__CONFIG_lead_generation_code__
<form method="POST" action="https://clicktrustdirect.activehosted.com/proc.php" id="_form_265_" class="_form _form_265 _inline-form _dark" novalidate>
<input type="hidden" name="u" value="265" />
<input type="hidden" name="f" value="265" />
<input type="hidden" name="s" />
<input type="hidden" name="c" value="0" />
<input type="hidden" name="m" value="0" />
<input type="hidden" name="act" value="sub" />
<input type="hidden" name="v" value="2" />
<div class="_form-content">
<div class="_form_element _x83367078 _full_width " >
<label class="_form-label">
Email*
</label>
<div class="_field-wrapper">
<input type="text" name="email" placeholder="Type your email" required/>
</div>
</div>
<div class="_form_element _field22 _full_width " >
</div>
<div class="_form_element _field41 _full_width " >
<label class="_form-label">
Relationship Status
</label>
<div class="_row _checkbox-radio">
<input id="field_41Single" type="radio" name="field[41]" value="Single" >
<span>
<label for="field_41Single">
Single
</span>
</div>
<div class="_row _checkbox-radio">
<input id="field_41Seeing someone regularly (nothing serious yet)" type="radio" name="field[41]" value="Seeing someone regularly (nothing serious yet)" >
<span>
<label for="field_41Seeing someone regularly (nothing serious yet)">
Seeing someone regularly (nothing serious yet)
</span>
</div>
<div class="_row _checkbox-radio">
<input id="field_41Girlfriend (exclusive)" type="radio" name="field[41]" value="Girlfriend (exclusive)" >
<span>
<label for="field_41Girlfriend (exclusive)">
Girlfriend (exclusive)
</span>
</div>
<div class="_row _checkbox-radio">
<input id="field_41Married" type="radio" name="field[41]" value="Married" >
<span>
<label for="field_41Married">
Married
</span>
</div>
<div class="_row _checkbox-radio">
<input id="field_41Divorced" type="radio" name="field[41]" value="Divorced" >
<span>
<label for="field_41Divorced">
Divorced
</span>
</div>
</div>
<div class="_form_element _field4 _full_width " >
<label class="_form-label">
What's Your Age Range?*
</label>
<div class="_field-wrapper">
<select name="field[4]" required>
<option selected>
</option>
<option value="18-25" >
18-25
</option>
<option value="26-35" >
26-35
</option>
<option value="36-45" >
36-45
</option>
<option value="46-55" >
46-55
</option>
<option value="56-65" >
56-65
</option>
<option value="66+" >
66+
</option>
</select>
</div>
</div>
<div class="_form_element _field25 _full_width " >
<input type="hidden" name="field[25]" value="" />
</div>
<div class="_form_element _field26 _full_width " >
<input type="hidden" name="field[26]" value="" />
</div>
<div class="_form_element _field13 _full_width " >
<input type="hidden" name="field[13]" value="" />
</div>
<div class="_form_element _field14 _full_width " >
<input type="hidden" name="field[14]" value="" />
</div>
<div class="_form_element _field15 _full_width " >
<input type="hidden" name="field[15]" value="" />
</div>
<div class="_form_element _field16 _full_width " >
<input type="hidden" name="field[16]" value="" />
</div>
<div class="_form_element _field17 _full_width " >
<input type="hidden" name="field[17]" value="" />
</div>
<div class="_form_element _field18 _full_width " >
<input type="hidden" name="field[18]" value="" />
</div>
<div class="_form_element _field28 _full_width " >
</div>
<div class="_form_element _field31 _full_width " >
<input type="hidden" name="field[31]" value="" />
</div>
<div class="_form_element _field32 _full_width " >
<input type="hidden" name="field[32]" value="" />
</div>
<div class="_form_element _field33 _full_width " >
<input type="hidden" name="field[33]" value="" />
</div>
<div class="_form_element _field34 _full_width " >
<input type="hidden" name="field[34]" value="" />
</div>
<div class="_form_element _field35 _full_width " >
