document.write("<script type='text/javascript' src='/inc/js/time/WdatePicker.js'></script>");
document.write("<script type='text/javascript' src='/inc/js/lhgcore/lhgcore.min.js'></script>");
document.write("<script type='text/javascript' src='/inc/js/lhgcore/lhgdialog.min.js'></script>");
document.write("<script type='text/javascript' src='/inc/main.js'></script>");
document.write("<script type='text/javascript' src='/inc/js/swfobject.js'></script>");
document.write("<form name='myform' action='/plus/Form/ACT.F.ASP?A=Save&ModeID=6' method='post'> ");
document.write("<table border='0' align='center' cellpadding='2' cellspacing='1' class=xtalbe>");
document.write("<tr><td align='right'>姓名：</td><td align='left'><input type='text' title='' name='xm_ACT' size='40' value=''>  </td></tr>");
document.write("<tr><td align='right'>电话：</td><td align='left'><input type='text' title='' name='dh_ACT' size='40' value=''>  </td></tr>");
document.write("<tr><td align='right'>邮箱：</td><td align='left'><input type='text' title='' name='yx_ACT' size='40' value=''>  </td></tr>");
document.write("<tr><td align='right'>QQ：</td><td align='left'><input type='text' title='' name='qq_ACT' size='40' value=''>  </td></tr>");
document.write("<tr><td align='right'>举报内容：</td><td align='left'><textarea title='' name='nr_ACT' style='height:100px;width:300px;'></textarea>  <font color=red title='必填'>*</font>  </td></tr>");

document.write("<tr><td>验证码：</td><td>");
document.write("<input type='text' size='10' name='Code'> <img style='cursor:hand;'  src='/inc/Code.asp?s=+Math.random();' id='IMG1' onclick=this.src='/inc/Code.asp?s=+Math.random();' alt='看不清楚? 换一张！'>");
document.write("</td></tr>");
document.write("<tr> <td  colspan='2' align='center'>");
document.write("<input type=submit   name=Submit1 value='  提 交  ' />&nbsp;");
document.write("<input type='reset' name='Submit2'  value='  重 置  ' /></td></tr></table></form>");