var html = "<form method=\"post\" name=\"AA_Question_Type_Form\" action=\"https://s1209148949.t.eloqua.com/e/f2\" onsubmit=\"return handleFormSubmit(this)\" id=\"form139\" class=\"elq-form\"><input value=\"AA_Question_Type_Form\" type=\"hidden\" name=\"elqFormName\"><input value=\"1209148949\" type=\"hidden\" name=\"elqSiteId\"><input name=\"elqCampaignId\" type=\"hidden\"><div class=\"layout container-fluid\"><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement0\" class=\"elq-field-style form-element-layout row\"><div class=\"col-sm-12 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div style=\"text-align:left;\"><h4 class=\"elq-heading form-element-form-text\">First, lets collect your contact information </h4></div></div></div><div class=\"form-element-instruction\">Extended Contact Info Field Group was used</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-3 col-xs-12\"><div id=\"formElement1\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1321\">Title</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"title\" id=\"fe1321\" value=\"\" style=\"width:100%;\"></div></div></div></div></div></div></div><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-3 col-xs-12\"><div id=\"formElement2\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1322\">First Name</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"firstName\" id=\"fe1322\" value=\"\" style=\"width:100%;\"></div></div></div></div></div></div></div><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-6 col-xs-12\"><div id=\"formElement3\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1323\">Last Name</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-8\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"lastName\" id=\"fe1323\" value=\"\" style=\"width:100%;\"></div></div></div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement4\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1324\">Email Address<span class=\"elq-required\">*</span></label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"emailAddress\" id=\"fe1324\" value=\"~~eloqua..type--emailfield..syntax--EmailAddress~~\" style=\"width:100%;\"></div></div></div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement5\" class=\"elq-field-style form-element-layout row\"><div class=\"col-sm-12 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div style=\"text-align:left;\"><h4 class=\"elq-heading form-element-form-text\">Answer these series of questions related to your pizza preference</h4></div></div></div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement6\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1325\">Pizza Chain Preference</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-8\"><div class=\"field-control-wrapper\"><select class=\"elq-item-select\" id=\"fe1325\" name=\"dropdownMenu\" style=\"width:100%;\" data-value=\"\"><option value=\"Please Select\">Please Select</option><option value=\"Pizza Hut\">Pizza Hut</option><option value=\"Domino's\">Domino's</option><option value=\"Papa John's\">Papa John's</option><option value=\"Little Caesars\">Little Caesars</option><option value=\"Sbarro\">Sbarro</option></select></div></div></div><div class=\"form-element-instruction\">Question type - Single Picklist</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement7\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1326\">Pizza Crust Preference</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\" id=\"fe1326\"><div class=\"list-order two-column\"><input type=\"radio\" id=\"radio-Thin Crust_tw6zokll\" value=\"Thin Crust\" name=\"radioButtons\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Thin Crust_tw6zokll\">Thin Crust</label><br></div><div class=\"list-order two-column\"><input type=\"radio\" id=\"radio-Thick Crust_zv0j4cmf\" value=\"Thick Crust\" name=\"radioButtons\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Thick Crust_zv0j4cmf\">Thick Crust</label><br></div><div class=\"list-order two-column\"><input type=\"radio\" id=\"radio-Hand Tossed_1p68z1ki\" value=\"Hand Tossed\" name=\"radioButtons\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Hand Tossed_1p68z1ki\">Hand Tossed</label><br></div><div class=\"list-order two-column\"><input type=\"radio\" id=\"radio-Stuffed Crust_to5n61p\" value=\"Stuffed Crust\" name=\"radioButtons\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Stuffed Crust_to5n61p\">Stuffed Crust</label><br></div><div class=\"list-order two-column\"><input type=\"radio\" id=\"radio-Original_88hymdet\" value=\"Original\" name=\"radioButtons\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Original_88hymdet\">Original</label><br></div></div></div></div><div class=\"form-element-instruction\">Question Type - Radio Button</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement8\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1327\">Sauce Preference - select as many as you wish</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-4\"><div class=\"field-control-wrapper\"><select class=\"elq-item-select\" id=\"fe1327\" name=\"multipleSelectMenu\" style=\"width:100%;\" multiple=\"\" data-value=\"\"><option value=\"Alfredo\">Alfredo</option><option value=\"Tomato\">Tomato</option><option value=\"Pesto\">Pesto</option><option value=\"Garlic Parmesan\">Garlic Parmesan</option><option value=\"Honey BBQ\">Honey BBQ</option></select></div></div></div><div class=\"form-element-instruction\">Question type - Multiple Picklist</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement9\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1329\">Cheese Preference</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\" id=\"fe1329\"><div class=\"list-order one-column\"><input type=\"radio\" id=\"radio-Less Cheese_lijktjoa\" value=\"Less Cheese\" name=\"radioButtons2\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Less Cheese_lijktjoa\">Less Cheese</label><br></div><div class=\"list-order one-column\"><input type=\"radio\" id=\"radio-Extra Cheese_y8gzax7i\" value=\"Extra Cheese\" name=\"radioButtons2\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Extra Cheese_y8gzax7i\">Extra Cheese</label><br></div><div class=\"list-order one-column\"><input type=\"radio\" id=\"radio-Normal amount of Cheese_53uiq02\" value=\"Normal amount of Cheese\" name=\"radioButtons2\"><label class=\"checkbox-aligned elq-item-label\" for=\"radio-Normal amount of Cheese_53uiq02\">Normal amount of Cheese</label><br></div></div></div></div><div class=\"form-element-instruction\">Question type - Radio Buttons</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement10\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1330\">Topping Preference - select as many