<input type="hidden" name="field[35]" value="" />
</div>
<div class="_form_element _field36 _full_width " >
<input type="hidden" name="field[36]" value="" />
</div>
<div class="_form_element _field37 _full_width " >
<input type="hidden" name="field[37]" value="" />
</div>
<div class="_form_element _field38 _full_width " >
<input type="hidden" name="field[38]" value="" />
</div>
<div class="_form_element _field39 _full_width " >
<input type="hidden" name="field[39]" value="" />
</div>
<div class="_form_element _field40 _full_width " >
<input type="hidden" name="field[40]" value="" />
</div>
<div class="_form_element _field42 _full_width " >
<input type="hidden" name="field[42]" value="" />
</div>
<div class="_form_element _field43 _full_width " >
<label class="_form-label">
Occupation - Text Area
</label>
<div class="_field-wrapper">
<textarea name="field[43]" placeholder="" ></textarea>
</div>
</div>
<div class="_form_element _field44 _full_width " >
<label class="_form-label">
Hobbies - Text Area
</label>
<div class="_field-wrapper">
<textarea name="field[44]" placeholder="" ></textarea>
</div>
</div>
<div class="_button-wrapper _full_width">
<button id="_form_265_submit" class="_submit" type="submit">
Submit
</button>
</div>
<div class="_clear-element">
</div>
</div>
<div class="_form-thank-you" style="display:none;">
</div>
</form><script type="text/javascript">
window.cfields = {"41":"relationship_status","4":"whats_your_age_range","25":"tid","26":"vtid","13":"channel","14":"medium","15":"source","16":"campaign","17":"term","18":"content","31":"s1","32":"s2","33":"s3","34":"s4","35":"s5","36":"s6","37":"s7","38":"subid","39":"thirtynine","40":"status","42":"on_submit_open_url","43":"occupation","44":"hobbies"};
window._show_thank_you = function(id, message, trackcmp_url) {
var form = document.getElementById('_form_' + id + '_'), thank_you = form.querySelector('._form-thank-you');
form.querySelector('._form-content').style.display = 'none';
thank_you.innerHTML = message;
thank_you.style.display = 'block';
if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) {
// Site tracking URL to use after inline form submission.
_load_script(trackcmp_url);
}
if (typeof window._form_callback !== 'undefined') window._form_callback(id);
};
window._show_error = function(id, message, html) {
var form = document.getElementById('_form_' + id + '_'), err = document.createElement('div'), button = form.querySelector('button'), old_error = form.querySelector('._form_error');
if (old_error) old_error.parentNode.removeChild(old_error);
err.innerHTML = message;
err.className = '_error-inner _form_error _no_arrow';
var wrapper = document.createElement('div');
wrapper.className = '_form-inner';
wrapper.appendChild(err);
button.parentNode.insertBefore(wrapper, button);
document.querySelector('[id^="_form"][id$="_submit"]').disabled = false;
if (html) {
var div = document.createElement('div');
div.className = '_error-html';
div.innerHTML = html;
err.appendChild(div);
}
};
window._load_script = function(url, callback) {
var head = document.querySelector('head'), script = document.createElement('script'), r = false;
script.type = 'text/javascript';
script.charset = 'utf-8';
script.src = url;
if (callback) {
script.onload = script.onreadystatechange = function() {
if (!r && (!this.readyState || this.readyState == 'complete')) {
r = true;
callback();
}
};
}
head.appendChild(script);
};
(function() {
if (window.location.search.search("excludeform") !== -1) return false;
var getCookie = function(name) {
var match = document.cookie.match(new RegExp('(^|; )' + name + '=([^;]+)'));
return match ? match[2] : null;
}
var setCookie = function(name, value) {
var now = new Date();
var time = now.getTime();
var expireTime = time + 1000 * 60 * 60 * 24 * 365;
