document.write('  <style type="text/css">');   
document.write('  <!--   ');
document.write('  .style1 {font-family: Verdana, Arial, Helvetica, sans-serif}');   
document.write('  .style2 {font-size: 9px}   ');
document.write('  .style3 {font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 24px; }');   
document.write('  .style4 {   ');
document.write('  	font-family: Verdana, Arial, Helvetica, sans-serif;');   
document.write('  	font-size: 24px;   ');
document.write('  	color: #990000;   ');
document.write('  	font-weight: bold;   ');
document.write('  }   ');
document.write('  -->   ');
document.write('  </style> ');  
document.write('   <table width="100%" border="1">');    
document.write('     <tr>    ');
document.write('       <td><table width="95%" border="0" align="center">');    
document.write('         <tr> ');
document.write('           <td>&nbsp;</td>'); 
document.write('           <td align="right" valign="top"><a href="javascript:hideObject()">Fermer cette fen&ecirc;tre</a></td>'); 
document.write('         </tr> ');
document.write('         <tr>    ');
document.write('           <td width="33%" valign="top"><img src="images/couvnewsletter.jpg" width="350" height="429" /></td>');    
document.write('           <td width="67%" valign="top"><p align="center" class="style3"><strong>Recevez dans votre bo&icirc;te e-mail la newsletter :</strong></p>');    
document.write('             <p align="center" class="style4">&quot;La Cl&eacute; Pour Cultiver La <br />');
document.write('             Confiance En Soi&quot;</p>    ');
document.write('             <p class="style1">Un outil indispensable pour la r&eacute;ussite sociale et professionnelle !</p>');    
document.write('             <p class="style1">Remplissez juste le formulaire suivant :<br />    ');
document.write('               <br />    ');
document.write('             </p>    ');
document.write('             <form action="http://www.cybermailing.com/mailing/subscribe.php" method="post" name="form1" class="style1" id="form1">');    
document.write('               <table width="75%" border="0">    ');
document.write('                 <tr>    ');
document.write('                   <td width="38%" class="style1">Votre pr&eacute;nom</td>');    
document.write('                   <td width="62%" class="style1"><label>    ');
document.write('                     <input name="Name" type="text" maxlength="255">');    
document.write('                   </label></td>    ');
document.write('                 </tr>    ');
document.write('                 <tr>    ');
document.write('                   <td class="style1">Votre e-mail*</td>');    
document.write('                   <td class="style1"><label>    ');
document.write('                     <input name="Email" type="text" maxlength="255">');    
document.write('                   </label></td>    ');
document.write('                 </tr>    ');
document.write('                 <tr>    ');
document.write('                   <td colspan="2" align="center" class="style1"><label>');    
document.write('   								<input type="hidden" name="Liste" value="21501">    ');
document.write('                     <input type="submit" name="button" id="button" value="Je veux recevoir la newsletter" />');    
document.write('                     <br />    ');
document.write('                     <br />    ');
document.write('                     <span class="style2">* Aucun envoi de courrier non sollicit&eacute; - votre adresse<br />');    
document.write('                     reste sur le site et ne sera &eacute;chang&eacute;e ni c&eacute;d&eacute;e a des tiers</span></label></td>');    
document.write('                   </tr>    ');
document.write('               </table>    ');
document.write('              </form>    ');
document.write('             <p class="style1">&nbsp;</p>');    
document.write('             <p>&nbsp;</p></td>    ');
document.write('         </tr>    ');
document.write('       </table></td> ');   
document.write('     </tr>    ');
document.write('   </table>    ');