document.write("Enter your scores to see how you'd do at US med schools.<br />")
document.write("<table border=0 cellspacing=0 cellpadding=3 cols=2 width='200'>")
document.write("<form name='medsearchform' action='http://www.studentdoc.com/medical-schools.php' method='post'>")

document.write("<tr> <td width='140'>MCAT Bio Score:</td>")
document.write("<td> <input type='text' name='mcat-bio' value='0' maxlength='3' size='3'> </td></tr>")

document.write("<tr> <td>MCAT Physics Score:</td>")
document.write("<td> <input type='text' name='mcat-physics' value='0' maxlength='3' size='3'> </td></tr>")

document.write("<tr> <td>MCAT Verbal Score:</td>")
document.write("<td> <input type='text' name='mcat-verbal' value='0' maxlength='3' size='3'> </td></tr>")

document.write("<tr> <td>Cumulative GPA:</td>")
document.write("<td> <input type='text' name='gpa' value='0' maxlength='3' size='3'> </td></tr>")

document.write("<tr><td colspan=2>State of residence</td></tr><tr><td colspan=2><select name='state'>");

document.write("<option value='' selected='selected'>Select a State</option> ");
document.write("		<option value='AL'>Alabama</option> ");
document.write("		<option value='AK'>Alaska</option> ");
document.write("		<option value='AZ'>Arizona</option> ");
document.write("		<option value='AR'>Arkansas</option> ");
document.write("		<option value='CA'>California</option> ");
document.write("		<option value='CO'>Colorado</option> ");
document.write("		<option value='CT'>Connecticut</option> ");
document.write("		<option value='DE'>Delaware</option> ");
document.write("		<option value='DC'>District Of Columbia</option> ");
document.write("		<option value='FL'>Florida</option> ");
document.write("		<option value='GA'>Georgia</option> ");
document.write("		<option value='HI'>Hawaii</option> ");
document.write("		<option value='ID'>Idaho</option> ");
document.write("		<option value='IL'>Illinois</option> ");
document.write("		<option value='IN'>Indiana</option> ");
document.write("		<option value='IA'>Iowa</option> ");
document.write("		<option value='KS'>Kansas</option> ");
document.write("		<option value='KY'>Kentucky</option> ");
document.write("		<option value='LA'>Louisiana</option> ");
document.write("		<option value='ME'>Maine</option> ");
document.write("		<option value='MD'>Maryland</option> ");
document.write("		<option value='MA'>Massachusetts</option> ");
document.write("		<option value='MI'>Michigan</option> ");
document.write("		<option value='MN'>Minnesota</option> ");
document.write("		<option value='MS'>Mississippi</option> ");
document.write("		<option value='MO'>Missouri</option> ");
document.write("		<option value='MT'>Montana</option> ");
document.write("		<option value='NE'>Nebraska</option> ");
document.write("		<option value='NV'>Nevada</option> ");
document.write("		<option value='NH'>New Hampshire</option> ");
document.write("		<option value='NJ'>New Jersey</option> ");
document.write("		<option value='NM'>New Mexico</option> ");
document.write("		<option value='NY'>New York</option> ");
document.write("		<option value='NC'>North Carolina</option> ");
document.write("		<option value='ND'>North Dakota</option> ");
document.write("		<option value='OH'>Ohio</option> ");
document.write("		<option value='OK'>Oklahoma</option>"); 
document.write("		<option value='OR'>Oregon</option> ");
document.write("		<option value='PA'>Pennsylvania</option> ");
document.write("		<option value='RI'>Rhode Island</option> ");
document.write("		<option value='SC'>South Carolina</option> ");
document.write("		<option value='SD'>South Dakota</option> ");
document.write("		<option value='TN'>Tennessee</option> ");
document.write("		<option value='TX'>Texas</option> ");
document.write("		<option value='UT'>Utah</option> ");
document.write("		<option value='VT'>Vermont</option> ");
document.write("		<option value='VA'>Virginia</option> ");
document.write("		<option value='WA'>Washington</option> ");
document.write("		<option value='WV'>West Virginia</option> ");
document.write("		<option value='WI'>Wisconsin</option> ");
document.write("		<option value='WY'>Wyoming</option>");

document.write("		</select>");

document.write("<input type='hidden' name='wholeus' value='1'>");
document.write("<input type='hidden' name='schnum' value='0'></td></tr>");

document.write("<tr><td colspan=2><input type='submit' name='submit' value='search Med Schools'>");

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