function bjpenn_signup() {

			document.write( '' +
			
			
'<div style="width:185px;background-color:#FAFA99">' +
'<div style="padding:3px;"><b>Live Like a Champion Instructor\'s' +
' Newsletter</b></div>' +
'<form action=' +
'"https://m112.infusionsoft.com/AddForms/processForm.jsp" method=' +
'"post"><input value="118" id="formid" name="formid" type="hidden">' +
'<input value="CustomFormWeb" id="type" name="type" type="hidden">' +
'<table>' +
'<tr>' +
'<td colspan="99" style=' +
'"padding:4px;background-color:#000000;color:#FFFFFF">Sign Up' +
' Now!</td>' +
'</tr>' +
'<tr>' +
'<td>First Name * <input type="text" name="Contact0FirstName" value=' +
'""></td>' +
'</tr>' +
'<tr>' +
'<td>Last Name *<input type="text" name="Contact0LastName" value=' +
'""></td>' +
'</tr>' +
'<tr>' +
'<td>Email *<input type="text" name="Contact0Email" value=""></td>' +
'</tr>' +
'<tr>' +
'<td colspan="2"><input class="button np inf-button" value="Submit"' +
'id="Submit" name="Submit" type="submit"></td>' +
'</tr>' +
'</table>' +
'</form>' +
'</div>'
									
						);

	}
	
	bjpenn_signup();