now.setTime(expireTime);
document.cookie = name + '=' + value + '; expires=' + now + ';path=/';
}
var addEvent = function(element, event, func) {
if (element.addEventListener) {
element.addEventListener(event, func);
} else {
var oldFunc = element['on' + event];
element['on' + event] = function() {
oldFunc.apply(this, arguments);
func.apply(this, arguments);
};
}
}
var _removed = false;
var form_to_submit = document.getElementById('_form_265_');
var allInputs = form_to_submit.querySelectorAll('input, select, textarea'), tooltips = [], submitted = false;
var getUrlParam = function(name) {
var regexStr = '[\?&]' + name + '=([^&#]*)';
var results = new RegExp(regexStr, 'i').exec(window.location.href);
return results != undefined ? decodeURIComponent(results[1]) : false;
};
for (var i = 0; i < allInputs.length; i++) {
var regexStr = "field\\[(\\d+)\\]";
var results = new RegExp(regexStr).exec(allInputs[i].name);
if (results != undefined) {
allInputs[i].dataset.name = window.cfields[results[1]];
} else {
allInputs[i].dataset.name = allInputs[i].name;
}
var fieldVal = getUrlParam(allInputs[i].dataset.name);
if (fieldVal) {
if (allInputs[i].type == "radio" || allInputs[i].type == "checkbox") {
if (allInputs[i].value == fieldVal) {
allInputs[i].checked = true;
}
} else {
allInputs[i].value = fieldVal;
}
}
}
var remove_tooltips = function() {
for (var i = 0; i < tooltips.length; i++) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
}
tooltips = [];
};
var remove_tooltip = function(elem) {
for (var i = 0; i < tooltips.length; i++) {
if (tooltips[i].elem === elem) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
tooltips.splice(i, 1);
return;
}
}
};
var create_tooltip = function(elem, text) {
var tooltip = document.createElement('div'), arrow = document.createElement('div'), inner = document.createElement('div'), new_tooltip = {};
if (elem.type != 'radio' && elem.type != 'checkbox') {
tooltip.className = '_error';
arrow.className = '_error-arrow';
inner.className = '_error-inner';
inner.innerHTML = text;
tooltip.appendChild(arrow);
tooltip.appendChild(inner);
elem.parentNode.appendChild(tooltip);
} else {
tooltip.className = '_error-inner _no_arrow';
tooltip.innerHTML = text;
elem.parentNode.insertBefore(tooltip, elem);
new_tooltip.no_arrow = true;
}
new_tooltip.tip = tooltip;
new_tooltip.elem = elem;
tooltips.push(new_tooltip);
return new_tooltip;
};
var resize_tooltip = function(tooltip) {
var rect = tooltip.elem.getBoundingClientRect();
var doc = document.documentElement, scrollPosition = rect.top - ((window.pageYOffset || doc.scrollTop) - (doc.clientTop || 0));
if (scrollPosition < 40) {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _below';
} else {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _above';
}
};
var resize_tooltips = function() {
if (_removed) return;
for (var i = 0; i < tooltips.length; i++) {
if (!tooltips[i].no_arrow) resize_tooltip(tooltips[i]);
}
};
var validate_field = function(elem, remove) {
var tooltip = null, value = elem.value, no_error = true;
remove ? remove_tooltip(elem) : false;
if (elem.type != 'checkbox') elem.className = elem.className.replace(/ ?_has_error ?/g, '');
if (elem.getAttribute('required') !== null) {
if (elem.type == 'radio' || (elem.type == 'checkbox' && /any/.test(elem.className))) {
var elems = form_to_submit.elements[elem.name];
if (!(elems instanceof NodeList || elems instanceof HTMLCollection) || elems.length <= 1) {
no_error = elem.checked;
}
else {
no_error = false;
for (var i = 0; i < elems.length; i++) {
if (elems[i].checked) no_error = true;
}
}
if (!no_error) {
tooltip = create_tooltip(elem, "Please select an option.");
}
} else if (elem.type =='checkbox') {
var elems = form_to_submit.elements[elem.name], found = false, err = [];
no_error = true;
for (var i = 0; i < elems.length; i++) {
