function doRequest()
{
document.writeln('<form method="post" action="./cgi-bin/email/kvrcEmail.pl" ');
document.writeln('onSubmit="return checkForm(this)">');

document.writeln('<input type="hidden" name="print_blank_fields" value="1">');
document.writeln('<input type="hidden" name="subject" ');
document.writeln('value="Ocean Kauai Vacation Rentals Inquiry">');
document.writeln('<input type="hidden" name="Title" ');
document.writeln('value="You have an inquiry from http://www.okvrc.com">');

document.writeln('<input type="hidden" name="redirect" ');
document.writeln('value="http://www.okvrc.com/thanks-email.html">');
document.writeln('<input type="hidden" name="recipient" value="211" />');
document.writeln('<input type="hidden" name="required" value="realname,email">');

document.writeln('<input type="hidden" Name="Website" ');
document.writeln('value="<http://www.kauai-vacation-rental-condos.com>">');
document.writeln('<input type="hidden" Name="*" ');
document.writeln('value="============================================================ :*">');
document.writeln('<input type="hidden" name="print_config" ');
document.writeln('value="realname,email,subject,title">');

document.writeln('<center>');
document.writeln('<table border="2" cellpadding="8" cellspacing="0" width="450" ');
document.writeln('bgcolor="EEEEEE">');
document.writeln('<tr align="left" valign="top">');
document.writeln('<td width="450">');

document.writeln('<br>');
document.writeln('Which condo are you interested in:</FONT>');
document.writeln('<select name="Condo">');
document.writeln('<option selected>ALL');
document.writeln('<option>PK 102');
document.writeln('<option>PK 106');
document.writeln('<option>PK 114');
document.writeln('<option>PK 211');
document.writeln('<option>PK 315');
document.writeln('<option>PK 304');
document.writeln('<option>PK 307');
document.writeln('<option>KS 115');
document.writeln('<option>ALL');
document.writeln('</select>');
document.writeln('<br><br>');

document.writeln('<table border="0" cellspacing="0" cellpadding="0" width=450">');
document.writeln('<tr>');
document.writeln('<td>Arrival Date:&nbsp;</td>');
document.writeln('<td>');
document.writeln('<select name="Arrival">');
document.writeln('<option selected>Jan');
document.writeln('<option>Feb');
document.writeln('<option>Mar');
document.writeln('<option>Apr');
document.writeln('<option>May');
document.writeln('<option>Jun');
document.writeln('<option>Jul');
document.writeln('<option>Aug');
document.writeln('<option>Sep');
document.writeln('<option>Oct');
document.writeln('<option>Nov');
document.writeln('<option>Dec');
document.writeln('</select>');
document.writeln('</td>');

document.writeln('<td>');
document.writeln('<SELECT NAME="Arrival">');
document.writeln('<OPTION selected>01');
document.writeln('<OPTION>02');
document.writeln('<OPTION>03');
document.writeln('<OPTION>04');
document.writeln('<OPTION>05');
document.writeln('<OPTION>06');
document.writeln('<OPTION>07');
document.writeln('<OPTION>08');
document.writeln('<OPTION>09');
document.writeln('<OPTION>10');
document.writeln('<OPTION>11');
document.writeln('<OPTION>12');
document.writeln('<OPTION>13');
document.writeln('<OPTION>14');
document.writeln('<OPTION>15');
document.writeln('<OPTION>16');
document.writeln('<OPTION>17');
document.writeln('<OPTION>18');
document.writeln('<OPTION>19');
document.writeln('<OPTION>20');
document.writeln('<OPTION>21');
document.writeln('<OPTION>22');
document.writeln('<OPTION>23');
document.writeln('<OPTION>24');
document.writeln('<OPTION>25');
document.writeln('<OPTION>26');
document.writeln('<OPTION>27');
document.writeln('<OPTION>28');
document.writeln('<OPTION>29');
document.writeln('<OPTION>30');
document.writeln('<OPTION>31');
document.writeln('</SELECT>');
document.writeln('</TD>');

document.writeln('<TD>');
document.writeln('<SELECT NAME="Arrival">');
document.writeln('<OPTION selected>2012');
document.writeln('<OPTION>2013');
document.writeln('</SELECT>');
document.writeln('</TD>');
document.writeln('</TR>');

document.writeln('<TR>');
document.writeln('<TD> Departure Date:</TD>');
document.writeln('<TD>');
document.writeln('<SELECT NAME="Departure">');
document.writeln('<OPTION selected>Jan');
document.writeln('<OPTION>Feb');
document.writeln('<OPTION>Mar');
document.writeln('<OPTION>Apr');
document.writeln('<OPTION>May');
document.writeln('<OPTION>Jun');
document.writeln('<OPTION>Jul');
document.writeln('<OPTION>Aug');
document.writeln('<OPTION>Sep');
document.writeln('<OPTION>Oct');
document.writeln('<OPTION>Nov');
document.writeln('<OPTION>Dec');
document.writeln('</SELECT>');
document.writeln('</TD>');

