- You can modify the font style and form style to suit your website. 

   - Code lines with comments ???Do not remove this code???  are required for the form to work properly, make sure that you do not remove these lines of code. 

   - The Mandatory check script can modified as to suit your business needs. 

   - It is important that you test the modified form before going live.-->

<div id='crmWebToEntityForm' style='width:600px;margin:auto;'>

   <META HTTP-EQUIV ='content-type' CONTENT='text/html;charset=UTF-8'>

   <form action='https://crm.zoho.com/crm/WebToLeadForm' name=WebToLeads4282678000001062031 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory4282678000001062031()' accept-charset='UTF-8'>

 <input type='text' style='display:none;' name='xnQsjsdp' value='9cb14c0a08180b3f1d4445eec74a2c3b278bb2fac3a103d0c64a1ffbef9821da'></input> 

 <input type='hidden' name='zc_gad' id='zc_gad' value=''></input> 

 <input type='text' style='display:none;' name='xmIwtLD' value='17f488030d90cf420fc780d3f72d6bf4d550da9e058f63ad98fd137f963840d5'></input> 

 <input type='text'  style='display:none;' name='actionType' value='TGVhZHM='></input>

 <input type='text' style='display:none;' name='returnURL' value='https://campaign.wou.edu.my/thank-you' > </input><br></br>

 <!-- Do not remove this code. -->

 <input type='text' style='display:none;' id='ldeskuid' name='ldeskuid'></input>

 <input type='text' style='display:none;' id='LDTuvid' name='LDTuvid'></input>

 <!-- Do not remove this code. -->

<style>

#crmWebToEntityForm tr , #crmWebToEntityForm td { 

padding:6px;

border-spacing:0px;

border-width:0px;

}

</style>

<table style='width:600px;background-color:#ffffff;background-color:white;color:black'><tr><td colspan='2' align='left' style='color:black;font-family:Arial;font-size:14px;word-break: break-word;'><strong>Ask Me</strong></td></tr> <br></br><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Name<span style='color:red;'>*</span></td><td style='width:40%;' ><input type='text' style='width:100%;box-sizing:border-box;'  maxlength='80' name='Last Name' /></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Contact Number<span style='color:red;'>*</span></td><td style='width:40%;' ><input type='text' style='width:100%;box-sizing:border-box;'  maxlength='30' name='Phone' /></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Email<span style='color:red;'>*</span></td><td style='width:40%;' ><input type='text' style='width:100%;box-sizing:border-box;'  maxlength='100' name='Email' /></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>I'm Interested In<span style='color:red;'>*</span></td><td style='width:40%;'>

<select style='width:100%;box-sizing:border-box;' name='LEADCF21'>

<option value='-None-'>-None-</option>

<option value='Business'>Business</option>

<option value='Computing'>Computing</option>

<option value='Education'>Education</option>

<option value='Electronic&#x2f;Mechatronic'>Electronic&#x2f;Mechatronic</option>

<option value='Postgraduate'>Postgraduate</option>

</select></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Education Level<span style='color:red;'>*</span></td><td style='width:40%;'>

<select style='width:100%;box-sizing:border-box;' name='LEADCF24'>

<option value='-None-'>-None-</option>

<option value='MASTER'>MASTER</option>

<option value='DEGREE'>DEGREE</option>

<option value='DIPLOMA'>DIPLOMA</option>

<option value='STPM&#x2f;FOUNDATION&#x2f;MATRICULATION&#x20;OR&#x20;EQUIVALENT'>STPM&#x2f;FOUNDATION&#x2f;MATRICULATION OR EQUIVALENT</option>

<option value='SPM&#x2f;UEC&#x20;OR&#x20;EQUIVALENT'>SPM&#x2f;UEC OR EQUIVALENT</option>

<option value='SRP&#x2f;PMR&#x20;OR&#x20;EQUIVALENT'>SRP&#x2f;PMR OR EQUIVALENT</option>

</select></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Preferred Location<span style='color:red;'>*</span></td><td style='width:40%;'>

