test – BigTravelStore

<div id='crmWebToEntityForm' style='width:600px;margin:auto;'>
<META HTTP-EQUIV ='content-type' CONTENT='text/html;charset=UTF-8'>
<form action='https://crm.zoho.com/crm/WebForm' name=WebForm1139299000006599693 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory()' accept-charset='UTF-8'>


<input type='text' style='display:none;' name='xnQsjsdp' value='13d727aa7618af6efd97f7eb7c264cc10b1f655052fef0b6b55584778ff9582d'/>
<input type='hidden' name='zc_gad' id='zc_gad' value=''/>
<input type='text' style='display:none;' name='xmIwtLD' value='dee3ed7107407a60601993865d8c4781ad7f750bcef7aa4a7b9681fae5db26cd'/>
<input type='text' style='display:none;' name='actionType' value='Q3VzdG9tTW9kdWxlNA=='/>

<input type='text' style='display:none;' name='returnURL' value='http://www.activatemysimnow.com/' />

<style>
tr , td {
padding:6px;
border-spacing:0px;
border-width:0px;
}
</style>
<table style='width:600px;background-color:white;color:black'>

<tr><td colspan='2' style='text-align:left;color:black;font-family:Arial;font-size:14px;'><strong>Activation Portal</strong></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Customer Name<span style='color:red;'>*</span></td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='255' name='COBJ4CF2' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Company Name</td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='255' name='COBJ4CF3' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Email<span style='color:red;'>*</span></td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='100' name='Email' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>SIM CARD Number<span style='color:red;'>*</span></td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='120' name='NAME' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Activation Date</td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='20' name='COBJ4CF82' placeholder='MM/dd/yyyy' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Plan<span style='color:red;'>*</span></td><td style='width:250px;'>
<select style='width:250px;' name='COBJ4CF4'>
<option value='-None-'>-None-</option>
<option value='ILD ADD-ON'>ILD ADD-ON</option>
<option value='1GB ADD-ON'>1GB ADD-ON</option>
<option value='500MB ADD-ON'>500MB ADD-ON</option>
<option value='SIMPLE $40'>SIMPLE $40</option>
<option value='SIMPLE $50'>SIMPLE $50</option>
<option value='SIMPLE $60'>SIMPLE $60</option>
<option value='H2O $50'>H2O $50</option>
<option value='H2O $40'>H2O $40</option>
<option value='H2O $30'>H2O $30</option>
<option value='NEWTM 1PREP75'>NEWTM 1PREP75</option>
<option value='NEWTM 1PREP75+15'>NEWTM 1PREP75+15</option>
<option value='NEWTM SP45'>NEWTM SP45</option>
<option value='NEWTM SP45+5'>NEWTM SP45+5</option>
<option value='NEWTM SP45+15'>NEWTM SP45+15</option>
<option value='NEWTM SP55'>NEWTM SP55</option>
<option value='NEWTM SP55+5'>NEWTM SP55+5</option>
<option value='NEWTM SP55+15'>NEWTM SP55+15</option>
<option value='Lyca $29 30 days'>Lyca $29 30 days</option>
<option value='Lyca $29 60 days'>Lyca $29 60 days</option>
<option value='Lyca $23 30 days'>Lyca $23 30 days</option>
<option value='H20 $30 60 DAYS'>H20 $30 60 DAYS</option>
<option value='H20 $40 60 DAYS'>H20 $40 60 DAYS</option>
<option value='H20 $50 60 DAYS'>H20 $50 60 DAYS</option>
<option value='EasyGo $20-Plan 30-day'>EasyGo $20-Plan 30-day</option>
</select></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Product Label<span style='color:red;'>*</span></td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='255' name='COBJ4CF7' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Zip Code</td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='9' name='COBJ4CF51' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>PUK (For Lyca Only)</td><td style='width:250px;' ><input type='text' style='width:250px;' maxlength='255' name='COBJ4CF12' /></td></tr>

<tr><td style='nowrap:nowrap;text-align:left;font-size:12px;font-family:Arial;width:200px;'>Special Instructions </td><td> <textarea name='COBJ4CF5' maxlength='2000' style='width:250px;'> </textarea></td></tr>

<tr><td colspan='2' style='text-align:center; padding-top:15px;'>
<input style='font-size:12px;color:#131307' type='submit' value='Submit' />
<input type='reset' style='font-size:12px;color:#131307' value='Reset' />
</td>
</tr>
</table>
<script>
var mndFileds=new Array('NAME','COBJ4CF7','COBJ4CF2','COBJ4CF4','Email');
var fldLangVal=new Array('SIM CARD Number','Product Label','Customer Name','Plan','Email');
var name='';
var email='';

function checkMandatory() {
for(i=0;i<mndFileds.length;i++) {
var fieldObj=document.forms['WebForm1139299000006599693'][mndFileds[i]];
if(fieldObj) {
if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0) {
if(fieldObj.type =='file')
{
alert('Please select a file to upload.');
fieldObj.focus();
return false;
}
alert(fldLangVal[i] +' cannot be empty.');
fieldObj.focus();
return false;
} else if(fieldObj.nodeName=='SELECT') {
if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {
alert(fldLangVal[i] +' cannot be none.');
fieldObj.focus();
return false;
}
} else if(fieldObj.type =='checkbox'){
if(fieldObj.checked == false){
alert('Please accept '+fldLangVal[i]);
fieldObj.focus();
return false;
}
}
try {
if(fieldObj.name == 'Last Name') {
name = fieldObj.value;
}
} catch (e) {}
}
}
}

</script>
</form>
</div>