document.writeln('<TD>');
document.writeln('<SELECT NAME="Departure">');
document.writeln('<OPTION selected>01');
document.writeln('<OPTION>02');
document.writeln('<OPTION>03');
document.writeln('<OPTION>04');
document.writeln('<OPTION>05');
document.writeln('<OPTION>06');
document.writeln('<OPTION>07');
document.writeln('<OPTION>08');
document.writeln('<OPTION>09');
document.writeln('<OPTION>10');
document.writeln('<OPTION>11');
document.writeln('<OPTION>12');
document.writeln('<OPTION>13');
document.writeln('<OPTION>14');
document.writeln('<OPTION>15');
document.writeln('<OPTION>16');
document.writeln('<OPTION>17');
document.writeln('<OPTION>18');
document.writeln('<OPTION>19');
document.writeln('<OPTION>20');
document.writeln('<OPTION>21');
document.writeln('<OPTION>22');
document.writeln('<OPTION>23');
document.writeln('<OPTION>24');
document.writeln('<OPTION>25');
document.writeln('<OPTION>26');
document.writeln('<OPTION>27');
document.writeln('<OPTION>28');
document.writeln('<OPTION>29');
document.writeln('<OPTION>30');
document.writeln('<OPTION>31');
document.writeln('</SELECT>');
document.writeln('</TD>');

document.writeln('<TD>');
document.writeln('<SELECT NAME="Departure">');
document.writeln('<OPTION selected>2012');
document.writeln('<OPTION>2013');
document.writeln('</SELECT>');
document.writeln('</TD>');
document.writeln('</TR>');
document.writeln('</table>');

document.writeln('<br>');
document.writeln('Number of Nights Needed:&nbsp;');
document.writeln('<input type="text" name="Nights" maxlength="3" size="3">');

document.writeln('<br><br>');
document.writeln('<input type="radio" name="Flexible_Dates" value="My dates are flexible.">');
document.writeln('My dates are flexible. &nbsp; &nbsp;');
document.writeln('<br>');
document.writeln('<input type="radio" name="Flexible_Dates" ');
document.writeln('value="My dates are slightly flexible.">');
document.writeln('My dates are slightly Flexible. &nbsp; &nbsp;');
document.writeln('<br>');
document.writeln('<input type="radio" name="Flexible_Dates" value="No, my dates are firm.">');
document.writeln('No, my dates are Firm.');
document.writeln('<hr><br>');
document.writeln('<p>Please tell us how many people are in your party:  </p>');

document.writeln('<table border="0" width="400" cellspacing="0" cellpadding="0">');
document.writeln('<tr>');

document.writeln('<td>');
document.writeln('<select name="Adults">');
document.writeln('<OPTION>0');
document.writeln('<OPTION>1');
document.writeln('<OPTION>2');
document.writeln('<OPTION>3');
document.writeln('<OPTION>4');
document.writeln('<OPTION>5');
document.writeln('<OPTION>6');
document.writeln('</select> ');
document.writeln('</td>');
document.writeln('<td>Over 18</td>');

document.writeln('<TD><SELECT NAME="Children">');
document.writeln('<OPTION>0');
document.writeln('<OPTION>1');
document.writeln('<OPTION>2');
document.writeln('<OPTION>3');
document.writeln('<OPTION>4');
document.writeln('</SELECT></TD>');

document.writeln('<td>Under 18</td>');
document.writeln('<TD><SELECT NAME="Infants">');
document.writeln('<OPTION>0');
document.writeln('<OPTION>1');
document.writeln('<OPTION>2');
document.writeln('<OPTION>3');
document.writeln('<OPTION>4');
document.writeln('</SELECT></TD>');

document.writeln('<td>Infants</td>');
document.writeln('</tr>');
document.writeln('</table>');

document.writeln('<hr> <br>');
document.writeln('Please provide us with your contact information.');
document.writeln('<P>');

document.writeln('<table border="0" cellspacing="0" cellpadding="0" width="450">');
document.writeln('<tr>');
document.writeln('<td>Your Name:&nbsp;</td>');
document.writeln('<td colspan="3">');
document.writeln('<input type="text" name="realname" maxlength="60" size="40">');
document.writeln('</td>');
document.writeln('</tr>');

document.writeln('<tr>');
document.writeln('<td>');
document.writeln('Email Address:&nbsp;<br><font size="-2" color="#CC0033">');
document.writeln('&nbsp;&nbsp;&nbsp;(required)</font>');
document.writeln('</td>');
document.writeln('<td colspan="3"><input type="text" name="email" maxlength="60" size="40">');
document.writeln('</td></tr>');

document.writeln('<TR> <TD colspan="4">&nbsp;</TD> </TR>');