<select style='width:100%;box-sizing:border-box;' name='LEADCF22'>

<option value='-None-'>-None-</option>

<option value='Penang'>Penang</option>

<option value='Ipoh'>Ipoh</option>

<option value='Johor&#x20;Bahru'>Johor Bahru</option>

<option value='Kuching'>Kuching</option>

<option value='Kuala&#x20;Lumpur'>Kuala Lumpur</option>

<option value='Bandar&#x20;Utama'>Bandar Utama</option>

<option value='Klang'>Klang</option>

</select></td><td style='width:30%;'></td></tr><tr><td  style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%;'>Message<span style='color:red;'>*</span> </td><td style='width:40%;'> <textarea name='Description' maxlength='32000' style='width:100%;'>&nbsp;</textarea></td><td style='width:30%;'></td></tr><tr style='display:none;' ><td style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%'>Lead Source</td><td style='width:40%;'>

<select style='width:100%;box-sizing:border-box;' name='Lead Source'>

<option value='-None-'>-None-</option>

<option value='Careline&#x20;-&#x20;Email'>Careline - Email</option>

<option value='Careline&#x20;-&#x20;Call'>Careline - Call</option>

<option value='Careline&#x20;-&#x20;Chat'>Careline - Chat</option>

<option value='Loyalty&#x20;-&#x20;Alumni'>Loyalty - Alumni</option>

<option value='Loyalty&#x20;-&#x20;F&amp;F'>Loyalty - F&amp;F</option>

<option value='Online&#x20;-&#x20;FB&#x2f;IG'>Online - FB&#x2f;IG</option>

<option value='Online&#x20;-&#x20;Google'>Online - Google</option>

<option value='Outdoor&#x20;-&#x20;Banner'>Outdoor - Banner</option>

<option value='Outdoor&#x20;-&#x20;Flyer'>Outdoor - Flyer</option>

<option value='Print&#x20;-&#x20;Magazine'>Print - Magazine</option>

<option value='Print&#x20;-&#x20;Newspaper'>Print - Newspaper</option>

<option value='Radio'>Radio</option>

<option value='RC&#x20;-&#x20;Roadshow'>RC - Roadshow</option>

<option value='RC&#x20;-&#x20;Preview'>RC - Preview</option>

<option value='Website'>Website</option>

</select></td><td style='width:30%;'></td></tr><tr style='display:none;' ><td style='word-break: break-word;text-align:left;font-size:12px;font-family:Arial;width:30%'>Lead Source &#x28;WOU&#x29;</td><td style='width:40%;'>

<select style='width:100%;box-sizing:border-box;' name='LEADCF43'>

<option value='-None-'>-None-</option>

<option value='Careline&#x20;-&#x20;Email'>Careline - Email</option>

<option value='Careline&#x20;-&#x20;Call'>Careline - Call</option>

<option value='Careline&#x20;-&#x20;Chat'>Careline - Chat</option>

<option value='Loyalty&#x20;-&#x20;Alumni'>Loyalty - Alumni</option>

<option value='Loyalty&#x20;-&#x20;F&amp;F'>Loyalty - F&amp;F</option>

<option value='Online&#x20;-&#x20;FB&#x2f;IG'>Online - FB&#x2f;IG</option>

<option value='Online&#x20;-&#x20;Google'>Online - Google</option>

<option value='Outdoor&#x20;-&#x20;Banner'>Outdoor - Banner</option>

<option value='Outdoor&#x20;-&#x20;Flyer'>Outdoor - Flyer</option>

<option value='Print&#x20;-&#x20;Magazine'>Print - Magazine</option>

<option value='Print&#x20;-&#x20;Newspaper'>Print - Newspaper</option>

<option value='Radio'>Radio</option>

<option value='RC&#x20;-&#x20;Roadshow'>RC - Roadshow</option>

<option value='RC&#x20;-&#x20;Preview'>RC - Preview</option>

<option selected value='Website'>Website</option>

</select></td><td style='width:30%;'></td></tr>

<tr><td colspan='2' style='text-align:center; padding-top:15px;font-size:12px;'>

<input style='margin-right: 5px;cursor: pointer;font-size:12px;color:#000000' id='formsubmit' type='submit' value='Submit'  ></input> <input type='reset' name='reset' style='cursor: pointer;font-size:12px;color:#000000' value='Reset' ></input> </td></tr></table>

