document.writeln('<div>Solve the following captcha:<br>');
document.writeln('<a href="http://www.freeforms.org/captcha.cfm"><img src="http://www.freeforms.org/captchas/captcha162.png" width=90 height=30 alt="Solve This Captcha by Typing the Word or Solving the Equation" style="float:left;" border=0></a>');
document.writeln('<input type="text" name="answer" value="" size=5>');
document.writeln('<input type="hidden" name="cap_key1" value="4w==">');
document.writeln('<input type="hidden" name="cap_key2" value="6Q==">');
document.writeln('<input type="hidden" name="cap_key3" value="qd72mw=="></div>');