<form action="//submit.form" id="ContactUs100" method="post" onsubmit="return ValidateForm(this);">
<script type="text/javascript">
function ValidateForm(frm) {
if (frm.Name.value == "") { alert('Name is required.'); frm.Name.focus(); return false; }
if (frm.FromEmailAddress.value == "") { alert('Email address is required.'); frm.FromEmailAddress.focus(); return false; }
if (frm.FromEmailAddress.value.indexOf("@") < 1 || frm.FromEmailAddress.value.indexOf(".") < 1) { alert('Please enter a valid email address.'); frm.FromEmailAddress.focus(); return false; }
if (frm.Comments.value == "") { alert('Please enter comments or questions.'); frm.Comments.focus(); return false; }
return true; }
</script>
<table style="width:100%;max-width:550px;border:0;" cellpadding="8" cellspacing="0">
<tr> <td>
<label for="Name">Name*:</label>
</td> <td>
<input name="Name" type="text" maxlength="60" style="width:100%;max-width:250px;" />
</td> </tr> <tr> <td>
<label for="PhoneNumber">Phone number:</label>
</td> <td>
<input name="PhoneNumber" type="text" maxlength="43" style="width:100%;max-width:250px;" />
</td> </tr> <tr> <td>
<label for="FromEmailAddress">Email address*:</label>
</td> <td>
<input name="FromEmailAddress" type="text" maxlength="90" style="width:100%;max-width:250px;" />
</td> </tr> <tr> <td>
<label for="Comments">Comments*:</label>
</td> <td>
<textarea name="Comments" rows="7" cols="40" style="width:100%;max-width:350px;"></textarea>
</td> </tr> <tr> <td>
* - required fields
</td> <td>
<div style="float:right"><a href="https://www.100forms.com" id="lnk100" title="form to email">form to email</a></div>
<input name="skip_Submit" type="submit" value="Submit" />
<script src="https://www.100forms.com/js/FORMKEY:38665ATPY82D/SEND:[email protected]" type="text/javascript"></script>
</td> </tr>
</table>
</form>