<form id="form" action="[[~[[*id]]]]" enctype="text/plain" method="post"> <h2>Get A Quote</h2> <div class="line number1 index0 alt2">[[!FormIt? &hooks=`math` &validate=`math:required`]]</div> <p>[[!+fi.validation_error_message:notempty=`<p>[[!+fi.validation_error_message]]</p>`]]</p> <p>Fill out the form below and a representative will contact within two business days</p> <!--fields--> <div><label for="name"> Name: [[!+fi.error.placeholder_name:notempty=`<span class="label label-important">This is a required field.</span>`]] </label> <input id="name" name="name" required="" type="text" value="[[!+fi.name]]" placeholder="First Last" /></div> <div><label for="tel">Telephone:<span class="error">[[!+fi.error.tel]]</span> <input name="tel" required="" size="35" type="tel" placeholder="(508)555-555" /></label></div> <div><label for="email">Email:<span class="error">[[!+fi.error.email]]</span></label> <input required="" size="35" type="email" value="[[!+fi.email]]" placeholder="[email protected]" /></div> <div><label for="message">Quote Type<span class="error">[[+fi.error.Insurance Type]]</span> </label><select name="Insurance Type:"> <option value="Home">Home</option> <option value="Automobile">Automobile</option> <option value="Business">Business</option> <option value="Life">Life</option> <option value="Health">Health</option> <option value="Marine">Marine</option> </select></div> <label>[[!+fi.op1]] [[!+fi.operator]] [[!+fi.op2]]?</label> [[!+fi.error.math]] <input name="math" required="" type="text" value="[[!+fi.math]]" placeholder="Anti-Spam Put math Answer here" /> <div><button id="contact-submit" name="submit" type="submit">Send Email</button></div> </form>
[[!FormIt? &hooks=`math,email,redirect` &emailTpl=`emailTpl` &emailTo=`[email protected]` &redirectTo=`7` &validate=`name:required, tel:required, email:email:required, type:required, math:required` ]] <h2>Contact Form</h2> [[!+fi.validation_error_message:notempty=`<p>[[!+fi.validation_error_message]]</p>`]] <form action="[[~[[*id]]]]" method="post" class="form"> <div> <label for="name"> Name: <span class="error">[[!+fi.error.name]]</span> </label> <input id="name" name="name" type="text" value="[[!+fi.name]]" placeholder="First Last"> </div> <div> <label for="tel"> Telephone: <span class="error">[[!+fi.error.tel]]</span> </label> <input id="tel" name="tel" type="tel" value="[[!+fi.tel]]" placeholder="(508)555-555"> </div> <div> <label for="email"> Email: <span class="error">[[!+fi.error.email]]</span> </label> <input id="email" name="email" type="email" value="[[!+fi.email]]" placeholder="[email protected]"> </div> <div> <label for="type"> Quote Type: <span class="error">[[!+fi.error.type]]</span> </label> <select name="type" value="[[!+fi.type]]"> <option value="">Select an option...</option> <option value="Home" [[!+fi.type:FormItIsSelected=`Home`]]>Home</option> <option value="Automobile" [[!+fi.type:FormItIsSelected=`Automobile`]]>Automobile</option> <option value="Business" [[!+fi.type:FormItIsSelected=`Business`]]>Business</option> <option value="Life" [[!+fi.type:FormItIsSelected=`Life`]]>Life</option> <option value="Health" [[!+fi.type:FormItIsSelected=`Health`]]>Health</option> <option value="Marine" [[!+fi.type:FormItIsSelected=`Marine`]]>Marine</option> </select> </div> <div> <label>[[!+fi.op1]] [[!+fi.operator]] [[!+fi.op2]]?</label> [[!+fi.error.math]] <input type="text" name="math" value="[[!+fi.math]]"> <input type="hidden" name="op1" value="[[!+fi.op1]]"> <input type="hidden" name="op2" value="[[!+fi.op2]]"> <input type="hidden" name="operator" value="[[!+fi.operator]]"> </div> <div> <button id="contact-submit" name="submit" type="submit">Send Email</button> </div> </form>