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today.setDate(09);
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shuzaicode = shuzaicode + '<table border="0" cellpadding="2" cellspacing="2">';
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shuzaicode = shuzaicode + '	<td><input type="text" size="20" name="data_301_1" value="';
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shuzaicode = shuzaicode + '<tr><td align="right"><span class="required">*&nbsp;</span><span class="display">Address  </span></td>';
shuzaicode = shuzaicode + '	<td><input type="text" size="20" name="data_303_1" value="';
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shuzaicode = shuzaicode + '" maxlength="128"></td>';
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shuzaicode = shuzaicode + '" maxlength="128"></td>';
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shuzaicode = shuzaicode + '<tr><td align="right"><span class="required">*&nbsp;</span><span class="display">City:</span></td>';
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shuzaicode = shuzaicode + '<tr><td align="right"><span class="required">*&nbsp;</span><span class="display">Phone Number  </span></td>';
shuzaicode = shuzaicode + '	<td><input type="text" size="12" name="data_305" value="';
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shuzaicode = shuzaicode + '" maxlength="20"></td>';
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shuzaicode = shuzaicode + '	<td><input type="text" size="20" name="data_306" value="';
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shuzaicode = shuzaicode + '" maxlength="40"></td>';
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shuzaicode = shuzaicode + '<tr><td align="right"><span class="display">Sex  </span></td>';
shuzaicode = shuzaicode + '	<td>';
shuzaicode = shuzaicode + '		<table border="0" cellpadding="0" cellspacing="2">';
shuzaicode = shuzaicode + '		<tr><td><input type="radio" name="data_307" value="m" ></td>';
shuzaicode = shuzaicode + '			<td>Male</td><td>&nbsp;&nbsp;&nbsp;&nbsp;</td>';
shuzaicode = shuzaicode + '			<td><input type="radio" name="data_307" value="f" ></td>';
shuzaicode = shuzaicode + '			<td>Female</td>';
shuzaicode = shuzaicode + '		</tr></table>';
shuzaicode = shuzaicode + '	</td>';
shuzaicode = shuzaicode + '</tr>';
shuzaicode = shuzaicode + '<tr><td align="right"><span class="display">Sex  </span></td>';
shuzaicode = shuzaicode + '	<td>';
shuzaicode = shuzaicode + '		<table border="0" cellpadding="0" cellspacing="2">';
shuzaicode = shuzaicode + '		<tr><td><input type="radio" name="data_308" value="m" ></td>';
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shuzaicode = shuzaicode + '</tr>';
shuzaicode = shuzaicode + '<tr><td align="right" valign="top"><span class="display">What shoe brand do you like best?  </span></td>';
shuzaicode = shuzaicode + '     <td valign="top">';
shuzaicode = shuzaicode + '             <table border="0" cellpadding="0" cellspacing="0">';
                
shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_498"  > </td>';
shuzaicode = shuzaicode + '                     <td>Reef  </td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_499"  > </td>';
shuzaicode = shuzaicode + '                     <td>DC  </td>';
shuzaicode = shuzaicode + '             </tr>';
                
shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_500"  > </td>';
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shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_502"  > </td>';
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shuzaicode = shuzaicode + '             <tr>';
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shuzaicode = shuzaicode + '                     <td>Osiris  </td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_507"  > </td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_309" value="option_id_508"  > </td>';
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shuzaicode = shuzaicode + '<tr><td align="right" valign="top"><span class="display">Where do you shop?  </span></td>';
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shuzaicode = shuzaicode + '             <tr>';
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shuzaicode = shuzaicode + '             <tr>';
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shuzaicode = shuzaicode + '             <tr>';
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shuzaicode = shuzaicode + '                     <td>Rock Star</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_311" value="option_id_522"  > </td>';
shuzaicode = shuzaicode + '                     <td>Red Bull </td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_311" value="option_id_523"  > </td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_311" value="option_id_524"  > </td>';
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shuzaicode = shuzaicode + '<tr><td align="right" valign="top"><span class="display">What clothing brand do you like to wear?  </span></td>';
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shuzaicode = shuzaicode + '             <table border="0" cellpadding="0" cellspacing="0">';
                
shuzaicode = shuzaicode + '             <tr>';
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shuzaicode = shuzaicode + '                     <td>O&#39;Neill</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_526"  > </td>';
shuzaicode = shuzaicode + '                     <td>Quiksilver</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_527"  > </td>';
shuzaicode = shuzaicode + '                     <td>Hurley</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_528"  > </td>';
shuzaicode = shuzaicode + '                     <td>Billabong</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_529"  > </td>';
shuzaicode = shuzaicode + '                     <td>Rip Curl</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_530"  > </td>';
shuzaicode = shuzaicode + '                     <td>RVCA</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_531"  > </td>';
shuzaicode = shuzaicode + '                     <td>Body Glove</td>';
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shuzaicode = shuzaicode + '             <tr>';
shuzaicode = shuzaicode + '                     <td><input type="radio" name="data_312" value="option_id_532"  > </td>';
shuzaicode = shuzaicode + '                     <td>Volcom</td>';
shuzaicode = shuzaicode + '             </tr>';
                
shuzaicode = shuzaicode + '             </table>';
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