document.write("<script language=\"javascript\" type=\"text/javascript\" src=\"http://www.ylxh.org/statics/js/dialog.js\"></script><link href=\"http://www.ylxh.org/statics/css/table_form.css\" rel=\"stylesheet\" type=\"text/css\" /><link href=\"http://www.ylxh.org/statics/css/dialog.css\" rel=\"stylesheet\" type=\"text/css\" /><script type=\"text/javascript\" src=\"http://www.ylxh.org/statics/js/dialog.js\"></script><div class=\"box\">    <h5></h5>    <div class=\"content\"><form method=\"post\" action=\"http://www.ylxh.org/index.php?m=formguide&c=index&a=show&formid=14&siteid=1\" name=\"myform\" id=\"myform\"><table class=\"table_form\" width=\"100%\" cellspacing=\"0\"><tbody> <tr>  <th width=\"120\"> <font color=\"red\">*</font> 单位名称  </th>  <td><input type=\"text\" name=\"info[company]\" id=\"company\" size=\"50\" value=\"\"  class=\"input-text\"  >  </td></tr><tr>  <th width=\"120\"> <font color=\"red\">*</font> 申请人  </th>  <td><input type=\"text\" name=\"info[applicant]\" id=\"applicant\" size=\"50\" value=\"\"  class=\"input-text\"  >  </td></tr><tr>  <th width=\"120\"> <font color=\"red\">*</font> 申请邮箱  </th>  <td><input type=\"text\" name=\"info[email]\" id=\"email\" size=\"50\" value=\"\"  class=\"input-text\"  >  </td></tr><tr>  <th width=\"120\"> <font color=\"red\">*</font> 手机  </th>  <td><input type=\"text\" name=\"info[mobi]\" id=\"mobi\" size=\"50\" value=\"\"  class=\"input-text\"  >  </td></tr><tr>  <th width=\"120\"> 申请说明  </th>  <td><textarea name=\'info[vipinfo]\' id=\'vipinfo\' style=\'width:50%;height:90px;\'   ></textarea>  </td></tr><tr><td></td><td><div class=\"submit ib\"><input type=\"submit\" name=\"dosubmit\" id=\"dosubmit\" value=\" 提交 \"></div> </td></tr></tbody></table></form>    </div></div>");