One - AJMC

<!DOCTYPE html> <html> <head><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0" /> <script async src="https://www.googletagmanager.com/gtag/js?id=G-K4V6L60P42"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-K4V6L60P42'); gtag('config', 'G-W1N2ZV5FR9'); </script> <script src="https://cdn.public.mjhls.com/lib/jquery/jquery-2.1.4.js"></script> <link rel="stylesheet" href="https://cdn.public.mjhls.com/lib/bootstrap/css/bootstrap.min.css" type="text/css" /> <link rel="stylesheet" href="/libs/jquery/bootstrap/dist/css/bootstrap-theme.css" type="text/css" /> <script src="/forms/js/cube.engage.go.form.js" type="text/javascript"></script> <link id="SVG_StyleSheet" type="text/css" href="/forms/css/SVG_StyleSheet.css" rel="stylesheet" /> <link id="AgilityHeadScripts_MainStyleSheet" 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:root { --MainColor: #005387; --MainHoverColor: #004b7a; --footerTextColor: white; --footerColor: var(--MainColor); --Logo: url('https://one.ajmc.com/assets/logos/ajmc_25lockup.webp'); --LogoWhite: none; --svgDisplay: initial; --svgCheckboxFillChecked: var(--MainColor); --svgCheckboxStroke: #D6D6D6; --svgCheckboxStrokeWidth: 3; --svgRadioStroke: #D6D6D6; --svgRadioFillChecked: var(--MainColor); --validationColor: #F9E9EA; --validationAltColor: #D77A7A; --validationListDisplay: block; } a, a:visited { color: var(--MainColor); } a:hover, a:focus { color: var(--MainHoverColor); } .simpleValidation { background-color: var(--validationColor); color: var(--validationAltColor); border-left: 10px solid var(--validationAltColor); padding: 25px; border-radius: 12px; } .simpleValidation ul { margin-top: .85em; display: var(--validationListDisplay); } .form-group.has-error > label, .form-group.has-error > label > span { color: var(--validationAltColor); } .form-group.has-error .form-control { border-color: var(--validationAltColor); } #HeaderBar > .container::before, #HeaderBar > .container::after { display: none; } #HeaderBar > .container { display: flex; align-items: center; height: 100%; } #HeaderBar > .container a { flex: 1; } ul > li > input + label { cursor: pointer; text-indent: -25px; margin-left: 25px; } svg { margin-right: 5px; vertical-align: bottom; } #HeaderHref { width: 300px; display: block; margin: 5px auto; } #Logo { background: transparent var(--Logo) no-repeat center center / contain; width: 100%; height: 50px; margin: 15px 0; } #HeaderBar { width: 100%; height: 65px; background-color: var(--MainColor); margin-bottom: 40px; position: sticky; z-index: 1; top: 0; } sup { top: -.25em; } #LogoScroll { background: transparent var(--LogoWhite) no-repeat left center / contain; width: 100%; height: 40px; margin: 8px 0; display: none; } html { height: 100%; } body { min-height: 100%; } footer { position: -webkit-sticky; position: -moz-sticky; position: -ms-sticky; position: -o-sticky; position: sticky; top: 100%; margin-top: 50px; padding: 25px 0; background-color: var(--footerColor); } footer > div { color: var(--footerTextColor); } input[type="radio"]:focus + label, input[type="checkbox"]:focus + label { outline: 1px dotted var(--MainColor); } input[type="radio"], input[type="checkbox"] { opacity: 0; position: absolute; } input[type="radio"] + label, input[type="checkbox"] + label { padding-bottom: 3px; } @media only screen and (max-width: 767px) { #LogoScroll { background-position: center center; } #HeaderHref { width: 100%; max-width: 300px; } footer { text-align: center; } } </style> <script> document.addEventListener('DOMContentLoaded', () => { document.addEventListener('click', bodyClick); $('input, select, textarea').on('input change', inputChange); }); function inputChange() { if($(this).val() !== '') { $(this).closest('.form-group').removeClass('has-error'); } } function bodyClick() { const errorEls = document.querySelectorAll('.has-error'); for(const el of errorEls) { const input = el.querySelector('input, select, textarea'); if(input && input.value !== '') { el.classList.remove('has-error'); } } } let params = GetQueryParams(); let scrollOffset = 95; let scrollLogoVisible = false; const brandName = 'AJMC'; const termsAndConditions = 'https://www.ajmc.com/terms/'; const privacyPolicy = 'https://www.ajmc.com/privacy/'; document.addEventListener("DOMContentLoaded", function() { const brandNames = document.querySelectorAll('.brandName'); for (const el of brandNames) { el.innerText = brandName; } const bottom = document.querySelector('#LogoContainer').getBoundingClientRect().bottom; const scrollPx = window.scrollY; scrollOffset = bottom + scrollY; if (window.scrollY >= scrollOffset) { document.getElementById('LogoScroll').style.display = 'block'; scrollLogoVisible = true; } window.addEventListener('scroll', function() { if (window.scrollY >= scrollOffset && !scrollLogoVisible) { 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//Return obj to allow for method chains return obj; } function IsNullEmptyOrUndefined(val) { return val === null || val === undefined || val === ""; } function GetQueryParams() { return new URLSearchParams(window.location.search.toLowerCase()); } let docStyle = null; function GetStyleVariable(variable, value) { if (docStyle === null) { docStyle = getComputedStyle(document.documentElement); } if (!variable.startsWith('--')) { variable = '--' + variable; } if (!IsNullEmptyOrUndefined(value)) { document.documentElement.style.setProperty(variable, value); } let retVal = docStyle.getPropertyValue(variable); retVal = retVal.replace(/url[(]['"]|["'][)][;]?/gi, ""); return retVal; } </script> <link rel="apple-touch-icon" sizes="x" href="/apple-touch-icon.png?ver=YY0805041528"> <link rel="icon" type="image/png" sizes="32x32" href="/favicon-32x32.png?ver=YY0805041528"> <link rel="icon" type="image/png" sizes="16x16" href="/favicon-16x16.png?ver=YY0805041528"> <link rel="manifest" href="/site.webmanifest?ver=YY0805041528"> <link rel="mask-icon" href="/safari-pinned-tab.svg?ver=YY0805041528" color="#ffffff"> <link rel="shortcut icon" href="/favicon.ico?ver=YY0805041528"> <meta name="msapplication-TileColor" content="#ffffff"> <meta name="theme-color" content="#ffffff"><title> One - AJMC </title></head> <body id="AgilityBody" class="page-form_bootstrap"> <div id='LogoContainer' class='container'> <a id='HeaderHref' href="https://www.ajmc.com/"> <div id='Logo'></div> </a> </div> <div id='HeaderBar'> <div class='container'> <a href="https://www.ajmc.com/"> <div id='LogoScroll'></div> </a> </div> </div> <form method="post" action="./" onsubmit="javascript:return WebForm_OnSubmit();" id="AgilityForm"> <div class="aspNetHidden"> <input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="" /> <input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="" /> <input type="hidden" name="__LASTFOCUS" id="__LASTFOCUS" value="" /> <input type="hidden" 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class="row countryRow"> <div id="main_DynamicControl_0_3_17_CountryColSpec" class="col-md-3 form-group countryColumn"> <label id="main_DynamicControl_0_3_17_CountryLabel" for="<%=CountryValue.ClientID%>" class="formTopLabel">Country</label> <span class="valIndicator"> <span id="main_DynamicControl_0_3_17_CountryValueReqd" style="display:none;"><span style='color: #8a2003;font-weight:bold;'>*</span></span> </span> <select name="ctl00$main$DynamicControl_0_3_17$CountryValue" onchange="javascript:setTimeout('__doPostBack(\'ctl00$main$DynamicControl_0_3_17$CountryValue\',\'\')', 0)" id="main_DynamicControl_0_3_17_CountryValue" class="form-control"> <option