function Contact() {
	var dc = "dc" + Math.floor( Math.random() * 1001 );
	var na = "na" + Math.floor( Math.random() * 1001 );
	var em = "em" + Math.floor( Math.random() * 1001 );
	var ty = "ty" + Math.floor( Math.random() * 1001 );
	var ms = "ms" + Math.floor( Math.random() * 1001 );

	document.write("<div align='center'><div class='spacer'></div><form action='contact.php' method='post'><input name='"+dc+"' value='1' type='hidden'><table style='color: #45607D; font-size: 11px;'><tbody><tr><td style='text-align: right;' width='50%'>Your Name &nbsp;</td><td width='50%'>&nbsp; <input name='"+na+"' type='text'></td></tr><tr><td style='text-align: right;' width='50%'>Your E-mail Address &nbsp;</td><td width='50%'>&nbsp; <input name='"+em+"' type='text'></td></tr><tr><td style='text-align: right;' width='50%'>Subject &nbsp;</td><td width='50%'>&nbsp; <select name='"+ty+"'><option>Set an appointment</option><option>Banner / Link exchange</option><option>Other</option></select></td></tr><tr><td colspan='2'>Message:<br><textarea name='"+ms+"' style='width: 350px; height: 100px; font-family: Arial,Helvetica;'></textarea></td></tr><tr><td colspan='2' style='text-align: center;'><input  type='submit' value='  Send  '><br></td></tr></tbody></table></form></div>");
}