document.write('<form method=POST action=""><p>');
		  document.write('<table width="75%" border="0" cellspacing="8" cellpadding="3" align="center">');
		    document.write('<tr>');
		      document.write('<td align="right"></td>');
		      document.write('<td align="left">Your Comments</td>');
	        document.write('</tr>');
		    document.write('<tr> ');
		      document.write('<td align="right">Your Name</td>');
		      document.write('<td align="left">');
		        document.write('<input type=text name="field1"></td>');
		    document.write('</tr>');
		    document.write('<tr>'); 
		      document.write('<td align="right">Your email address</td>');
		      document.write('<td align="left">');
		        document.write('<input type="Text" name="textfield2"></td>');
		    document.write('</tr>');
		    document.write('<tr> ');
		      document.write('<td valign="top" align="right">Your Comment</td>');
		      document.write('<td valign="top" align="left">');
		        document.write('<textarea name="comment" ></textarea></td>');
		    document.write('</tr>');
		    document.write('<tr> ');
		      document.write('<td valign="top" align="right"></td>');
		      document.write('<td valign="top" >');
	              document.write('<input type="submit" name="Comment" value="Submit"></td>');
		    document.write('</tr>');
		  document.write('</table></p>');
document.write('</form>');