value="AF">Afghanistan</option> <option value="AX">Åland Islands</option> <option value="AL">Albania</option> <option value="AA">Alderaan </option> <option value="DZ">Algeria</option> <option value="AS">American Samoa</option> <option value="AD">Andorra</option> <option value="AO">Angola</option> <option value="AI">Anguilla</option> 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value="CY">Cyprus</option> <option value="CZ">Czech Republic</option> <option value="DK">Denmark</option> <option value="DJ">Djibouti</option> <option value="DM">Dominica</option> <option value="DO">Dominican Republic</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="GQ">Equatorial Guinea</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="FK">Falkland Islands (malvinas)</option> <option value="FO">Faroe Islands</option> <option value="FJ">Fiji</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GF">French Guiana</option> <option value="PF">French Polynesia</option> <option value="TF">French Southern Territories</option> <option value="GA">Gabon</option> <option value="GM">Gambia</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GI">Gibraltar</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GD">Grenada</option> <option value="GP">Guadeloupe</option> <option value="GU">Guam</option> <option value="GT">Guatemala</option> <option value="GG">Guernsey</option> <option value="GN">Guinea</option> <option value="GW">Guinea-Bissau</option> <option value="GY">Guyana</option> <option value="HT">Haiti</option> <option value="HM">Heard Island And McDonald Islands</option> <option value="VA">Holy See (vatican City State)</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IR">Iran, Islamic Republic Of</option> <option value="IQ">Iraq</option> <option value="IE">Ireland</option> <option value="IM">Isle Of Man</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JE">Jersey</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KI">Kiribati</option> <option value="KP">Korea, Democratic People'S Republic Of</option> <option value="KR">Korea, Republic Of</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Lao People'S Democratic Republic</option> <option value="LV">Latvia</option> <option value="LB">Lebanon</option> <option value="LS">Lesotho</option> <option value="LR">Liberia</option> <option value="LY">Libyan Arab Jamahiriya</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao</option> <option value="MK">Macedonia, The Former Yugoslav Republic Of</option> <option value="MG">Madagascar</option> <option value="MW">Malawi</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MH">Marshall Islands</option> <option value="MQ">Martinique</option> <option value="MR">Mauritania</option> <option value="MU">Mauritius</option> <option value="YT">Mayotte</option> <option value="MX">Mexico</option> <option value="FM">Micronesia, Federated States Of</option> <option value="MD">Moldova, Republic Of</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="ME">Montenegro</option> <option value="MS">Montserrat</option> <option value="MA">Morocco</option> <option value="MZ">Mozambique</option> <option value="MM">Myanmar</option> <option value="NA">Namibia</option> <option value="NR">Nauru</option> <option value="NP">Nepal</option> <option value="NL">Netherlands</option> <option value="AN">Netherlands Antilles</option> <option value="NC">New Caledonia</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NE">Niger</option> <option value="NG">Nigeria</option> <option value="NU">Niue</option> <option value="NF">Norfolk Island</option> <option value="MP">Northern Mariana Islands</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PW">Palau</option> <option value="PS">Palestinian Territory, Occupied</option> <option value="PA">Panama</option> <option value="PG">Papua New Guinea</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PN">Pitcairn</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="QA">Qatar</option> <option value="RE">Réunion</option> <option value="RO">Romania</option> <option value="RU">Russian Federation</option> <option value="RW">Rwanda</option> <option value="BL">Saint Barthélemy</option> <option value="SH">Saint Helena, Ascension And Tristan Da Cunha</option> <option value="KN">Saint Kitts And Nevis</option> <option value="LC">Saint Lucia</option> <option value="MF">Saint Martin</option> <option value="PM">Saint Pierre And Miquelon</option> <option value="VC">Saint Vincent And The Grenadines</option> <option value="WS">Samoa</option> <option value="SM">San Marino</option> <option value="ST">Sao Tome And Principe</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="RS">Serbia</option> <option value="SC">Seychelles</option> <option value="SL">Sierra Leone</option> <option value="SG">Singapore</option> <option value="SX">Sint Maarten (Dutch)</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SB">Solomon Islands</option> <option value="SO">Somalia</option> 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IsValid: false } })); args.IsValid = false; } </script> </div> </div> <div id="main_DynamicControl_0_3_19_PartContainer" class="row partContainer textPart hidden" data-key="EkeyValue_Inbound"> <div id="main_DynamicControl_0_3_19_FormGroup" class="form-group col-md-4"> <label for="main_DynamicControl_0_3_19_TextField" class="formTopLabel"> <span id="main_DynamicControl_0_3_19_TextLabel">EkeyValue_Inbound</span>  <span class="valIndicator"> <span id="main_DynamicControl_0_3_19_TextFieldReqd" style="display:none;"><span style='color: #8a2003;'>*</span></span> <span id="main_DynamicControl_0_3_19_TextFieldRegex" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_19_TextFieldOtherValidator" style="visibility:hidden;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_19_EmailAddressRegex" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_19_EmailAddressMX" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> </span> </label> <input name="ctl00$main$DynamicControl_0_3_19$TextField" type="text" id="main_DynamicControl_0_3_19_TextField" class="form-control textInput" placeholder=" " /> </div> <input type="hidden" name="ctl00$main$DynamicControl_0_3_19$SourceGuid" id="main_DynamicControl_0_3_19_SourceGuid" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_19$PersonGuid" id="main_DynamicControl_0_3_19_PersonGuid" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_19$PersonSaveField" id="main_DynamicControl_0_3_19_PersonSaveField" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_19$SourceField" id="main_DynamicControl_0_3_19_SourceField" /> <script> $(document).ready(function () { if (`` !== "" && `` !== "") { $(``).change(function () { var type = $(this).prop('type'); var active = true; if (type !== "checkbox") { if (type === "radio") { active = $(this).is(":checked"); } if (active && $(this).val() === ``) { $('#main_DynamicControl_0_3_19_FormGroup').slideDown('fast'); } else { $('#main_DynamicControl_0_3_19_FormGroup').slideUp('fast'); } } else { $(this).closest('.checkboxInput').find("input").each(function (i, check) { if ($(check).val() === ``) { if ($(check).is(":checked")) { $('#main_DynamicControl_0_3_19_FormGroup').slideDown('fast'); } else { $('#main_DynamicControl_0_3_19_FormGroup').slideUp('fast'); } } }); } }); $("#main_DynamicControl_0_3_19_FormGroup").hide(); $(``).change(); } }); function main_DynamicControl_0_3_19_PartContainer_OtherValidation(src, args) { args.IsValid = ($('#main_DynamicControl_0_3_19_FormGroup').css('display').toLowerCase() === 'none' || $("#main_DynamicControl_0_3_19_TextField").val() !