document.write("<link href='/crmp_widget/crmp_mail.css' rel='stylesheet' type='text/css' />");
document.write("<div class='crmp_main'>");
document.write("<form class='crmp_form' action='http://ethreemail.com/e3ds/subscribe.php' method='post' name='subscribe' target='_blank'>");
document.write("<input type='hidden' value='19c8da3b' name='group_e3ds_id' />");
document.write("<input type='hidden' value='' name='posted_url' />");
document.write("<input type='hidden' value='1' name='standard_form' />");
document.write("<label accesskey='n' for='fn'>Nume:</label>");
document.write("<input type='text' value='' name='subscriber_name' id='n' size='13' maxlength='84' class='crmp_input'/><br />");
document.write("<label accesskey='e' for='em'>email:</label>");
document.write("<input type='text' value='' name='subscriber_email' id='em' size='13' maxlength='84' class='crmp_input' />");
document.write("<div><input type='submit' class='crmp_btn' value='' /></div>");
document.write("</form>");
document.write("</div>");