First Name* |
Last Name* |
Home Address* |
City* |
State* |
ZIP Code* |
Home Phone* |
Mobile Phone |
Email* |
Place a checkmark next to how you would |
Account Number |
[[!recaptchav2_render]] [[!+fi.error.recaptchav2_error]] |
(the code preview is contained in backticks)
[[!FormIt? &hooks=
recaptchav2,spam,email,redirect
&emailTpl=vipEmail
&emailSubject=Submission via VIP form
&emailTo=robert@domain.com
&emailFrom=fromemail@domain.com
&redirectTo=1169
&validate=firstName:required:minLength=^2^, lastName:required:minLength=^2^, address1:required, city:required, zipcode:required:minLength=^5^, phone:required, state:required, emailAddress:required
]]<form action="[[~[[*id]]]]" method="post" id="vipForm" name="vipForm"> . . . [[!recaptchav2_render]] [[!+fi.error.recaptchav2_error]] </form>
[[!+fi.error.firstName:notempty=`Please enter a valid first name.`]]
[[!+fi.error.lastName:notempty=`Please enter a valid last name.`]]
[[!+fi.error.address1:notempty=`Please enter a valid address.`]]
[[!+fi.error.city:notempty=`Please enter a valid city.`]]
[[!+fi.error.zipcode:notempty=`Please enter a valid zip code.`]]
[[!+fi.error.state:notempty=`Please select a valid state.`]]
[[!+fi.error.phone:notempty=`Please select a home phone number.`]]
[[!+fi.error.emailAddress:notempty=`Please enter a valid email address.`]]