function OIF13081_build(){
				
				// 0
				// 0
				// 0
						var OIF13081_html = '<div class="OIF_firstname"><label>Name:</label><input type="text" id="OIF13081_txtFName" /><div id="OIF13081_txtFNameErr" class="OIF_Error" style="display:none"><label>Please enter your Firstname!</label></div></div><div class="OIF_surname"><label>Lastname:</label><input type="text" id="OIF13081_txtSName" /><div id="OIF13081_txtSNameErr" class="OIF_Error" style="display:none"><label>Please enter your Lastname!</label></div></div>';
					
				
				OIF13081_html = OIF13081_html + '<br/><div class="OIF_email"><label>Email:</label><input type="text" id="OIF13081_txtEmail"/><div id="OIF13081_txtEmailErr" class="OIF_Error" style="display:none"><label>Please enter a valid email address!</label></div></div>';


				
						OIF13081_html = OIF13081_html + '<br/><div class="OIF_subscribe"><input type="button" value="Subscribe" onclick="OIF13081_go();" /></div>';
					

				
				document.write('<div id="OIF_13081" class="OIF_Form"></div>');
				document.getElementById('OIF_13081').innerHTML = OIF13081_html;

				fileref=document.createElement("link");
				fileref.setAttribute("rel", "stylesheet");
				fileref.setAttribute("type", "text/css");
					
				if(getQV("id")=="View"){
					fileref.setAttribute("href", "https://www.infacta.com/customers/secure/optin/css/13081.css");
				}
				else
				{
					fileref.setAttribute("href", "http://www.infacta.com/customers/secure/optin/css/13081.css");
				}
				document.getElementsByTagName("head").item(0).appendChild(fileref);
			}
			
			function OIF13081_go()
			{
				var fn;
				var sn;
				var e;
				var go;
				
				go = true;
				
				fn = document.getElementById('OIF13081_txtFName').value;
				
				if(fn=="")
				{
					document.getElementById('OIF13081_txtFNameErr').style.display = 'block';
					go=false;
				}
				else
				{
					document.getElementById('OIF13081_txtFNameErr').style.display = 'none';
				}
				
				if(document.getElementById('OIF13081_txtSName'))
				{
					sn = document.getElementById('OIF13081_txtSName').value;
					
					if(sn=="")
					{
						document.getElementById('OIF13081_txtSNameErr').style.display = 'block';
						go=false;
					}
					else
					{
						document.getElementById('OIF13081_txtSNameErr').style.display = 'none';
					}
				}
				
				e = document.getElementById('OIF13081_txtEmail').value;
				
				if(isEmail(e)==false)
				{
					document.getElementById('OIF13081_txtEmailErr').style.display = 'block';
					go=false;
				}
				else
				{
					document.getElementById('OIF13081_txtEmailErr').style.display = 'none';
				}
				
				if(go)
				{
					var s = document.createElement("SCRIPT");
					var txt;
					
					if(getQV("id")=="View"){					
						txt = "https://www.infacta.com/customers/secure/optin/optin.aspx?fid=13081&fname=" + document.getElementById('OIF13081_txtFName').value + "&email=" + document.getElementById('OIF13081_txtEmail').value + "&fm=Thank you for Subscribing to Nova health products news letter, we will update you on product offerings and discounts.";
					}
					else{
						txt = "http://www.infacta.com/customers/secure/optin/optin.aspx?fid=13081&fname=" + document.getElementById('OIF13081_txtFName').value + "&email=" + document.getElementById('OIF13081_txtEmail').value + "&fm=Thank you for Subscribing to Nova health products news letter, we will update you on product offerings and discounts.";
					}
					
					
					if(document.getElementById('OIF13081_txtSName'))
					{
						txt = txt + "&sname=" + document.getElementById('OIF13081_txtSName').value;
					}						

					if(document.getElementById('OIF13081_text'))
					{
						txt = txt + "&tval=" + document.getElementById('OIF13081_text').checked + "&hval=" + document.getElementById('OIF13081_html').checked;
					}
					
					if(document.getElementById('OIF13081_cstOne'))
					{	
						txt = txt + "&cstOne=" + document.getElementById('OIF13081_cstOne').value;
					}
					
					if(document.getElementById('OIF13081_cstTwo'))
					{	
						txt = txt + "&cstTwo=" + document.getElementById('OIF13081_cstTwo').value;
					}
					
					if(document.getElementById('OIF13081_cstThree'))
					{	
						txt = txt + "&cstThree=" + document.getElementById('OIF13081_cstThree').value;
					}

					
					s.src = encode_utf8( txt );
					s.type = "text/javascript";
					var h = document.getElementsByTagName("head").item(0);
					h.appendChild(s);
				}
			}


			function getQV(variable) {

  				var query = window.location.search.substring(1);
				var vars = query.split("&");

  				for (var i=0;i<vars.length;i++) {

    					var pair = vars[i].split("=");

    					if (pair[0] == variable) {
      						return pair[1];
    					}
  				}

  				return "";
			}

			OIF13081_build();
			
			function isEmail(add){if(/^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,5})+$/.test(add)){return true;}else{return false;}}
			
			function encode_utf8( s )
			{
			  return unescape( encodeURIComponent( s ) );
			}

			function decode_utf8( s )
			{
			  return decodeURIComponent( escape( s ) );
			}