document.writeln("<form enctype=\"multipart/form-data\" action=\"form/use/Opinions/process.php\" method=\"post\">");
document.writeln("              <p><b><font size=\"2\">Casino:<\/font><\/b>*");
document.writeln("                <input type=\"text\" name=\"Casino\" size=\"21\">");
document.writeln("              <\/p>");
document.writeln("              <p><b>Rating:<\/b>* <font size=\"2\">");
document.writeln("                <input type=\"radio\" name=\"Rating\" value=\"Excellent\">");
document.writeln("                Excellent");
document.writeln("                <input type=\"radio\" name=\"Rating\" value=\"Good\">");
document.writeln("                Good");
document.writeln("                <input type=\"radio\" name=\"Rating\" value=\"Bad\">");
document.writeln("                Bad");
document.writeln("                <input type=\"radio\" name=\"Rating\" value=\"Rogue\">");
document.writeln("                Rogue<\/font><\/p>");
document.writeln("              <dl>");
document.writeln("                <dd>");
document.writeln("                  <textarea name=\"Comments\" rows=\"3\" cols=\"36\">Your Comments<\/textarea>");
document.writeln("                <\/dd>");
document.writeln("              <\/dl>");
document.writeln("              <dl>");
document.writeln("                <dd>");
document.writeln("                  <table>");
document.writeln("                    <tr>");
document.writeln("                      <td><font size=\"2\">Name or Alias*<\/font><\/td>");
document.writeln("                      <td><input type=\"text\" name=\"Name\" size=\"25\"><\/td>");
document.writeln("                    <\/tr>");
document.writeln("                    <tr>");
document.writeln("                      <td align=\"right\"><font size=\"2\">Email*: <\/font><\/td>");
document.writeln("                      <td><input type=\"text\" name=\"email\" size=\"25\">");
document.writeln("                        <sup><font size=\"2\">Your email won&#39;t be share<\/font><\/sup><\/td>");
document.writeln("                    <\/tr>");
document.writeln("                  <\/table>");
document.writeln("                <\/dd>");
document.writeln("              <\/dl>");
document.writeln("              <p>");
document.writeln("                <input type=\"checkbox\" name=\"Contactme\">");
document.writeln("                contact me<\/p>");
document.writeln("              <p>");
document.writeln("                <input type=\"submit\" value=\"Submit\">");
document.writeln("                <input type=\"reset\" value=\"Reset\">");
document.writeln("              <\/p>");
document.writeln("            <\/form>");