document.write("MCAT retake statistics show which scores can improve and which don't.<p>")

document.write("<table border=0 cellspacing=0 cellpadding=3 cols=2 width='200' >")
document.write("<form name='mcat-score-data' action='http://www.studentdoc.com/retake-mcat.php' method='post'>")
 
document.write("<tr> <td width='110'><font size='2'>MCAT Physics Score:</font><br />&nbsp;</td>")
document.write("<td> <input type='text' name='mcat-physics' value='0' size='4' maxlength='3'> </td></tr>")

document.write("<tr> <td width='110'><font size='2'>MCAT Biology Score:</font><br />&nbsp;</td>")
document.write("<td> <input type='text' name='mcat-bio' value='0' size='4' maxlength='3'> </td></tr>")

document.write("<tr> <td width='110'><font size='2'>MCAT Verbal Score:</font><br />&nbsp;</td>")
document.write("<td> <input type='text' name='mcat-verbal' value='0' size='4' maxlength='3'> </td></tr>")

document.write("<tr><td colspan=2> <center><input type='submit' name='submit' value='See chances'></center></td>")

document.write("                </tr>	              </form>	            </table>")