document.writeln('<form action="http://search.earth911.com" method="get" target="_blank">');
document.writeln('<table width="160" cellpadding="0" cellspacing="0"><tr>');
document.writeln(' 	<td colspan="2" height="50"><img src="http://www.earth911.org/locator/images/earths-hdr.gif" border="0"></td>');
document.writeln('</tr><tr>');
document.writeln('	<td align="center" colspan="2"><div style="color: #336699;  font-size: 13px; font-weight: bold; font-family: arial, sans-serif;">To locate your nearest recycling or household hazardous waste collection center, please enter your ZIP Code:</div></td>');
document.writeln('</tr><tr>');
document.writeln(' 	<td align="right"><input type="text" name="where" size="10" maxlength="7"></td>');
document.writeln('	<td><input type="image" src="http://www.earth911.org/locator/images/go_btn.gif"></td>');
document.writeln('</tr><tr>');
document.writeln('	<td align="center" colspan="2"><div style="color: #336699;  font-size: 10px; font-weight: normal; font-family: arial, sans-serif;"> 1-800-CLEANUP<br/>');
document.writeln('		<a href="http://earth911.com" target="_blank">Earth911.com</a><br/>');
document.writeln('		<i>Making Every Day Earth Day!</i><br/></div>');
document.writeln('	</td>');
document.writeln('</tr></table>');
document.writeln('</form>');