Posted By

ryarwood on 07/09/10


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Vertical Response Form


 / Published in: HTML
 

Example vertical response form. Need to setup inside their system as well. Thus the whole ?fid=b995c25bd1 thing.

  1. <form method="post" action="http://oi.vresp.com?fid=b995c25bd1" name="interestList" id="interestList" onsubmit="MM_validateForm('first_name','','R','last_name','','R','email_address','','R');return document.MM_returnValue">
  2. <table width="420" border="0" cellspacing="0" cellpadding="0">
  3. <tr>
  4. <td width="220"><span class="formCopy">First Name*</span>
  5. <input name="first_name" id="first_name" size="15" class="normalForm" alt="First Name" /></td>
  6. <td width="200"><span class="formCopy">Last Name*</span>
  7. <input name="last_name" id="last_name" size="15" class="normalForm" alt="Last Name" /></td>
  8. </tr>
  9. <tr>
  10. <td width="220"><span class="formCopy">Email*</span>
  11. <input name="email_address" id="email_address" size="15" class="normalForm" alt="Email" /></td>
  12. <td width="200"><span class="formCopy">Phone</span>
  13. <input name="home_phone" id="home_phone" size="15" class="normalForm" /></td>
  14. </tr>
  15. <tr>
  16. <td width="220"><span class="formCopy">Address</span>
  17. <input name="address_1" id="address_1" size="15" class="normalForm" /></td>
  18. <td width="200"><span class="formCopy">City</span>
  19. <input name="city" id="city" size="15" class="normalForm" /></td>
  20. </tr>
  21. <tr>
  22. <td width="220"><span class="formCopy">State</span>
  23. <select name="state" id="state" class="normalPull">
  24. <option value=''></option>
  25. <option value="_1">--United States--</option>
  26. <option value="AL">Alabama</option>
  27. <option value="AK">Alaska</option>
  28. <option value="AS">American Samoa</option>
  29. <option value="AZ">Arizona</option>
  30. <option value="AR">Arkansas</option>
  31. <option value="CA">California</option>
  32. <option value="CO">Colorado</option>
  33. <option value="CT">Connecticut</option>
  34. <option value="DE">Delaware</option>
  35. <option value="DC">District of Columbia</option>
  36. <option value="FL">Florida</option>
  37. <option value="GA">Georgia</option>
  38. <option value="GU">Guam</option>
  39. <option value="HI">Hawaii</option>
  40. <option value="ID">Idaho</option>
  41. <option value="IL">Illinois</option>
  42. <option value="IN">Indiana</option>
  43. <option value="IA">Iowa</option>
  44. <option value="KS">Kansas</option>
  45. <option value="KY">Kentucky</option>
  46. <option value="LA">Louisiana</option>
  47. <option value="ME">Maine</option>
  48. <option value="MD">Maryland</option>
  49. <option value="MA">Massachusetts</option>
  50. <option value="MI">Michigan</option>
  51. <option value="MN">Minnesota</option>
  52. <option value="MS">Mississippi</option>
  53. <option value="MO">Missouri</option>
  54. <option value="MT">Montana</option>
  55. <option value="NE">Nebraska</option>
  56. <option value="NV">Nevada</option>
  57. <option value="NH">New Hampshire</option>
  58. <option value="NJ">New Jersey</option>
  59. <option value="NM">New Mexico</option>
  60. <option value="NY">New York</option>
  61. <option value="NC">North Carolina</option>
  62. <option value="ND">North Dakota</option>
  63. <option value="OH">Ohio</option>
  64. <option value="OK">Oklahoma</option>
  65. <option value="OR">Oregon</option>
  66. <option value="PA">Pennsylvania</option>
  67. <option value="PR">Puerto Rico</option>
  68. <option value="RI">Rhode Island</option>
  69. <option value="SC">South Carolina</option>
  70. <option value="SD">South Dakota</option>
  71. <option value="TN">Tennessee</option>
  72. <option value="TX">Texas</option>
  73. <option value="UT">Utah</option>
  74. <option value="VT">Vermont</option>
  75. <option value="VI">Virgin Islands</option>
  76. <option value="VA">Virginia</option>
  77. <option value="WA">Washington</option>
  78. <option value="WV">West Virginia</option>
  79. <option value="WI">Wisconsin</option>
  80. <option value="WY">Wyoming</option>
  81. <option value="_2">--Canada--</option>
  82. <option value="AB">Alberta</option>
  83. <option value="BC">British Columbia</option>
  84. <option value="MB">Manitoba</option>
  85. <option value="NB">New Brunswick</option>
  86. <option value="NL">Newfoundland</option>
  87. <option value="NT">North West Territory</option>
  88. <option value="NS">Nova Scotia</option>
  89. <option value="NU">Nunavut</option>
  90. <option value="ON">Ontario</option>
  91. <option value="PE">Prince Edward Island</option>
  92. <option value="QC">Quebec</option>
  93. <option value="SK">Saskatchewan</option>
  94. <option value="YT">Yukon Territory</option>
  95. <option value="_3">Not Applicable</option>
  96. </select></td>
  97. <td width="200"><span class="formCopy">Zip</span>
  98. <input name="postalcode" id="postalcode" size="15" class="normalForm" /></td>
  99. </tr>
  100. <tr>
  101. <td>&nbsp;</td>
  102. <td align="right"><input name="formSubmission" type="image" src="/img/submit.gif" id="formSubmission" /></td>
  103. </tr>
  104. </table>
  105. </form>

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