<!-- Note :
- 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/Mechatronic'>Electronic/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/FOUNDATION/MATRICULATION OR EQUIVALENT'>STPM/FOUNDATION/MATRICULATION OR EQUIVALENT</option>
<option value='SPM/UEC OR EQUIVALENT'>SPM/UEC OR EQUIVALENT</option>
<option value='SRP/PMR OR EQUIVALENT'>SRP/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 Bahru'>Johor Bahru</option>
<option value='Kuching'>Kuching</option>
<option value='Kuala Lumpur'>Kuala Lumpur</option>
<option value='Bandar 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%;'> </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 - Email'>Careline - Email</option>
<option value='Careline - Call'>Careline - Call</option>
<option value='Careline - Chat'>Careline - Chat</option>
<option value='Loyalty - Alumni'>Loyalty - Alumni</option>
<option value='Loyalty - F&F'>Loyalty - F&F</option>
<option value='Online - FB/IG'>Online - FB/IG</option>
<option value='Online - Google'>Online - Google</option>
<option value='Outdoor - Banner'>Outdoor - Banner</option>
<option value='Outdoor - Flyer'>Outdoor - Flyer</option>
<option value='Print - Magazine'>Print - Magazine</option>
<option value='Print - Newspaper'>Print - Newspaper</option>
<option value='Radio'>Radio</option>
<option value='RC - Roadshow'>RC - Roadshow</option>
<option value='RC - 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 (WOU)</td><td style='width:40%;'>
<select style='width:100%;box-sizing:border-box;' name='LEADCF43'>
<option value='-None-'>-None-</option>
<option value='Careline - Email'>Careline - Email</option>
<option value='Careline - Call'>Careline - Call</option>
<option value='Careline - Chat'>Careline - Chat</option>
<option value='Loyalty - Alumni'>Loyalty - Alumni</option>
<option value='Loyalty - F&F'>Loyalty - F&F</option>
<option value='Online - FB/IG'>Online - FB/IG</option>
<option value='Online - Google'>Online - Google</option>
<option value='Outdoor - Banner'>Outdoor - Banner</option>
<option value='Outdoor - Flyer'>Outdoor - Flyer</option>
<option value='Print - Magazine'>Print - Magazine</option>
<option value='Print - Newspaper'>Print - Newspaper</option>
<option value='Radio'>Radio</option>
<option value='RC - Roadshow'>RC - Roadshow</option>
<option value='RC - 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.