Here is the code.....

<form action="http://www.justanswer.com/QuestionSubmit.aspx" method="post"> <div style="height:250px;width:300px;font-size:15px;"> <div style="float:left;padding:0px;width:298px;height:180px;background:#128094 url('http://www.justanswer.com/uploads/affiliates/top.gif') no-repeat;text-align:left;"> <h1 style="margin:5px 15px 0px;font-family: Arial, Verdana, Tahoma, MS Sans Serif;font-size:1em;font-weight:bold;color:#ffffff;">Ask a Vet online</h1><br> <h2 style="margin:0px 15px 0px;font-family: Arial, Verdana, Tahoma, MS Sans Serif;font-size:.8em;font-weight:normal;color:#ffffff;">11 Veterinarians are Online Now<br>A Question is Answered Every 9 Seconds!</h2> <div style="width:298px;margin-top:15px;height:120px;"> <div style="width:270px;height:120px;margin:0px auto;background:#128094 url('http://www.justanswer.com/uploads/affiliates/questionbox.gif') no-repeat;"> <textarea name="question" rows="3" cols="4"  id="question" tabindex="1" style="text-align:left;margin: 5px 0px 0px 5px;max-width:250px;height:102px;resize:none;width:248px;color:#333;font-family: Arial, Verdana, Tahoma, MS Sans Serif;font-size:.8em;font-weight:normal;border:0px solid #fff;overflow:auto;" onfocus="question_onfocus(this, event)" onblur="question_onblur(this, event)" onkeydown="limitText(this);" onkeyup="limitText(this);">Type your question here</textarea></div></div></div><div style="float:left;padding:0px;width:298px;;margin:0px;height:59px;background:#128094 url('http://www.justanswer.com/uploads/affiliates/bottom.gif') no-repeat;"><div style="margin: 10px 10px 10px 5px;width: 283px;"><img style="margin-left:10px; float: left;" src='http://www.justanswer.com/uploads/affiliates/logopwd.gif' alt="JustAnswer" /> <input type="hidden" id="FID" name="FID" value="103" />  <input type="hidden" name="RID" value="" /> <input type='image' style='float:right;' src='http://ww2.justanswer.com/uploads/affiliates/submit.gif' alt='Submit' /></div></div></div></form><script language="javascript" type="text/javascript"> var maxCharCount = 1000; var showCharAt = 200; String.prototype.trim = function() { return this.replace(/^\s*|\s*$/, ""); }; function question_onfocus(t, e) { if (t.value.trim() =="Type your question here") { t.value=""; } return true; }; function question_onblur(t, e) { if (t.value.trim() =="") { t.value="Type your question here"; } return true; }; function limitText(limitField) { var limitCount = document.getElementById('countdown'); if (limitField.value.length > maxCharCount) { limitField.value = limitField.value.substring(0, maxCharCount); limitField.scrollTop = limitField.scrollHeight; } }  </script><body>

How to add affiliate ID -