<!-- Note :
   - You can modify the font style and form style to suit your website. 
   - Code lines with comments Do not remove this code are required for the form to work properly, make sure that you do not remove these lines of code. 
   - The Mandatory check script can modified as to suit your business needs. 
   - It is important that you test the modified form before going live.-->
<div id = 'crmWebToEntityForm' class = 'zcwf_lblRight crmWebToEntityForm' style = 'background-color: &#x23;FFFFFF;color: black;max-width: 600px;'>
	<meta name = 'viewport' content = 'width=device-width, initial-scale=1.0'>
		<META HTTP-EQUIV = 'content-type' CONTENT = 'text/html;charset=UTF-8'>
			<form id = 'webform5588360000015262001' action = 'https://crm.zoho.com/crm/WebToLeadForm' name = WebToLeads5588360000015262001 method = 'POST' onSubmit = 'javascript:document.charset="UTF-8"; return checkMandatory5588360000015262001()' accept-charset = 'UTF-8'>
				<input type = 'text' style = 'display:none;' name = 'xnQsjsdp' value = '8bd4458371ea396e4209c549b04d397ec62a7b9074c47d2e7475e0a1446e6f5e'>
				</input>
				<input type = 'hidden' name = 'zc_gad' id = 'zc_gad' value = ''>
				</input>
				<input type = 'text' style = 'display:none;' name = 'xmIwtLD' value = '0f75a11681a14643f184cc979971800313252a55552647e211628081b124274a0e00411621b3cf753938cbc2269e61f9'>
				</input>
				<input type = 'text' style = 'display:none;' name = 'actionType' value = 'TGVhZHM='>
				</input>
				<input type = 'text' style = 'display:none;' name = 'returnURL' value = 'https&#x3a;&#x2f;&#x2f;www.reslogic.com&#x2f;thank-you'>
				</input>
				<!-- Do not remove this code. -->
				<input type = 'text' style = 'display:none;' id = 'ldeskuid' name = 'ldeskuid'>
				</input>
				<input type = 'text' style = 'display:none;' id = 'LDTuvid' name = 'LDTuvid'>
				</input>
				<!-- Do not remove this code. -->
				<style>
					html, body {
						margin: 0px;
					}
					.formsubmit.zcwf_button {
						color: white !important;
						background: transparent linear-gradient;
					}
					#crmWebToEntityForm.zcwf_lblRight {
						width: 100%;
						padding: 25px;
						margin: 0 auto;
						box-sizing: border-box;
					}
					#crmWebToEntityForm.zcwf_lblRight * {
						box-sizing: border-box;
					}
					#crmWebToEntityForm {
						text-align: left;
					}
					#crmWebToEntityForm * {
						direction: ltr;
					}
					.zcwf_lblRight .zcwf_title {
						word-wrap: break-word;
						padding: 0px 6px 10px;
						font-weight}
					.zcwf_lblRight.cpT_primaryBtn:hover {
						background: linear-gradient;
						box-shadow: 0 -2px 0 0  #0159b9 inset !important;
						border: 0 !important;
						color:  #fff !important;
						outline: 0 !important;
					}
					.zcwf_lblRight .zcwf_col_fld input [type = text],  input [type = password],  .zcwf_lblRight .zcwf_col_fld textarea {
						width: 60%;
						border: 1px solid  #c0c6cc !important;
						resize: vertical;
						border-radius: 2px;
						float: left;
					}
					.zcwf_lblRight .zcwf_col_lab {
						width: 30%;
						word-break: break-word;
						padding: 0px 6px 0px;
						margin-right: 10px;
						margin-top: 5px;
						float: left;
						min-height: 1px;
						text-align: right;
					}
					.zcwf_lblRight .zcwf_col_fld {
						float: left;
						width: 68%;
						padding: 0px 6px 0px;
						position: relative;
						margin-top: 5px;
					}
					.zcwf_lblRight .zcwf_privacy {
						padding: 6px;
					}
					.zcwf_lblRight .wfrm_fld_dpNn {
						display: none;
					}
					.dIB {
						display: inline-block;
					}
					.zcwf_lblRight .zcwf_col_fld_slt {
						width: 60%;
						border: 1px solid  #ccc;
						background:  #fff;
						border-radius: 4px;
						font-size: 12px;
						float: left;
						resize: vertical;
						padding: 2px 5px;
					}
					.zcwf_lblRight .zcwf_row:after,  .zcwf_lblRight .zcwf_col_fld:after {
						content: '';
						display: table;
						clear: both;
					}
					.zcwf_lblRight .zcwf_col_help {
						float: left;
						margin-left: 7px;
						font-size: 12px;
						max-width: 35%;
						word-break: break-word;
					}
