document.write("Private Fitness Request Form\n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write("\n"); document.write("function TAMax( ta, countspan, maxlength ) {\n"); document.write(" if (ta.value.length > maxlength){\n"); document.write(" ta.value = ta.value.substring( 0, maxlength );\n"); document.write(" ta.blur();\n"); document.write(" ta.focus();\n"); document.write(" return false;\n"); document.write(" }\n"); document.write(" else {\n"); document.write(" countspan.innerHTML = maxlength - ta.value.length;\n"); document.write(" }\n"); document.write("}\n"); document.write("\n"); document.write("
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How you heard about us:
Full Name:
Address:
City:
State:  
Zip:
Home Phone:\n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write("
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Cell Phone:\n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write(" \n"); document.write("
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Best time to call: \n"); document.write("\n"); document.write("\n"); document.write("
Morning
Afternoon
Evening
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Email:
Your Gender: \n"); document.write("\n"); document.write("
MaleFemale
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Your present age:
Date of birth:
Your height:  
Your current weight:
List any health issues:
Worked with a trainer before: \n"); document.write("\n"); document.write("
YesNo
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Preferred gender of trainer: \n"); document.write("\n"); document.write("\n"); document.write("
Male
Female
Does not matter
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Fitness Goals: \n"); document.write("\n"); document.write("\n"); document.write("\n"); document.write("\n"); document.write("\n"); document.write("\n"); document.write("
Lose weight
Gain weight
Maintain weight
Greater strength
Greater endurance
Develope muscle
General conditioning
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Days/Times want to work with trainer:
Date you would like to start:
Exercise equipment you have:
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