== ""); } </script> </div> <div id="main_DynamicControl_0_3_20_PartContainer" class="row partContainer textPart hidden" data-key="Interest_Inbound"> <div id="main_DynamicControl_0_3_20_FormGroup" class="form-group col-md-4"> <label for="main_DynamicControl_0_3_20_TextField" class="formTopLabel"> <span id="main_DynamicControl_0_3_20_TextLabel">Interest_Inbound</span>  <span class="valIndicator"> <span id="main_DynamicControl_0_3_20_TextFieldReqd" style="display:none;"><span style='color: #8a2003;'>*</span></span> <span id="main_DynamicControl_0_3_20_TextFieldRegex" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_20_TextFieldOtherValidator" style="visibility:hidden;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_20_EmailAddressRegex" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> <span id="main_DynamicControl_0_3_20_EmailAddressMX" style="display:none;"><span style='color: #8a2003; font-weight:bold;'>*</span></span> </span> </label> <input name="ctl00$main$DynamicControl_0_3_20$TextField" type="text" id="main_DynamicControl_0_3_20_TextField" class="form-control textInput" placeholder=" " /> </div> <input type="hidden" name="ctl00$main$DynamicControl_0_3_20$SourceGuid" id="main_DynamicControl_0_3_20_SourceGuid" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_20$PersonGuid" id="main_DynamicControl_0_3_20_PersonGuid" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_20$PersonSaveField" id="main_DynamicControl_0_3_20_PersonSaveField" /> <input type="hidden" name="ctl00$main$DynamicControl_0_3_20$SourceField" id="main_DynamicControl_0_3_20_SourceField" /> <script> $(document).ready(function () { if (`` !== "" && `` !== "") { $(``).change(function () { var type = $(this).prop('type'); var active = true; if (type !== "checkbox") { if (type === "radio") { active = $(this).is(":checked"); } if (active && $(this).val() === ``) { $('#main_DynamicControl_0_3_20_FormGroup').slideDown('fast'); } else { $('#main_DynamicControl_0_3_20_FormGroup').slideUp('fast'); } } else { $(this).closest('.checkboxInput').find("input").each(function (i, check) { if ($(check).val() === ``) { if ($(check).is(":checked")) { $('#main_DynamicControl_0_3_20_FormGroup').slideDown('fast'); } else { $('#main_DynamicControl_0_3_20_FormGroup').slideUp('fast'); } } }); } }); $("#main_DynamicControl_0_3_20_FormGroup").hide(); $(``).change(); } }); function main_DynamicControl_0_3_20_PartContainer_OtherValidation(src, args) { args.IsValid = ($('#main_DynamicControl_0_3_20_FormGroup').css('display').toLowerCase() === 'none' || $("#main_DynamicControl_0_3_20_TextField").val() !== ""); } </script> </div> </div> <script> $(document).ready(function() { BuildPage(); SetUpQueryLogic(); WireEvents(); }); function setVariable(variable, value) { if(!variable.startsWith('--')) { variable = '--' + variable; } const root = document.querySelector(':root'); root.style.setProperty(variable, value); } function pageLoad() { $('.addressType select').attr('data-label', 'Address Type'); $('div[id$=Address2Row] input').attr('data-req', 'false'); $('div[id$=Address3Row] input').attr('data-req', 'false'); if(countryChanged) { countryChanged = false; changeAddress(false); setVariable('stateColumnDisplay', 'block'); } } function addSecondDistroHeader() { const li = document.createElement('li'); const h3 = document.createElement('h3'); h3.innerHTML = "I'd like to receive the following print publications:"; li.appendChild(h3) document.querySelectorAll('.distroType li')[3].after(li) } function BuildPage() { addSecondDistroHeader(); $("#MagazineContainer").hide() const termsLink = `<a href='${termsAndConditions}' target='_blank'>Terms and Conditions</a>`; const privacyPolicyLink = `<a href='${privacyPolicy}' target='_blank'>Privacy Policy</a>`; const label = document.querySelector('.terms ul li label'); let html = label.innerHTML; html = html.replace('Terms and Conditions', termsLink); html = html.replace('Privacy Policy', privacyPolicyLink); label.innerHTML = html; const distroTypes = document.querySelectorAll('.distroType input'); /** * No Defaults for(let i = 0; i < distroTypes.length; i++) { if(i > 1) { break; } distroTypes[i].checked = true; } **/ } function getDistroTypeVal() { const types = document.querySelectorAll('.distroType input'); let value = ''; for(const type of types) { let inputVal = type.value.trim(); if(type.checked && inputVal !== '') { value += type.value + ','; } } if(value.endsWith(',')) { value = value.slice(0, -1); } return value; } let fullAddress = false; function changeAddress(changeCss = true) { let newStyle = fullAddress ? 'block' : 'none'; let newAfter = fullAddress ? '.cityColumn' : '.countryColumn'; $('.stateColumn').detach().insertAfter(newAfter); if(changeCss) { setVariable('fullAddressDisplay', newStyle); } for (const validator of Page_Validators) { if(validator.id.includes("ZipValueRegex") && !validator.isvalid) { $(".zipColumn input").val(''); break; } } } function WireEvents() { $('.countryRow select').change((e) => { const tempFullAddress = fullAddress; fullAddress = true; setVariable('stateColumnDisplay', 'none'); changeAddress(false); fullAddress = tempFullAddress; countryChanged = true; $(".zipColumn input").val(''); }); $(".distroType input").change(function() { if(getDistroTypeVal().toLowerCase().includes('magazine') || getDistroTypeVal().toLowerCase().endsWith('journal')) { if($("#MagazineContainer").css('display') === 'none') { $("#MagazineContainer").slideDown('fast'); $(".typeOfMagazine input[value='Print Subscription Only']").prop('checked', true).change(); } } else { $("#MagazineContainer").slideUp('fast', () => { $(".typeOfMagazine :checked").prop('checked', false); }); fullAddress = false; changeAddress(); } }); $(".typeOfMagazine input").change(function() { if(this.value.toLowerCase().includes('print')) { fullAddress = true; changeAddress(); } else { fullAddress = false; changeAddress(); } }); $('.singleSelectPart:eq(0) select').change(function() { if(this.value === 'Other') { $('.singleSelectPart:eq(0) .col-md-4:eq(1)').slideDown('fast'); } else { $('.singleSelectPart:eq(0) .col-md-4:eq(1)').slideUp('fast'); } }); /** Because default is none selected, we must fire for all boxes not just checked **/ $('.distroType input').change(); } function SetUpQueryLogic() { if(params.get('enewsletter') === "1") { $(".distroType input").first().prop('checked', true); } if(params.get('magazine') === "1") { $(".distroType input").last().prop('checked', true); } switch(params.get('magazinetype')) { case "print": $(".typeOfMagazine input").eq(1).prop('checked', true).change(); break; case "digital": $(".typeOfMagazine input").eq(2).prop('checked', true).change(); break; default: $(".typeOfMagazine input").eq(0).prop('checked', true).change(); break; } } let countryChanged = false; let previouslyInvalid = false; //Optional Validation function WebForm_OnSubmit() { if(countryChanged) { // Fixes a very small bug if the user attempts to submit an invalid form, // then changes their country twice setTimeout(() => { if($('.stateColumn').css('display') === 'none') { $('.countryColumn select').change(); } }, 1000); return true; } let isValid = true; let html = ""; let privacyErrorMessage = ''; $(".alert-danger").hide(); $('.has-error').removeClass('has-error'); //Append all error messages for (var i in Page_Validators) { if (!Page_Validators[i].isvalid) { const ignoreZip = !fullAddress || $('.zipColumn').css('display') === 'none'; if(Page_Validators[i].id.includes('ZipValueRegex') && ignoreZip) { $(".zipColumn input").val(''); continue; } isValid = false; if(Page_Validators[i].errormessage.includes('Privacy Policy')) { privacyErrorMessage = Page_Validators[i].errormessage; } else { html += "<li>" + Page_Validators[i].errormessage + "</li>"; } const control = document.getElementById(Page_Validators[i].controltovalidate); $(control).closest('.form-group').addClass('has-error'); } } let selector = ".stateColumn, .countryColumn"; if(fullAddress) { selector += ', .cityColumn, .addressColumn, .zipColumn, .addressType .form-group'; } const formGroups = document.querySelectorAll(selector); for(const formGroup of formGroups) { const label = formGroup.querySelector('label'); if(!label) { continue; } const input = formGroup.querySelector('input, select, textarea'); if(!input){ continue; } const attrLabel = input.getAttribute('data-label'); const attrReq = input.getAttribute('data-req'); if(input.value == null || input.value.trim() === '' && attrReq !