document.write("<table cellpadding=3 cellspacing=1 border=0 width=\"124\">");
 document.write("<tr><td width=\"100%\" bgcolor=\"#D0E2EA\">");
 document.write("<b><small>Сколько вам лет?</small></b>");
 document.write("<font style=\"color:#000000;");
 document.write("       font-family:Verdana, Arial;");
 document.write("       font-size: 8pt;\"> ");
 document.write("<form action=\"http://www.net-ee.com/cgi-bin/opros/vote.cgi\" method=POST>");
 document.write("<input TYPE=RADIO NAME=single_vote value=0> меньше 10<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=1> 10 - 14<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=2> 14 - 18<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=3> 18 - 21<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=4> 21 - 30<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=5> 30 - 40<br>");
 document.write("<input TYPE=RADIO NAME=single_vote value=6> больше 40<br>");
 document.write("");
 document.write("<center><input type=submit name=sbtsubmit value=\"Голосовать!\" style=\"background-color:#ffffff; border:#000000 1 solid; color:#000000; font-size: 8pt;\"></center>");
 document.write("</form>");
 document.write("</font>");
 document.write("</td></tr></table>");
 document.write("");