document.write('<div style="border: 1px solid #ccc; background: #fff; width: 300px; min-height: 250px">');
document.write('<div style="padding: 10px; font-family: arial; font-size: 15px; color: #000; background: #eee">Choose One Item For Your Capsule Wardrobe</div>');
document.write('<div style="padding: 10px; font-family: arial; font-size: 14px; color: #000">');
document.write('<form action="http://www.websitegoodies.com/vote.php" method="post">');
document.write('<input type="hidden" name="id" value="115813">');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929545" /> &nbsp; Dress Shoes</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929546" /> &nbsp; Tie</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929547" /> &nbsp; Blazer</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929548" /> &nbsp; Blouse</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929549" /> &nbsp; Dress Shirt</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929550" /> &nbsp; Skirt</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929551" /> &nbsp; Briefcase</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929552" /> &nbsp; Dress Pants</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929553" /> &nbsp; Sport Coat</label></div>');
        document.write('<div style="vertical-align: middle; padding: 3px 0"><label style="font-weight: normal"><input type="radio" name="vote" value="929554" /> &nbsp; Accessories</label></div>');
document.write('<div align="center" style="margin-top: 10px">');
document.write('<input type="submit" value="Submit My Vote"><br /><br />');
document.write('<a href="http://www.websitegoodies.com/pollresults.php?id=115813" target="_blank">View Results</a>');
document.write('</div>');
document.write('</form>');
document.write('</div>');
document.write('</div>');