if (elems[i].getAttribute('required') === null) continue;
if (!found && elems[i] !== elem) return true;
found = true;
elems[i].className = elems[i].className.replace(/ ?_has_error ?/g, '');
if (!elems[i].checked) {
no_error = false;
elems[i].className = elems[i].className + ' _has_error';
err.push("Checking %s is required".replace("%s", elems[i].value));
}
}
if (!no_error) {
tooltip = create_tooltip(elem, err.join('<br/>'));
}
} else if (elem.tagName == 'SELECT') {
var selected = true;
if (elem.multiple) {
selected = false;
for (var i = 0; i < elem.options.length; i++) {
if (elem.options[i].selected) {
selected = true;
break;
}
}
} else {
for (var i = 0; i < elem.options.length; i++) {
if (elem.options[i].selected && !elem.options[i].value) {
selected = false;
}
}
}
if (!selected) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Please select an option.");
}
} else if (value === undefined || value === null || value === '') {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "This field is required.");
}
}
if (no_error && elem.name == 'email') {
if (!value.match(/^[\+_a-z0-9-'&=]+(\.[\+_a-z0-9-']+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,})$/i)) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Enter a valid email address.");
}
}
if (no_error && /date_field/.test(elem.className)) {
if (!value.match(/^\d\d\d\d-\d\d-\d\d$/)) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Enter a valid date.");
}
}
tooltip ? resize_tooltip(tooltip) : false;
return no_error;
};
var needs_validate = function(el) {
return el.name == 'email' || el.getAttribute('required') !== null;
};
var validate_form = function(e) {
var err = form_to_submit.querySelector('._form_error'), no_error = true;
if (!submitted) {
submitted = true;
for (var i = 0, len = allInputs.length; i < len; i++) {
var input = allInputs[i];
if (needs_validate(input)) {
if (input.type == 'text') {
addEvent(input, 'blur', function() {
this.value = this.value.trim();
validate_field(this, true);
});
addEvent(input, 'input', function() {
validate_field(this, true);
});
} else if (input.type == 'radio' || input.type == 'checkbox') {
(function(el) {
var radios = form_to_submit.elements[el.name];
for (var i = 0; i < radios.length; i++) {
addEvent(radios[i], 'click', function() {
validate_field(el, true);
});
}
})(input);
} else if (input.tagName == 'SELECT') {
addEvent(input, 'change', function() {
validate_field(this, true);
});
}
}
}
}
remove_tooltips();
for (var i = 0, len = allInputs.length; i < len; i++) {
var elem = allInputs[i];
if (needs_validate(elem)) {
if (elem.tagName.toLowerCase() !== "select") {
elem.value = elem.value.trim();
}
validate_field(elem) ? true : no_error = false;
}
}
if (!no_error && e) {
e.preventDefault();
}
resize_tooltips();
return no_error;
};
addEvent(window, 'resize', resize_tooltips);
addEvent(window, 'scroll', resize_tooltips);
window._old_serialize = null;
if (typeof serialize !== 'undefined') window._old_serialize = window.serialize;
_load_script("//d3rxaij56vjege.cloudfront.net/form-serialize/0.3/serialize.min.js", function() {
window._form_serialize = window.serialize;
if (window._old_serialize) window.serialize = window._old_serialize;
});
var form_submit = function(e) {
e.preventDefault();
if (validate_form()) {
// use this trick to get the submit button & disable it using plain javascript
document.querySelector('[id^="_form"][id$="_submit"]').disabled = true;
var serialized = _form_serialize(document.getElementById('_form_265_'));
var err = form_to_submit.querySelector('._form_error');
err ? err.parentNode.removeChild(err) : false;
_load_script('https://clicktrustdirect.activehosted.com/proc.php?' + serialized + '&jsonp=true');
}
return false;
};
addEvent(form_to_submit, 'submit', form_submit);
})();
</script>__CONFIG_lead_generation_code__