document.writeln('<tr><td>');
document.writeln('Address 1:&nbsp;');
document.writeln('</td><td colspan="3"> <input type=text name=Address1 size=40></td></tr>');
document.writeln('<tr><td>');
document.writeln('Address 2:&nbsp;');
document.writeln('</td><td colspan="3"> <input type=text name=Address2 size=40></td></tr>');

document.writeln('<tr><td> City:&nbsp; </td>');
document.writeln('<td> <input type=text name=City size=16></td>');
document.writeln('<td>State:&nbsp;</td>');
document.writeln('<td><input type=text name=State size=14>');
document.writeln('</td></tr>');

document.writeln('<tr><td>Postal Code:&nbsp;</td>');
document.writeln('<td> <input type=text name=PostalCode size=10></td>');
document.writeln('<td>Country:&nbsp;</td>');
document.writeln('<td><input type=text name=Country size=14>');
document.writeln('</td></tr>');

document.writeln('<br>');
document.writeln('<br>');

document.writeln('<TR>');
document.writeln('<TD>Day Phone:</TD>');
document.writeln('<TD colspan="3">');
document.writeln('<INPUT TYPE="TEXT" SIZE="6" MAXLENGTH="3" NAME="DayPhone">&nbsp;');
document.writeln('<INPUT TYPE="TEXT" NAME="DayPhone" SIZE="30" MAXLENGTH="10">');
document.writeln('</TD>');
document.writeln('</TR>');

document.writeln('<TR>');
document.writeln('<TD>Evening :</TD>');
document.writeln('<TD colspan="3">');
document.writeln('<INPUT TYPE="TEXT" SIZE="6" MAXLENGTH="3" NAME="EveningPhone">&nbsp;');
document.writeln('<INPUT TYPE="TEXT" NAME="EveningPhone" SIZE="30" MAXLENGTH="10">');
document.writeln('</td></tr>');

document.writeln('</table>');

document.writeln('<hr><br>');
document.writeln('Please enter any questions or comments that you have in the');
document.writeln('space provided below.  You can enter as much text as you need.  ');
document.writeln('<p>');

document.writeln('<table border="0" cellspacinG="0" cellpadding="0" width="400">');
document.writeln('<TR align="left" valign="top">');

document.writeln('<td>Questions:&nbsp;&nbsp;</TD>');
document.writeln('<td><textarea name="Message" rows=4 cols=40 wrap=virtual></textarea></td>');
document.writeln('</tr>');
document.writeln('</table>');

document.writeln('<hr><br>');
document.writeln('<center>');
document.writeln('<table border="0" cellspacing="0" cellpadding="0" width="400">');
document.writeln('<tr>');
document.writeln('<td colspan="2">Are You Familiar with this Property? &nbsp;&nbsp;');
document.writeln('<input type="radio" name="familiar_with_property" value="yes">Yes');
document.writeln('<input type="radio" name="familiar_with_property" value="no">No');
document.writeln('</td></tr>');
document.writeln('<tr><td colspan="2">&nbsp;</td></tr>');
document.writeln('<tr>');
document.writeln('<td valign="top">Visit Kauai Often? &nbsp;&nbsp;<br>');
document.writeln('<input type="radio" name="Been_to_kauai_Before" ');
document.writeln('value="our_first_time">our first time<br>');
document.writeln('<input type="radio" name="Been_to_kauai_Before" ');
document.writeln('value="once">only once before<br>');
document.writeln('<input type="radio" name="Been_to_kauai_Before" ');
document.writeln('value="2-5_times">just 2-5 times<br>');
document.writeln('<input type="radio" name="Been_to_kauai_Before" ');
document.writeln('value="over_5_times"> more than 5 Times<br>');
document.writeln('</td>');
document.writeln('<td valign="top">Main Purpose of Trip? &nbsp;&nbsp;<br>');
document.writeln('<input type="radio" name="Purpose" value="vacation">Vacation<br>');
document.writeln('<input type="radio" name="Purpose" value="honeymoon">Honeymoon<br>');
document.writeln('<input type="radio" name="Purpose" value="anniversary">Anniversary<br>');
document.writeln('<input type="radio" name="Purpose" value="wedding">Attending Wedding<br>');
document.writeln('<input type="radio" name="Purpose" value="business">Business<br>');
document.writeln('<input type="radio" name="Purpose" value="other">Other<br>');
document.writeln('</td>');
document.writeln('</tr>');
document.writeln('</table></center>');

document.writeln('<hr><br>');
document.writeln('<P>');
document.writeln('<center>');
document.writeln('<input type="submit" value="Send Reservation Inquiry">');
document.writeln('<br><br>');
document.writeln('You should receive a reply from us in less than 8 hours.  ');
document.writeln('</center>');

document.writeln('</td></tr></table>');
document.writeln('</center>');
document.writeln('</form>');
}