== 'false') { const txt = attrLabel == null ? label.innerText : attrLabel; let prefix = 'Enter a value for'; if(input.nodeName === 'SELECT') { prefix = 'Select a value for'; } html += `<li>${prefix} ${txt}</li>`; isValid = false; formGroup.classList.add('has-error'); } } if(!isValid) { if(privacyErrorMessage !== '') { html += '<li>' + privacyErrorMessage + '</li>'; } html = html.replace(/[*]/gmi, ''); if($('.simpleValidation ul').length === 0) { html = 'The highlighted fields are required to move forward.<ul>' + html + '<ul>'; $('.simpleValidation').html(html); } else { $('.simpleValidation ul').html(html); } $('.simpleValidation').show(); $(".valIndicator").hide(); document.body.scrollTop = 0; // For Safari document.documentElement.scrollTop = 0; // Everyone Else } else { // Hidden address parts should not have a saved value $('.addressPart').find('.form-control:hidden').val('') } return isValid; } </script> <div id="SubmitContainer" class="container"> <div id="main_SubmitBlock" class="row"> <div id="main_Disclaimer" class="disclaimer"></div> <div id="main_PageBreakBlock" class="col-md-12"> <input type="hidden" name="ctl00$main$IsCompletion" id="main_IsCompletion" value="True" /> <input type="submit" name="ctl00$main$SubmitButton" value="Submit" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$main$SubmitButton", "", true, "", "", false, false))" id="main_SubmitButton" class="btn" /> </div> </div> </div> </div> </div> <script type="text/javascript"> //<![CDATA[ var Page_ValidationSummaries = new Array(document.getElementById("main_DynamicControl_0_3_2_ValSummary")); var Page_Validators = new Array(document.getElementById("main_DynamicControl_0_3_5_MultiSelectListReqd"), document.getElementById("main_DynamicControl_0_3_5_MultiSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_8_SingleSelectListReqd"), document.getElementById("main_DynamicControl_0_3_8_SingleSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_9_SingleSelectListReqd"), document.getElementById("main_DynamicControl_0_3_9_SingleSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_12_TextFieldReqd"), document.getElementById("main_DynamicControl_0_3_12_TextFieldRegex"), document.getElementById("main_DynamicControl_0_3_12_TextFieldOtherValidator"), document.getElementById("main_DynamicControl_0_3_12_EmailAddressRegex"), document.getElementById("main_DynamicControl_0_3_12_EmailAddressMX"), document.getElementById("main_DynamicControl_0_3_13_TextFieldReqd"), document.getElementById("main_DynamicControl_0_3_13_TextFieldRegex"), document.getElementById("main_DynamicControl_0_3_13_TextFieldOtherValidator"), document.getElementById("main_DynamicControl_0_3_13_EmailAddressRegex"), document.getElementById("main_DynamicControl_0_3_13_EmailAddressMX"), document.getElementById("main_DynamicControl_0_3_14_TextFieldReqd"), document.getElementById("main_DynamicControl_0_3_14_TextFieldRegex"), document.getElementById("main_DynamicControl_0_3_14_TextFieldOtherValidator"), document.getElementById("main_DynamicControl_0_3_14_EmailAddressRegex"), document.getElementById("main_DynamicControl_0_3_14_EmailAddressMX"), document.getElementById("main_DynamicControl_0_3_15_SingleSelectListReqd"), document.getElementById("main_DynamicControl_0_3_15_SingleSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_16_SingleSelectListReqd"), document.getElementById("main_DynamicControl_0_3_16_SingleSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_17_CountryValueReqd"), document.getElementById("main_DynamicControl_0_3_17_AddressLine1ValueReqd"), document.getElementById("main_DynamicControl_0_3_17_AddressLine2ValueReqd"), document.getElementById("main_DynamicControl_0_3_17_CityValueReqd"), document.getElementById("main_DynamicControl_0_3_17_StateValueReqd"), document.getElementById("main_DynamicControl_0_3_17_ZipValueReqd"), document.getElementById("main_DynamicControl_0_3_17_ZipValueRegex"), document.getElementById("main_DynamicControl_0_3_18_MultiSelectListReqd"), document.getElementById("main_DynamicControl_0_3_18_MultiSelectOtherValidator"), document.getElementById("main_DynamicControl_0_3_19_TextFieldReqd"), document.getElementById("main_DynamicControl_0_3_19_TextFieldRegex"), document.getElementById("main_DynamicControl_0_3_19_TextFieldOtherValidator"), document.getElementById("main_DynamicControl_0_3_19_EmailAddressRegex"), document.getElementById("main_DynamicControl_0_3_19_EmailAddressMX"), document.getElementById("main_DynamicControl_0_3_20_TextFieldReqd"), document.getElementById("main_DynamicControl_0_3_20_TextFieldRegex"), document.getElementById("main_DynamicControl_0_3_20_TextFieldOtherValidator"), document.getElementById("main_DynamicControl_0_3_20_EmailAddressRegex"), document.getElementById("main_DynamicControl_0_3_20_EmailAddressMX")); //]]> </script> <script type="text/javascript"> //<![CDATA[ var main_DynamicControl_0_3_2_ValSummary = document.all ? document.all["main_DynamicControl_0_3_2_ValSummary"] : document.getElementById("main_DynamicControl_0_3_2_ValSummary"); main_DynamicControl_0_3_2_ValSummary.headertext = "The highlighted fields are required to move forward."; var main_DynamicControl_0_3_5_MultiSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_5_MultiSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_5_MultiSelectListReqd"); main_DynamicControl_0_3_5_MultiSelectListReqd.errormessage = "Choose at least one email or print publication to receive"; main_DynamicControl_0_3_5_MultiSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_5_MultiSelectListReqd.evaluationfunction = "CustomValidatorEvaluateIsValid"; main_DynamicControl_0_3_5_MultiSelectListReqd.clientvalidationfunction = "main_DynamicControl_0_3_5_MultiSelectList_Validate"; var main_DynamicControl_0_3_5_MultiSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_5_MultiSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_5_MultiSelectOtherValidator"); main_DynamicControl_0_3_5_MultiSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_5_MultiSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_8_SingleSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_8_SingleSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_8_SingleSelectListReqd"); main_DynamicControl_0_3_8_SingleSelectListReqd.controltovalidate = "main_DynamicControl_0_3_8_SingleSelectList"; main_DynamicControl_0_3_8_SingleSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_8_SingleSelectListReqd.enabled = "False"; main_DynamicControl_0_3_8_SingleSelectListReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_8_SingleSelectListReqd.initialvalue = ""; var main_DynamicControl_0_3_8_SingleSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_8_SingleSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_8_SingleSelectOtherValidator"); main_DynamicControl_0_3_8_SingleSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_8_SingleSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_9_SingleSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_9_SingleSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_9_SingleSelectListReqd"); main_DynamicControl_0_3_9_SingleSelectListReqd.controltovalidate = "main_DynamicControl_0_3_9_SingleSelectList"; main_DynamicControl_0_3_9_SingleSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_9_SingleSelectListReqd.enabled = "False"; main_DynamicControl_0_3_9_SingleSelectListReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_9_SingleSelectListReqd.initialvalue = ""; var main_DynamicControl_0_3_9_SingleSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_9_SingleSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_9_SingleSelectOtherValidator"); main_DynamicControl_0_3_9_SingleSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_9_SingleSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_12_TextFieldReqd = document.all ? document.all["main_DynamicControl_0_3_12_TextFieldReqd"] : document.getElementById("main_DynamicControl_0_3_12_TextFieldReqd"); main_DynamicControl_0_3_12_TextFieldReqd.controltovalidate = "main_DynamicControl_0_3_12_TextField"; main_DynamicControl_0_3_12_TextFieldReqd.errormessage = "Enter your First Name"; main_DynamicControl_0_3_12_TextFieldReqd.display = "Dynamic"; main_DynamicControl_0_3_12_TextFieldReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_12_TextFieldReqd.initialvalue = ""; var main_DynamicControl_0_3_12_TextFieldRegex = document.all ? document.all["main_DynamicControl_0_3_12_TextFieldRegex"] : document.getElementById("main_DynamicControl_0_3_12_TextFieldRegex"); main_DynamicControl_0_3_12_TextFieldRegex.controltovalidate = "main_DynamicControl_0_3_12_TextField"; main_DynamicControl_0_3_12_TextFieldRegex.display = "Dynamic"; main_DynamicControl_0_3_12_TextFieldRegex.enabled = "False"; main_DynamicControl_0_3_12_TextFieldRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; var main_DynamicControl_0_3_12_TextFieldOtherValidator = document.all ? document.all["main_DynamicControl_0_3_12_TextFieldOtherValidator"] : document.getElementById("main_DynamicControl_0_3_12_TextFieldOtherValidator"); main_DynamicControl_0_3_12_TextFieldOtherValidator.enabled = "False"; main_DynamicControl_0_3_12_TextFieldOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_12_EmailAddressRegex = document.all ? document.all["main_DynamicControl_0_3_12_EmailAddressRegex"] : document.getElementById("main_DynamicControl_0_3_12_EmailAddressRegex"); main_DynamicControl_0_3_12_EmailAddressRegex.controltovalidate = "main_DynamicControl_0_3_12_TextField"; main_DynamicControl_0_3_12_EmailAddressRegex.display = "Dynamic"; main_DynamicControl_0_3_12_EmailAddressRegex.enabled = "False"; main_DynamicControl_0_3_12_EmailAddressRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_12_EmailAddressRegex.validationexpression = "^\\s*([\\w\\-\\.\\+]+)@((\\[([0-9]{1,3}\\.){3}[0-9]{1,3}\\])|(([\\w\\-]+\\.)+)([a-zA-Z]{2,14}))\\s*$"; var main_DynamicControl_0_3_12_EmailAddressMX = document.all ? document.all["main_DynamicControl_0_3_12_EmailAddressMX"] : document.getElementById("main_DynamicControl_0_3_12_EmailAddressMX"); main_DynamicControl_0_3_12_EmailAddressMX.controltovalidate = "main_DynamicControl_0_3_12_TextField"; main_DynamicControl_0_3_12_EmailAddressMX.errormessage = "a valid email address"; main_DynamicControl_0_3_12_EmailAddressMX.display = "Dynamic"; main_DynamicControl_0_3_12_EmailAddressMX.enabled = "False"; main_DynamicControl_0_3_12_EmailAddressMX.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_13_TextFieldReqd = document.all ? document.all["main_DynamicControl_0_3_13_TextFieldReqd"] : document.getElementById("main_DynamicControl_0_3_13_TextFieldReqd"); main_DynamicControl_0_3_13_TextFieldReqd.controltovalidate = "main_DynamicControl_0_3_13_TextField"; main_DynamicControl_0_3_13_TextFieldReqd.errormessage = "Enter your Last Name"; main_DynamicControl_0_3_13_TextFieldReqd.display = "Dynamic"; main_DynamicControl_0_3_13_TextFieldReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_13_TextFieldReqd.initialvalue = ""; var main_DynamicControl_0_3_13_TextFieldRegex = document.all ? document.all["main_DynamicControl_0_3_13_TextFieldRegex"] : document.getElementById("main_DynamicControl_0_3_13_TextFieldRegex"); main_DynamicControl_0_3_13_TextFieldRegex.controltovalidate = "main_DynamicControl_0_3_13_TextField"; main_DynamicControl_0_3_13_TextFieldRegex.display = "Dynamic"; main_DynamicControl_0_3_13_TextFieldRegex.enabled = "False"; main_DynamicControl_0_3_13_TextFieldRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; var main_DynamicControl_0_3_13_TextFieldOtherValidator = document.all ? document.all["main_DynamicControl_0_3_13_TextFieldOtherValidator"] : document.getElementById("main_DynamicControl_0_3_13_TextFieldOtherValidator"); main_DynamicControl_0_3_13_TextFieldOtherValidator.enabled = "False"; main_DynamicControl_0_3_13_TextFieldOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_13_EmailAddressRegex = document.all ? document.all["main_DynamicControl_0_3_13_EmailAddressRegex"] : document.getElementById("main_DynamicControl_0_3_13_EmailAddressRegex"); main_DynamicControl_0_3_13_EmailAddressRegex.controltovalidate = "main_DynamicControl_0_3_13_TextField"; main_DynamicControl_0_3_13_EmailAddressRegex.display = "Dynamic"; main_DynamicControl_0_3_13_EmailAddressRegex.enabled = "False"; main_DynamicControl_0_3_13_EmailAddressRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_13_EmailAddressRegex.validationexpression = "^\\s*([\\w\\-\\.\\+]+)@((\\[([0-9]{1,3}\\.){3}[0-9]{1,3}\\])|(([\\w\\-]+\\.)+)([a-zA-Z]{2,14}))\\s*$"; var main_DynamicControl_0_3_13_EmailAddressMX = document.all ? document.all["main_DynamicControl_0_3_13_EmailAddressMX"] : document.getElementById("main_DynamicControl_0_3_13_EmailAddressMX"); main_DynamicControl_0_3_13_EmailAddressMX.controltovalidate = "main_DynamicControl_0_3_13_TextField"; main_DynamicControl_0_3_13_EmailAddressMX.errormessage = "a valid email address"; main_DynamicControl_0_3_13_EmailAddressMX.display = "Dynamic"; main_DynamicControl_0_3_13_EmailAddressMX.enabled = "False"; main_DynamicControl_0_3_13_EmailAddressMX.