[[!FormIt? &hooks=`recaptchav2,spam,email,redirect` &emailTpl=`leademailTpl` &emailTo=`****[email protected],***[email protected]` &emailToName=`Sales Team` &validate=`workemail:blank,name:required,phone:required,message:required` &redirectTo=`2` &spamCheckIp=`1` &spamEmailFields=`email` ]]
<div class="form-johann">
<div class="row text-center"><h4><span class="orange">GET A QUOTE • SCHEDULE YOUR SERVICE EMERGENCY SERVICE AVAILABLE</span></h4></div>
<div>
<form action="[[~[[*id]]]]" method="post">
<input type="hidden" name="workemail" value="" />
<input class="col-md-12" type="text" id="name" name="name" placeholder="Name*" required/>
<input class="col-md-12" type="text" id="email" name="email" placeholder="Email"/>
<input class="col-md-12" type="text" id="phone" name="phone" placeholder="Phone*" required />
<label class="col-md-8">Is Your System Working Properly?</label>
<input type="checkbox" name="ACStatus[]" value="Working Properly" [[!+fi.ACStatus:FormItIsChecked=`Working Properly`]] > Yes
<input type="checkbox" name="ACStatus[]" value="It is Not Working Properly" [[!+fi.ACStatus:FormItIsChecked=`It is Not Working Properly`]] > No
<textarea class="col-md-12" name="message" placeholder="Message*" required></textarea>
<div class="form-item">
[[!recaptchav2_render]]
[[!+fi.error.recaptchav2_error]]
</div>
<input type="submit" value="BOOK YOUR SERVICE NOW!" name="leadsubmit" />
</form>
</div>
</div>