					.zcwf_lblRight .zcwf_help_icon {
						cursor: pointer;
						width: 16px;
						height: 16px;
						display: inline-block;
						background:  #fff;
						border: 1px solid  #c0c6cc;
						color:  #c1c1c1;
						text-align: center;
						font-size: 11px;
						line-height: 16px;
						font-weight: bold;
						border-radius: 50%;
					}
					.zcwf_lblRight .zcwf_row {
						margin: 15px 0px;
					}
					.zcwf_lblRight .formsubmit {
						margin-right: 5px;
						cursor: pointer;
						color:  #313949;
						font-size: 12px;
					}
					.zcwf_lblRight .zcwf_privacy_txt {
						width: 90%;
						color: rgb(0, 0, 0);
						font-size: 12px;
						font-family: Arial;
						display: inline-block;
						vertical-align: top;
						color:  #313949;
						padding-top: 2px;
						margin-left: 6px;
					}
					.zcwf_lblRight .zcwf_button {
						font-size: 12px;
						color:  #313949;
						border: 1px solid  #c0c6cc;
						padding: 3px 9px;
						border-radius: 4px;
						cursor: pointer;
						max-width: 120px;
						overflow: hidden;
						text-overflow: ellipsis;
						white-space: nowrap;
					}
					.zcwf_lblRight .zcwf_tooltip_over {
						position: relative;
					}
					.zcwf_lblRight .zcwf_tooltip_ctn {
						position: absolute;
						background:  #dedede;
						padding: 3px 6px;
						top: 3px;
						border-radius: 4px;
						word-break: break-word;
						min-width: 100px;
						max-width: 150px;
						color:  #313949;
						z-index: 100;
					}
					.zcwf_lblRight .zcwf_ckbox {
						float: left;
					}
					.zcwf_lblRight .zcwf_file {
						width: 55%;
						box-sizing: border-box;
						float: left;
					}
					.cBoth:after {
						content: '';
						display: block;
						clear: both;
					}
					@media all and  (max-width: 600px){
						.zcwf_lblRight .zcwf_col_lab,  .zcwf_lblRight .zcwf_col_fld {
							width: auto;
							float: none !important;
						}
						.zcwf_lblRight .zcwf_col_help {
							width: 40%;
						}
						.zcwf_lblRight.zcwf_rtl .zcwf_col_lab {
							text-align: left;
						}
						.zcwf_lblRight.zcwf_rtl .zcwf_col_lab {
							text-align: right;
						}
					}
				</style>
				<div class = 'zcwf_title' style = 'max-width: 600px;color: black; font-family:Arial;'>
					Free Offer
				</div>
				<div class = 'zcwf_row'>
					<div class = 'zcwf_col_lab' style = 'font-size:12px; font-family: Arial;'>
						<label for = 'Last_Name'>
							Last Name
							<span style = 'color:red;'>
								*
							</span>
						</label>
					</div>
					<div class = 'zcwf_col_fld'>
						<input type = 'text' id = 'Last_Name' aria-required = 'true' aria-label = 'Last Name' name = 'Last Name' aria-valuemax = '80' maxlength = '80'>
						</input>
						<div class = 'zcwf_col_help'>
						</div>
					</div>
				</div>
				<div class = 'zcwf_row'>
					<div class = 'zcwf_col_lab' style = 'font-size:12px; font-family: Arial;'>
						<label for = 'Website'>
							Website
							<span style = 'color:red;'>
								*
							</span>
						</label>
					</div>
					<div class = 'zcwf_col_fld'>
						<input type = 'text' id = 'Website' aria-required = 'true' aria-label = 'Website' name = 'Website' aria-valuemax = '255' maxlength = '255'>
						</input>
						<div class = 'zcwf_col_help'>
						</div>
					</div>
				</div>
				<div class = 'zcwf_row'>
					<div class = 'zcwf_col_lab' style = 'font-size:12px; font-family: Arial;'>
						<label for = 'Email'>
							Email
							<span style = 'color:red;'>
								*
							</span>
						</label>
					</div>
					<div class = 'zcwf_col_fld'>
						<input type = 'text' ftype = 'email' autocomplete = 'false' id = 'Email' aria-required = 'true' aria-label = 'Email' name = 'Email' aria-valuemax = '100' crmlabel = '' maxlength = '100'>
						</input>
						<div class = 'zcwf_col_help'>
						</div>
					</div>
				</div>
				<div class = 'zcwf_row'>
					<div class = 'zcwf_col_lab'>
					</div>
					<div class = 'zcwf_col_fld'>
						<input type = 'submit' id = 'formsubmit' role = 'button' class = 'formsubmit zcwf_button' value = 'Submit' aria-label = 'Submit' title = 'Submit'>