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_14_TextFieldReqd = document.all ? document.all["main_DynamicControl_0_3_14_TextFieldReqd"] : document.getElementById("main_DynamicControl_0_3_14_TextFieldReqd"); main_DynamicControl_0_3_14_TextFieldReqd.controltovalidate = "main_DynamicControl_0_3_14_TextField"; main_DynamicControl_0_3_14_TextFieldReqd.errormessage = "Enter your Email Address"; main_DynamicControl_0_3_14_TextFieldReqd.display = "Dynamic"; main_DynamicControl_0_3_14_TextFieldReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_14_TextFieldReqd.initialvalue = ""; var main_DynamicControl_0_3_14_TextFieldRegex = document.all ? document.all["main_DynamicControl_0_3_14_TextFieldRegex"] : document.getElementById("main_DynamicControl_0_3_14_TextFieldRegex"); main_DynamicControl_0_3_14_TextFieldRegex.controltovalidate = "main_DynamicControl_0_3_14_TextField"; main_DynamicControl_0_3_14_TextFieldRegex.display = "Dynamic"; main_DynamicControl_0_3_14_TextFieldRegex.enabled = "False"; main_DynamicControl_0_3_14_TextFieldRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; var main_DynamicControl_0_3_14_TextFieldOtherValidator = document.all ? document.all["main_DynamicControl_0_3_14_TextFieldOtherValidator"] : document.getElementById("main_DynamicControl_0_3_14_TextFieldOtherValidator"); main_DynamicControl_0_3_14_TextFieldOtherValidator.enabled = "False"; main_DynamicControl_0_3_14_TextFieldOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_14_EmailAddressRegex = document.all ? document.all["main_DynamicControl_0_3_14_EmailAddressRegex"] : document.getElementById("main_DynamicControl_0_3_14_EmailAddressRegex"); main_DynamicControl_0_3_14_EmailAddressRegex.controltovalidate = "main_DynamicControl_0_3_14_TextField"; main_DynamicControl_0_3_14_EmailAddressRegex.errormessage = "Please supply a value for Email Address"; main_DynamicControl_0_3_14_EmailAddressRegex.display = "Dynamic"; main_DynamicControl_0_3_14_EmailAddressRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_14_EmailAddressRegex.validationexpression = "^\\s*([\\w\\-\\.\\+]+)@((\\[([0-9]{1,3}\\.){3}[0-9]{1,3}\\])|(([\\w\\-]+\\.)+)([a-zA-Z]{2,14}))\\s*$"; var main_DynamicControl_0_3_14_EmailAddressMX = document.all ? document.all["main_DynamicControl_0_3_14_EmailAddressMX"] : document.getElementById("main_DynamicControl_0_3_14_EmailAddressMX"); main_DynamicControl_0_3_14_EmailAddressMX.controltovalidate = "main_DynamicControl_0_3_14_TextField"; main_DynamicControl_0_3_14_EmailAddressMX.errormessage = "Please supply a value for Email Address"; main_DynamicControl_0_3_14_EmailAddressMX.display = "Dynamic"; main_DynamicControl_0_3_14_EmailAddressMX.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_15_SingleSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_15_SingleSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_15_SingleSelectListReqd"); main_DynamicControl_0_3_15_SingleSelectListReqd.controltovalidate = "main_DynamicControl_0_3_15_SingleSelectList"; main_DynamicControl_0_3_15_SingleSelectListReqd.errormessage = "Select your Occupation"; main_DynamicControl_0_3_15_SingleSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_15_SingleSelectListReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_15_SingleSelectListReqd.initialvalue = ""; var main_DynamicControl_0_3_15_SingleSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_15_SingleSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_15_SingleSelectOtherValidator"); main_DynamicControl_0_3_15_SingleSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_15_SingleSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_16_SingleSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_16_SingleSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_16_SingleSelectListReqd"); main_DynamicControl_0_3_16_SingleSelectListReqd.controltovalidate = "main_DynamicControl_0_3_16_SingleSelectList"; main_DynamicControl_0_3_16_SingleSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_16_SingleSelectListReqd.enabled = "False"; main_DynamicControl_0_3_16_SingleSelectListReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_16_SingleSelectListReqd.initialvalue = ""; var main_DynamicControl_0_3_16_SingleSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_16_SingleSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_16_SingleSelectOtherValidator"); main_DynamicControl_0_3_16_SingleSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_16_SingleSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_17_CountryValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_CountryValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_CountryValueReqd"); main_DynamicControl_0_3_17_CountryValueReqd.controltovalidate = "main_DynamicControl_0_3_17_CountryValue"; main_DynamicControl_0_3_17_CountryValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_CountryValueReqd.enabled = "False"; main_DynamicControl_0_3_17_CountryValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_CountryValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_AddressLine1ValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_AddressLine1ValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_AddressLine1ValueReqd"); main_DynamicControl_0_3_17_AddressLine1ValueReqd.controltovalidate = "main_DynamicControl_0_3_17_AddressLine1Value"; main_DynamicControl_0_3_17_AddressLine1ValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_AddressLine1ValueReqd.enabled = "False"; main_DynamicControl_0_3_17_AddressLine1ValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_AddressLine1ValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_AddressLine2ValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_AddressLine2ValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_AddressLine2ValueReqd"); main_DynamicControl_0_3_17_AddressLine2ValueReqd.controltovalidate = "main_DynamicControl_0_3_17_AddressLine2Value"; main_DynamicControl_0_3_17_AddressLine2ValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_AddressLine2ValueReqd.enabled = "False"; main_DynamicControl_0_3_17_AddressLine2ValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_AddressLine2ValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_CityValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_CityValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_CityValueReqd"); main_DynamicControl_0_3_17_CityValueReqd.controltovalidate = "main_DynamicControl_0_3_17_CityValue"; main_DynamicControl_0_3_17_CityValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_CityValueReqd.enabled = "False"; main_DynamicControl_0_3_17_CityValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_CityValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_StateValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_StateValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_StateValueReqd"); main_DynamicControl_0_3_17_StateValueReqd.controltovalidate = "main_DynamicControl_0_3_17_StateValue"; main_DynamicControl_0_3_17_StateValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_StateValueReqd.enabled = "False"; main_DynamicControl_0_3_17_StateValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_StateValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_ZipValueReqd = document.all ? document.all["main_DynamicControl_0_3_17_ZipValueReqd"] : document.getElementById("main_DynamicControl_0_3_17_ZipValueReqd"); main_DynamicControl_0_3_17_ZipValueReqd.controltovalidate = "main_DynamicControl_0_3_17_ZipValue"; main_DynamicControl_0_3_17_ZipValueReqd.display = "Dynamic"; main_DynamicControl_0_3_17_ZipValueReqd.enabled = "False"; main_DynamicControl_0_3_17_ZipValueReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_ZipValueReqd.initialvalue = ""; var main_DynamicControl_0_3_17_ZipValueRegex = document.all ? document.all["main_DynamicControl_0_3_17_ZipValueRegex"] : document.getElementById("main_DynamicControl_0_3_17_ZipValueRegex"); main_DynamicControl_0_3_17_ZipValueRegex.controltovalidate = "main_DynamicControl_0_3_17_ZipValue"; main_DynamicControl_0_3_17_ZipValueRegex.errormessage = "<span class=\'addressValError\'>Please supply a valid value for <span class=\'addressValErrorField\'>Postal Code</span></span>"; main_DynamicControl_0_3_17_ZipValueRegex.display = "Dynamic"; main_DynamicControl_0_3_17_ZipValueRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_17_ZipValueRegex.validationexpression = "^\\d{5}$|^\\d{5}-\\d{4}$"; var main_DynamicControl_0_3_18_MultiSelectListReqd = document.all ? document.all["main_DynamicControl_0_3_18_MultiSelectListReqd"] : document.getElementById("main_DynamicControl_0_3_18_MultiSelectListReqd"); main_DynamicControl_0_3_18_MultiSelectListReqd.errormessage = "Please accept the Terms and Conditions and Privacy Policy"; main_DynamicControl_0_3_18_MultiSelectListReqd.display = "Dynamic"; main_DynamicControl_0_3_18_MultiSelectListReqd.evaluationfunction = "CustomValidatorEvaluateIsValid"; main_DynamicControl_0_3_18_MultiSelectListReqd.clientvalidationfunction = "main_DynamicControl_0_3_18_MultiSelectList_Validate"; var main_DynamicControl_0_3_18_MultiSelectOtherValidator = document.all ? document.all["main_DynamicControl_0_3_18_MultiSelectOtherValidator"] : document.getElementById("main_DynamicControl_0_3_18_MultiSelectOtherValidator"); main_DynamicControl_0_3_18_MultiSelectOtherValidator.enabled = "False"; main_DynamicControl_0_3_18_MultiSelectOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_19_TextFieldReqd = document.all ? document.all["main_DynamicControl_0_3_19_TextFieldReqd"] : document.getElementById("main_DynamicControl_0_3_19_TextFieldReqd"); main_DynamicControl_0_3_19_TextFieldReqd.controltovalidate = "main_DynamicControl_0_3_19_TextField"; main_DynamicControl_0_3_19_TextFieldReqd.display = "Dynamic"; main_DynamicControl_0_3_19_TextFieldReqd.enabled = "False"; main_DynamicControl_0_3_19_TextFieldReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_19_TextFieldReqd.initialvalue = ""; var main_DynamicControl_0_3_19_TextFieldRegex = document.all ? document.all["main_DynamicControl_0_3_19_TextFieldRegex"] : document.getElementById("main_DynamicControl_0_3_19_TextFieldRegex"); main_DynamicControl_0_3_19_TextFieldRegex.controltovalidate = "main_DynamicControl_0_3_19_TextField"; main_DynamicControl_0_3_19_TextFieldRegex.display = "Dynamic"; main_DynamicControl_0_3_19_TextFieldRegex.enabled = "False"; main_DynamicControl_0_3_19_TextFieldRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; var main_DynamicControl_0_3_19_TextFieldOtherValidator = document.all ? document.all["main_DynamicControl_0_3_19_TextFieldOtherValidator"] : document.getElementById("main_DynamicControl_0_3_19_TextFieldOtherValidator"); main_DynamicControl_0_3_19_TextFieldOtherValidator.enabled = "False"; main_DynamicControl_0_3_19_TextFieldOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_19_EmailAddressRegex = document.all ? document.all["main_DynamicControl_0_3_19_EmailAddressRegex"] : document.getElementById("main_DynamicControl_0_3_19_EmailAddressRegex"); main_DynamicControl_0_3_19_EmailAddressRegex.controltovalidate = "main_DynamicControl_0_3_19_TextField"; main_DynamicControl_0_3_19_EmailAddressRegex.display = "Dynamic"; main_DynamicControl_0_3_19_EmailAddressRegex.enabled = "False"; main_DynamicControl_0_3_19_EmailAddressRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_19_EmailAddressRegex.validationexpression = "^\\s*([\\w\\-\\.\\+]+)@((\\[([0-9]{1,3}\\.){3}[0-9]{1,3}\\])|(([\\w\\-]+\\.)+)([a-zA-Z]{2,14}))\\s*$"; var main_DynamicControl_0_3_19_EmailAddressMX = document.all ? document.all["main_DynamicControl_0_3_19_EmailAddressMX"] : document.getElementById("main_DynamicControl_0_3_19_EmailAddressMX"); main_DynamicControl_0_3_19_EmailAddressMX.controltovalidate = "main_DynamicControl_0_3_19_TextField"; main_DynamicControl_0_3_19_EmailAddressMX.errormessage = "a valid email address"; main_DynamicControl_0_3_19_EmailAddressMX.display = "Dynamic"; main_DynamicControl_0_3_19_EmailAddressMX.enabled = "False"; main_DynamicControl_0_3_19_EmailAddressMX.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_20_TextFieldReqd = document.all ? document.all["main_DynamicControl_0_3_20_TextFieldReqd"] : document.getElementById("main_DynamicControl_0_3_20_TextFieldReqd"); main_DynamicControl_0_3_20_TextFieldReqd.controltovalidate = "main_DynamicControl_0_3_20_TextField"; main_DynamicControl_0_3_20_TextFieldReqd.display = "Dynamic"; main_DynamicControl_0_3_20_TextFieldReqd.enabled = "False"; main_DynamicControl_0_3_20_TextFieldReqd.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid"; main_DynamicControl_0_3_20_TextFieldReqd.initialvalue = ""; var main_DynamicControl_0_3_20_TextFieldRegex = document.all ? document.all["main_DynamicControl_0_3_20_TextFieldRegex"] : document.getElementById("main_DynamicControl_0_3_20_TextFieldRegex"); main_DynamicControl_0_3_20_TextFieldRegex.controltovalidate = "main_DynamicControl_0_3_20_TextField"; main_DynamicControl_0_3_20_TextFieldRegex.display = "Dynamic"; main_DynamicControl_0_3_20_TextFieldRegex.enabled = "False"; main_DynamicControl_0_3_20_TextFieldRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; var main_DynamicControl_0_3_20_TextFieldOtherValidator = document.all ? document.all["main_DynamicControl_0_3_20_TextFieldOtherValidator"] : document.getElementById("main_DynamicControl_0_3_20_TextFieldOtherValidator"); main_DynamicControl_0_3_20_TextFieldOtherValidator.enabled = "False"; main_DynamicControl_0_3_20_TextFieldOtherValidator.evaluationfunction = "CustomValidatorEvaluateIsValid"; var main_DynamicControl_0_3_20_EmailAddressRegex = document.all ? document.all["main_DynamicControl_0_3_20_EmailAddressRegex"] : document.getElementById("main_DynamicControl_0_3_20_EmailAddressRegex"); main_DynamicControl_0_3_20_EmailAddressRegex.controltovalidate = "main_DynamicControl_0_3_20_TextField"; main_DynamicControl_0_3_20_EmailAddressRegex.display = "Dynamic"; main_DynamicControl_0_3_20_EmailAddressRegex.enabled = "False"; main_DynamicControl_0_3_20_EmailAddressRegex.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid"; main_DynamicControl_0_3_20_EmailAddressRegex.validationexpression = "^\\s*([\\w\\-\\.\\+]+)@((\\[([0-9]{1,3}\\.){3}[0-9]{1,3}\\])|(([\\w\\-]+\\.)+)([a-zA-Z]{2,14}))\\s*$"; var main_DynamicControl_0_3_20_EmailAddressMX = document.all ? document.all["main_DynamicControl_0_3_20_EmailAddressMX"] : document.getElementById("main_DynamicControl_0_3_20_EmailAddressMX"); main_DynamicControl_0_3_20_EmailAddressMX.controltovalidate = "main_DynamicControl_0_3_20_TextField"; main_DynamicControl_0_3_20_EmailAddressMX.errormessage = "a valid email address"; main_DynamicControl_0_3_20_EmailAddressMX.display = "Dynamic"; main_DynamicControl_0_3_20_EmailAddressMX.enabled = "False"; main_DynamicControl_0_3_20_EmailAddressMX.evaluationfunction = "CustomValidatorEvaluateIsValid"; //]]> </script> <script type="text/javascript"> //<![CDATA[ (function(id) { var e = document.getElementById(id); if (e) { e.dispose = function() { Array.remove(Page_ValidationSummaries, document.getElementById(id)); } e = null; } })('main_DynamicControl_0_3_2_ValSummary'); var Page_ValidationActive = false; if (typeof(ValidatorOnLoad) == "function") { ValidatorOnLoad(); } function ValidatorOnSubmit() { if (Page_ValidationActive) { return ValidatorCommonOnSubmit(); } else { return true; } } document.getElementById('main_DynamicControl_0_3_5_MultiSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_5_MultiSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_5_MultiSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_5_MultiSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_8_SingleSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_8_SingleSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_8_SingleSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_8_SingleSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_9_SingleSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_9_SingleSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_9_SingleSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_9_SingleSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_12_TextFieldReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_12_TextFieldReqd')); } document.getElementById('main_DynamicControl_0_3_12_TextFieldRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_12_TextFieldRegex')); } document.getElementById('main_DynamicControl_0_3_12_TextFieldOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_12_TextFieldOtherValidator')); } document.getElementById('main_DynamicControl_0_3_12_EmailAddressRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_12_EmailAddressRegex')); } document.getElementById('main_DynamicControl_0_3_12_EmailAddressMX').