var FMChannel		= "200085";
var FMWebsite 		= "www.clicklife.co.uk";
var FMEmailClient	= "chris@businessdata.com";
var FMReturnPage 	= "";
document.write("<style>");
document.write("TABLE.MainFormPanel { width: 100%; }");
document.write(".MainFormPanel H1 { font-size: 22px; }");
document.write(".MainFormPanel TD { height: 23px; font-family: Arial; font-size: 12px; }");
document.write(".MainFormPanel INPUT, SELECT { font-family: Arial; font-size: 12px; }");
document.write("TABLE.MainForm { margin: 4px 0px 4px 0px; }");
document.write(".MainForm TD { height: 23px; font-weight: normal; padding: 0px 3px 0px 3px; color: #1C1E51; font-family: Arial; font-size: 12px; }");
document.write(".MainForm INPUT, SELECT { font-family: Arial; font-size: 12px; color: #000000; }");
document.write("</style>");
document.write("<script language=\"JavaScript\" src=\"http://affiliates.clickgroup.com/lifeinsurance/lifeform.js\"></script>");