First Name*
Last Name*
Primary Email*
City
Company

window.onload = function() { var N=navigator.appName, ua=navigator.userAgent, tem;var M=ua.match(/(opera|chrome|safari|firefox|msie)\/?\s*(\.?\d+(\.\d+)*)/i);if(M && (tem= ua.match(/version\/([\.\d]+)/i))!= null) M[2]= tem[1];M=M? [M[1], M[2]]: [N, navigator.appVersion, “-?”];var browserName = M[0];var form = document.forms[0], inputs = form.elements; form.onsubmit = function() { var required = [], att, val; for (var i = 0; i < inputs.length; i++) { att = inputs[i].getAttribute("required"); val = inputs[i].value; type = inputs[i].type; if(type == "email") {if(val != "") {var elemLabel = inputs[i].getAttribute("label");var emailFilter = /^[_/a-zA-Z0-9]+([!"#$%&()*+,./:;?\^_`{|}~-]?[a-zA-Z0-9/_/-])*@[a-zA-Z0-9]+([\_\-\.]?[a-zA-Z0-9]+)*\.([\-\_]?[a-zA-Z0-9])+(\.?[a-zA-Z0-9]+)?$/;var illegalChars= /[\(\)\\,\;\:\”\[\]]/ ;if (!emailFilter.test(val)) {alert(“For “+ elemLabel +” field please enter valid email address”); return false;} else if (val.match(illegalChars)) {alert(elemLabel +” field contains illegal characters”);return false;}}}if (att != null) { if (val.replace(/^\s+|\s+$/g, “”) == “”) { required.push(inputs[i].getAttribute(“label”)); } } } if (required.length > 0) { alert(“The following fields are required: ” + required.join()); return false; } var numberTypeInputs = document.querySelectorAll(“input[type=number]”);for (var i = 0; i < numberTypeInputs.length; i++) { val = numberTypeInputs[i].value;var elemLabel = numberTypeInputs[i].getAttribute("label");if(val != "") {var intRegex = /^[+-]?\d+$/;if (!intRegex.test(val)) {alert("For "+ elemLabel +" field please enter valid number"); return false;}}}}; }