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_12_EmailAddressMX')); } document.getElementById('main_DynamicControl_0_3_13_TextFieldReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_13_TextFieldReqd')); } document.getElementById('main_DynamicControl_0_3_13_TextFieldRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_13_TextFieldRegex')); } document.getElementById('main_DynamicControl_0_3_13_TextFieldOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_13_TextFieldOtherValidator')); } document.getElementById('main_DynamicControl_0_3_13_EmailAddressRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_13_EmailAddressRegex')); } document.getElementById('main_DynamicControl_0_3_13_EmailAddressMX').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_13_EmailAddressMX')); } document.getElementById('main_DynamicControl_0_3_14_TextFieldReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_14_TextFieldReqd')); } document.getElementById('main_DynamicControl_0_3_14_TextFieldRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_14_TextFieldRegex')); } document.getElementById('main_DynamicControl_0_3_14_TextFieldOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_14_TextFieldOtherValidator')); } document.getElementById('main_DynamicControl_0_3_14_EmailAddressRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_14_EmailAddressRegex')); } document.getElementById('main_DynamicControl_0_3_14_EmailAddressMX').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_14_EmailAddressMX')); } document.getElementById('main_DynamicControl_0_3_15_SingleSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_15_SingleSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_15_SingleSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_15_SingleSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_16_SingleSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_16_SingleSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_16_SingleSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_16_SingleSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_17_CountryValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_CountryValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_AddressLine1ValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_AddressLine1ValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_AddressLine2ValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_AddressLine2ValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_CityValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_CityValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_StateValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_StateValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_ZipValueReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_ZipValueReqd')); } document.getElementById('main_DynamicControl_0_3_17_ZipValueRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_17_ZipValueRegex')); } document.getElementById('main_DynamicControl_0_3_18_MultiSelectListReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_18_MultiSelectListReqd')); } document.getElementById('main_DynamicControl_0_3_18_MultiSelectOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_18_MultiSelectOtherValidator')); } document.getElementById('main_DynamicControl_0_3_19_TextFieldReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_19_TextFieldReqd')); } document.getElementById('main_DynamicControl_0_3_19_TextFieldRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_19_TextFieldRegex')); } document.getElementById('main_DynamicControl_0_3_19_TextFieldOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_19_TextFieldOtherValidator')); } document.getElementById('main_DynamicControl_0_3_19_EmailAddressRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_19_EmailAddressRegex')); } document.getElementById('main_DynamicControl_0_3_19_EmailAddressMX').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_19_EmailAddressMX')); } document.getElementById('main_DynamicControl_0_3_20_TextFieldReqd').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_20_TextFieldReqd')); } document.getElementById('main_DynamicControl_0_3_20_TextFieldRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_20_TextFieldRegex')); } document.getElementById('main_DynamicControl_0_3_20_TextFieldOtherValidator').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_20_TextFieldOtherValidator')); } document.getElementById('main_DynamicControl_0_3_20_EmailAddressRegex').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_20_EmailAddressRegex')); } document.getElementById('main_DynamicControl_0_3_20_EmailAddressMX').dispose = function() { Array.remove(Page_Validators, document.getElementById('main_DynamicControl_0_3_20_EmailAddressMX')); } //]]> </script> </form> <footer> <div class='container'> <div class='row'> <p class='col-md-12'> ©2025 MJH Life Sciences<sup>™</sup> and <span class='brandName'></span>. All rights reserved. </p> </div> </div> </footer> <script src="/forms/js/iframeResizer.contentWindow.js" type="text/javascript"></script> <script type="text/javascript" src="https://cdn.public.mjhls.com/lib/fetch-wrapper/FetchWrapper.js"></script> <script type="text/javascript" src="/js/LoggerWrapper.js"></script> <script src="/libs/jquery/bootstrap/dist/js/bootstrap.js"></script> <script type="text/javascript" src="//code.jquery.com/ui/1.11.4/jquery-ui.min.js"></script> <script type="text/javascript"> const _logger = new LoggerWrapper("633de4d4-743f-402b-b53f-bc3f8b2a141c", "f48b27c3-9ca8-408a-a044-1da616e2960f"); </script> <div style="display: none;"> <svg id="SVG_Radio" xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 20 20"> <g id="Ellipse_97" data-name="Ellipse 97" fill="var(--svgRadioBackground)" stroke="var(--svgRadioStroke)" stroke-width="var(--svgRadioStrokeWidth)"> <circle cx="10" cy="10" r="10" stroke="none"/> <circle cx="10" cy="10" r="9.5" fill="none"/> </g> <circle class="svg_radio_circle" id="Ellipse_100" data-name="Ellipse 100" cx="5" cy="5" r="5" transform="translate(5 5)" fill="var(--svgRadioFill)"/> </svg> <svg id="SVG_Checkbox" xmlns="http://www.w3.org/2000/svg" width="36" height="36" viewBox="0 0 36 36"> <g id="Rectangle_83" data-name="Rectangle 83" fill="var(--svgCheckboxBackground)" stroke="var(--svgCheckboxStroke)" stroke-width="var(--svgCheckboxStrokeWidth)"> <rect width="36" height="36" stroke="none"/> <rect x="0.5" y="0.5" width="35" height="35" fill="none"/> </g> <path id="done_FILL0_wght400_GRAD0_opsz48_2_" data-name="done_FILL0_wght400_GRAD0_opsz48(2)" d="M17.489,32.74,7.7,22.951l1.879-1.879,7.91,7.91L34.271,12.2l1.879,1.879Z" transform="translate(-3.7 -4.2)" fill="var(--svgCheckboxFill)"/> </svg> </div> <script type="text/javascript" src="/forms/js/SharedFormScript.js"></script> </body> </html>

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