							<input type = 'reset' class = 'zcwf_button' role = 'button' name = 'reset' value = 'Reset' aria-label = 'Reset' title = 'Reset'>
							</div>
						</div>
						<script>
							function validateEmail5588360000015262001(){
								var form = document.forms[ 'WebToLeads5588360000015262001' ];
								var emailFld = form.querySelectorAll( '[ftype=email]' );
								var i;
								for( i = 0; i < emailFld.length; i++ ){
									var emailVal = emailFld[ i ].value;
									if(( emailVal.replace( /^\s+|\s+$/g,'' )).length != 0 ){
										var atpos = emailVal.indexOf( '@' );
										var dotpos = emailVal.lastIndexOf( '.' );
										if( atpos < 1 || dotpos < atpos + 2 || dotpos + 2 >= emailVal.length ){
											alert( 'Please enter a valid email address. ' );
											emailFld[ i ].focus();
											return false;
										}
									}
								}
								return true;
							}
							function checkMandatory5588360000015262001(){
								var mndFileds = new Array( 'Last Name', 'Email', 'Website' );
								var fldLangVal = new Array( 'Last\x20Name', 'Email', 'Website' );
								for( i = 0; i < mndFileds.length; i++ ){
									var fieldObj = document.forms[ 'WebToLeads5588360000015262001' ][ mndFileds[ i ]];
									if( fieldObj ){
										if((( fieldObj.value ).replace( /^\s+|\s+$/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 ){}
									}
								}
								trackVisitor5588360000015262001();
								if( !validateEmail5588360000015262001()){
									return false;
								}
								var urlparams = new URLSearchParams( window.location.search );
								if( urlparams.has( 'service' ) && ( urlparams.get( 'service' ) === 'smarturl' )){
									var webform = document.getElementById( 'webform5588360000015262001' );
									var service = urlparams.get( 'service' );
									var smarturlfield = document.createElement( 'input' );
									smarturlfield.setAttribute( 'type', 'hidden' );
									smarturlfield.setAttribute( 'value', service );
									smarturlfield.setAttribute( 'name', 'service' );
									webform.appendChild( smarturlfield );
								}
								document.querySelector( '.crmWebToEntityForm .formsubmit' ).setAttribute( 'disabled', true );
							}
							function tooltipShow5588360000015262001( el ){
								var tooltip = el.nextElementSibling;
								var tooltipDisplay = tooltip.style.display;
								if( tooltipDisplay == 'none' ){
									var allTooltip = document.getElementsByClassName( 'zcwf_tooltip_over' );
									for( i = 0; i < allTooltip.length; i++ ){
										allTooltip[ i ].style.display = 'none';
									}
									tooltip.style.display = 'block';
								}
								else{
									tooltip.style.display = 'none';
								}
							}
						</script>
						<script type='text/javascript' id='VisitorTracking'>
							var $zoho = $zoho || {};
							$zoho.salesiq = $zoho.salesiq || {
								widgetcode: 'siqa9ac501b49f4fa262b1a888d00e806f001b4090bf490dccb6f368cecf45382ec',
								values: {},
								ready: function(){}
							};
							var d = document;
							s = d.createElement( 'script' );
							s.type = 'text/javascript';
							s.id = 'zsiqscript';
							s.defer = true;
							s.src = 'https://salesiq.zoho.com/widget';
							t = d.getElementsByTagName( 'script' )[0];
							t.parentNode.insertBefore( s, t );
							function trackVisitor5588360000015262001(){
								try{
									if( $zoho ){
										var LDTuvidObj = document.forms[ 'WebToLeads5588360000015262001' ][ 'LDTuvid' ];
										if( LDTuvidObj ){
											LDTuvidObj.value = $zoho.salesiq.visitor.uniqueid();
										}
										var firstnameObj = document.forms[ 'WebToLeads5588360000015262001' ][ 'First Name' ];
										if( firstnameObj ){
											name = firstnameObj.value + ' ' + name;
										}
										$zoho.salesiq.visitor.name( name );
										var emailObj = document.forms[ 'WebToLeads5588360000015262001' ][ 'Email' ];
										if( emailObj ){
											email = emailObj.value;
											$zoho.salesiq.visitor.email( email );
										}
									}
								}
								catch( e ){}
							}
						</script>
					</form>
				</div>