<script>

    var mndFileds=new Array('Last Name','Phone','Email','Description','LEADCF22','LEADCF24','LEADCF21');

    var fldLangVal=new Array('Name','Contact Number','Email','Message','Preferred Location','Education Level','I\'m Interested In'); 

    function checkMandatory4282678000001062031() {

                var name='';

var email='';

                var isError = 0;

for(i=0;i<mndFileds.length;i++) {

                 isError = 0;

  var fieldObj=document.forms['WebToLeads4282678000001062031'][mndFileds[i]];

  if(fieldObj) {

if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0) {

 if(fieldObj.type =='file')

{ 

 alert('Please select a file to upload.'); 

 fieldObj.focus(); 

 return false;

}

alert(fldLangVal[i] +' cannot be empty.'); 

             fieldObj.focus();

                          isError = 1;

             return false;

                          }

                         else{if(fieldObject.name == 'Email')

                         {if(!fieldObject.value.match(/[A-Za-z0-9._%\-+]+@[A-Za-z0-9.\-]+\.[a-zA-Z]{2,22}/))

                         {isError = 1;

                         alert('Enter a valid email-Id');

                         fieldObject.focus();

                         return false;

                         }

                         }

                         }else if(fieldObj.nodeName=='SELECT') {

            if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {

alert(fldLangVal[i] +' cannot be none.'); 

fieldObj.focus();

                                isError = 1

return false;

   }

} else if(fieldObj.type =='checkbox'){

       if(fieldObj.checked == false){

alert('Please accept  '+fldLangVal[i]);

fieldObj.focus();

                                isError = 1;

return false;

   } 

 }

 try {

     if(fieldObj.name == 'Last Name') {

name = fieldObj.value;

          }

} catch (e) {}

    }

}

trackVisitor();

document.getElementById('formsubmit').disabled=true;

}

</script><script type='text/javascript' id='VisitorTracking'>var $zoho= $zoho || {};$zoho.salesiq = $zoho.salesiq || {widgetcode:'9136e37c0a65b1dfabe2a89434c2f75d37a5914d986ae1e94187e346bd4017b9', values:{},ready:function(){}};var d=document;s=d.createElement('script');s.type='text/javascript';s.id='zsiqscript';s.defer=true;s.src='https://salesiq.zoho.com/widget';t=d.getElementsByTagName('script')[0];t.parentNode.insertBefore(s,t);function trackVisitor(){try{if($zoho){var LDTuvidObj = document.forms['WebToLeads4282678000001062031']['LDTuvid'];if(LDTuvidObj){LDTuvidObj.value = $zoho.salesiq.visitor.uniqueid();}var firstnameObj = document.forms['WebToLeads4282678000001062031']['First Name'];if(firstnameObj){name = firstnameObj.value +' '+name;}$zoho.salesiq.visitor.name(name);var emailObj = document.forms['WebToLeads4282678000001062031']['Email'];if(emailObj){email = emailObj.value;$zoho.salesiq.visitor.email(email);}}} catch(e){}}</script>

<!-- Do not remove this --- Analytics Tracking code starts --><script id='wf_anal' src='https://crm.zohopublic.com/crm/WebFormAnalyticsServeServlet?rid=17f488030d90cf420fc780d3f72d6bf4d550da9e058f63ad98fd137f963840d5gid9cb14c0a08180b3f1d4445eec74a2c3b278bb2fac3a103d0c64a1ffbef9821dagid885e3c1045bd9bdcc91bdf30f82b5696gid14f4ec16431e0686150daa43f3210513'></script><!-- Do not remove this --- Analytics Tracking code ends. --></form>

</div>

The email validation are not working. Can check on this script.

Thanks.

Regards,

Seetha.