" value="0" />');document.write('</div>');document.write('                    <div class="field">');document.write('<label for="slf_ethnic">What percentage of ethnic minority young people will be attending?</label>');document.write('                    <select name="ethnic">');document.write('<option value="-1">Please choose</option><option value="0">0%</option><option value="1">1%</option><option value="2">2%</option><option value="3">3%</option><option value="4">4%</option><option value="5">5%</option><option value="6">6%</option><option value="7">7%</option><option value="8">8%</option><option value="9">9%</option><option value="10">10%</option><option value="11">11%</option><option value="12">12%</option><option value="13">13%</option><option value="14">14%</option><option value="15">15%</option><option value="16">16%</option><option value="17">17%</option><option value="18">18%</option><option value="19">19%</option><option value="20">20%</option><option value="21">21%</option><option value="22">22%</option><option value="23">23%</option><option value="24">24%</option><option value="25">25%</option><option value="26">26%</option><option value="27">27%</option><option value="28">28%</option><option value="29">29%</option><option value="30">30%</option><option value="31">31%</option><option value="32">32%</option><option value="33">33%</option><option value="34">34%</option><option value="35">35%</option><option value="36">36%</option><option value="37">37%</option><option value="38">38%</option><option value="39">39%</option><option value="40">40%</option><option value="41">41%</option><option value="42">42%</option><option value="43">43%</option><option value="44">44%</option><option value="45">45%</option><option value="46">46%</option><option value="47">47%</option><option value="48">48%</option><option value="49">49%</option><option value="50">50%</option><option value="51">51%</option><option value="52">52%</option><option value="53">53%</option><option value="54">54%</option><option value="55">55%</option><option value="56">56%</option><option value="57">57%</option><option value="58">58%</option><option value="59">59%</option><option value="60">60%</option><option value="61">61%</option><option value="62">62%</option><option value="63">63%</option><option value="64">64%</option><option value="65">65%</option><option value="66">66%</option><option value="67">67%</option><option value="68">68%</option><option value="69">69%</option><option value="70">70%</option><option value="71">71%</option><option value="72">72%</option><option value="73">73%</option><option value="74">74%</option><option value="75">75%</option><option value="76">76%</option><option value="77">77%</option><option value="78">78%</option><option value="79">79%</option><option value="80">80%</option><option value="81">81%</option><option value="82">82%</option><option value="83">83%</option><option value="84">84%</option><option value="85">85%</option><option value="86">86%</option><option value="87">87%</option><option value="88">88%</option><option value="89">89%</option><option value="90">90%</option><option value="91">91%</option><option value="92">92%</option><option value="93">93%</option><option value="94">94%</option><option value="95">95%</option><option value="96">96%</option><option value="97">97%</option><option value="98">98%</option><option value="99">99%</option><option value="100">100%</option></select>');document.write('</div>');document.write('<div class="field"><label for="thirdparty">Receive third-party information**</label><input id="thirdparty" name="thirdparty" value="1" type="checkbox" checked="checked">');document.write('</div>');document.write('                <div style="clear:both">&nbsp;</div>');document.write('                <input type="hidden" name="test" value="test"/>');document.write('                <div class="submit">');document.write('                <input type="button" value="Submit" onclick="slf_send()" >');document.write('                </div>');document.write('                </form>');document.write('                <p>** Please tick this box if you wish to receive information from other companies approved by ourselves.</p>');document.write('               ');document.write('       <script 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