Template
<html>
<head>
<script type="text/javascript">
function goThere(){
    var Form = document.site;
    var place = "http://"+Form.url.value+"/checklist:_template/edit/true/norender/true/noredirect/true";
    window.open(place);
}
</script>
</head>
<body>
<form name="site">
<table>
<tr>
<td>
Enter Site URL<br />
<span style="font-size:80%;">ex: site.wikidot.com</span>
</td>
<td style="padding-left:8px;">
<input type="text" name="url" />
<input type="button" onclick="goThere()" value="Go!" />
</td></tr>
</table>
</form>
</body>
</html>
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