document.writeln('<div class="widget-body">\r\n<link href="http:\/\/www.whitefence.com\/qsrimages\/cannon\/widget-att\/widgetstyle.css" rel="stylesheet" type="text\/css">\r\n<script language="JavaScript" type="text\/javascript" src="http:\/\/www.whitefence.com\/addy\/scripts\/addyajax.js"><\/script><div class="widgetaddressbox">\r\n<script type="text\/javascript" src="\/\/www.whitefence.com\/addy\/scripts\/xmlhttp.js"><\/script><script type="text\/javascript" src="\/\/www.whitefence.com\/addy\/scripts\/modded_prototype.js"><\/script>\r\n<script type="text\/javascript" src="\/\/www.whitefence.com\/addy\/scripts\/simplexml.js"><\/script>\r\n<form action="https:\/\/www.whitefence.com\/WebObjects\/WhiteFence.woa\/wa\/selfRegister" method="POST" name="selfReg" class="widget" target="_blank">\r\n<div class="widget-street">Street Address:<br><input id="streetAddress" name="streetAddress" class="widget-streetaddress" tabindex="1"><\/div>\r\n<div class="widget-apt">Apt\/Suite:<br><input id="apartmentNumber" name="apartmentNumber" class="widget-apt" tabindex="2"><\/div>\r\n<div class="widget-zip">Zip Code:<br><input id="zipcode" name="zipcode" class="widget-zip" tabindex="3" onkeyup="javascript:ZipCheck();"><\/div>\r\n<input id="Submit" src="http:\/\/www.whitefence.com\/qsrimages\/cannon\/widget-att\/btn-continue.gif" tabindex="6" value="Submit" name="Submit" class="widget-go" type="image">\r\n<input name="scKey" type="hidden" id="scKey" value="highSpeedInternetAccess">\r\n<input type="hidden" name="redirectURL" value="topOffers">\r\n<input name="city" type="hidden">\r\n<input name="state" type="hidden">\r\n<input name="bpID" value="1079179" type="hidden">\r\n<input name="eID" value="1086004" type="hidden">\r\n<\/form>\r\n<\/div>\r\n<\/div>\r\n');