document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub2.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=126342056&formid=3998&formpadding=0\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:126342056:2:3998\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div> \"STOP THE ELLESMERE BUSWAY - (Scarborough/Guildwood)\" PETITION</div></div> <div class=\"bn-form-desc\"><p>Please fill out the fields below and you will be added to the petition. ');
document.write('Thanks for taking the time with this cause.</p></div></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Name <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1\" placeholder=\"your first and last name\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Your company name </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-162654467742188\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Email Address <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-2\" placeholder=\"you must enter a valid email address\" validator=\"email\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Your business and/or home address <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-162654473096816\" placeholder=\"\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Contact phone number </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-162654467742120\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">ORDER A FREE LAWN SIGN </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-checkbox\"><input type=\"checkbox\" name=\"Field-162801889477914[]\" value=\"Yes, please put a sign on my lawn!\"> <span class=\"bn-inner-label\">Yes, please put a sign on my lawn!</span></label></span></span></div></div><div class=\"fields-wrapper ui-sortable-handle\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Please keep me informed on this matter <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-checkbox\"><input type=\"checkbox\" name=\"Field-162801904164926[]\" value=\"Yes\" required=\"required\"> <span class=\"bn-inner-label\">Yes</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-checkbox\"><input type=\"checkbox\" name=\"Field-162801904164926[]\" value=\"No\" required=\"required\"> <span class=\"bn-inner-label\">No</span></label></span></span></div></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Tell us why you are against this <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><textarea name=\"Field-3\" placeholder=\"enter your comments here\" validator=\"\" required=\"required\">I am against the Scarborough/Guildwood Ellesmere Busway.  </textarea></span></label></div>  <input type=\"hidden\" name=\"carboncopy\" value=\"jessegoldberger@rogers.com\"> <input type=\"hidden\" name=\"thankyou\" value=\"\"> <input type=\"hidden\" name=\"thankyoutext\" value=\"Thank you for your form submission\"> <input type=\"hidden\" name=\"subject\" value=\"Stop the Ellesmere Busway\"><div class=\"bn-form-submit\"><button type=\"submit\" class=\"formbtn\">Submit Form</button></div> <style type=\"text/css\">.bnet-form ::-webkit-input-placeholder {');
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