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document.write(" | First Name: | \n");
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document.write(" | Last Name: | \n");
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document.write(" | Address 1: | \n");
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document.write(" | Address 2: | \n");
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document.write(" | City: | \n");
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document.write(" | State/Province: | \n");
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document.write(" | Zip Code: | \n");
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document.write(" | Country: | \n");
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document.write(" | Web Site: | \n");
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document.write(" | Email Address: | \n");
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document.write(" | Verify Email: | \n");
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document.write(" | Home Phone: | \n");
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document.write("Check one: | \n");
document.write("\n");
document.write("New Member
Member Renewal
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document.write("Is this a gift membership?: | \n");
document.write("\n");
document.write("Yes
No
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document.write(" | If yes above, name of giver:: | \n");
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document.write("Want to explore email exchange program with other members?: | \n");
document.write("\n");
document.write("Yes
No
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document.write(" |
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document.write(" | If new member, how did you hear about us?: | \n");
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document.write("What is your growing space? Check all that apply.: | \n");
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document.write("Greenhouse
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document.write("Sunroom/Porch
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document.write("Light Garden
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document.write("Hydroponic
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document.write("Window
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document.write(" | If you have a greenhouse, specify brand.: | \n");
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document.write("May we share your non-financial info above with other members?: | \n");
document.write("\n");
document.write("Yes
No
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document.write(" |
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document.write("Payment Type? Check one: | \n");
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document.write("Credit Card/PayPal
Check/Money Order
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