as you wish</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\" id=\"fe1330\"><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Peppers_w8y6djy\" value=\"Peppers\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Peppers_w8y6djy\">Peppers</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Onions_xe485lcu\" value=\"Onions\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Onions_xe485lcu\">Onions</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Olives_k7d4yxdi\" value=\"Olives\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Olives_k7d4yxdi\">Olives</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Mushrooms_v541ii48\" value=\"Mushrooms\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Mushrooms_v541ii48\">Mushrooms</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Jalapenos_q74n4ih\" value=\"Jalapenos\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Jalapenos_q74n4ih\">Jalapenos</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Garlic_e02hxsvd\" value=\"Garlic\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Garlic_e02hxsvd\">Garlic</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Pineapple_1evu326m\" value=\"Pineapple\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Pineapple_1evu326m\">Pineapple</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Bacon_ivjm56x\" value=\"Bacon\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Bacon_ivjm56x\">Bacon</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Ham_ddi1m7q\" value=\"Ham\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Ham_ddi1m7q\">Ham</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Beef_6mnd80o\" value=\"Beef\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Beef_6mnd80o\">Beef</label><br></div><div class=\"list-order three-column\"><input type=\"checkbox\" id=\"checkbox-Pepperoni_uu88jhfr\" value=\"Pepperoni\" name=\"checkboxes\"><label class=\"checkbox-aligned elq-item-label\" for=\"checkbox-Pepperoni_uu88jhfr\">Pepperoni</label><br></div></div></div></div><div class=\"form-element-instruction\">Question type - Checkboxes</div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement11\" class=\"elq-field-style form-element-layout row\"><div class=\"col-sm-12 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div style=\"text-align:left;\"><h4 class=\"elq-heading form-element-form-text\">We have your Pizza preference, answer a few additional questions next time you visit us </h4></div></div></div><div class=\"form-element-instruction\">Progressive profile test</div></div></div></div></div></div><div class=\"row\"><div id=\"pps0\" class=\"pp-stage first\"><div class=\"pp-field grid-layout-col first-shown\" style=\"display:none;\" id=\"epp0_0\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement12\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1331\">Signup for Rewards and Marketing Emails</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div><div class=\"single-checkbox-row row\"><input type=\"checkbox\" name=\"singleCheckbox\" id=\"fe1331\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1331~~\"></div></div></div></div><div class=\"form-element-instruction\">Question type - Single Checkbox</div></div></div></div></div></div><div id=\"pps1\" class=\"pp-stage\"><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_0\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement13\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1338\">Address 1</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-8\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"address1\" id=\"fe1338\" value=\"\" style=\"width:100%;\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1338~~\"></div></div></div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_1\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement14\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1339\">Address 2</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-8\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"address2\" id=\"fe1339\" value=\"\" style=\"width:100%;\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1339~~\"></div></div></div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_2\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement15\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1340\">City</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-4\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"city\" id=\"fe1340\" value=\"~~eloqua..type--emailfield..syntax--City~~\" style=\"width:100%;\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1340~~\"></div></div></div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_3\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement16\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1341\">State or Province</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-4\"><div class=\"field-control-wrapper\"><select class=\"elq-item-select\" id=\"fe1341\" name=\"stateProv\" style=\"width:100%;\" data-value=\"~~eloqua..type--emailfield..syntax--State_Prov~~\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1341~~\"><option value=\"\">Please Select...</option><option value=\"AK\">Alaska</option><option value=\"AL\">Alabama</option><option value=\"AR\">Arkansas</option><option value=\"AS\">American Samoa</option><option value=\"AZ\">Arizona</option><option value=\"CA\">California</option><option value=\"CO\">Colorado</option><option value=\"CT\">Connecticut</option><option value=\"DC\">D.C.</option><option value=\"DE\">Delaware</option><option value=\"FL\">Florida</option><option value=\"FM\">Micronesia</option><option value=\"GA\">Georgia</option><option value=\"GU\">Guam</option><option value=\"HI\">Hawaii</option><option value=\"IA\">Iowa</option><option value=\"ID\">Idaho</option><option value=\"IL\">Illinois</option><option value=\"IN\">Indiana</option><option value=\"KS\">Kansas</option><option value=\"KY\">Kentucky</option><option value=\"LA\">Louisiana</option><option value=\"MA\">Massachusetts</option><option value=\"MD\">Maryland</option><option value=\"ME\">Maine</option><option value=\"MH\">Marshall Islands</option><option value=\"MI\">Michigan</option><option value=\"MN\">Minnesota</option><option value=\"MO\">Missouri</option><option value=\"MP\">Marianas</option><option value=\"MS\">Mississippi</option><option value=\"MT\">Montana</option><option value=\"NC\">North Carolina</option><option value=\"ND\">North Dakota</option><option value=\"NE\">Nebraska</option><option value=\"NH\">New Hampshire</option><option value=\"NJ\">New Jersey</option><option value=\"NM\">New Mexico</option><option value=\"NV\">Nevada</option><option value=\"NY\">New York</option><option value=\"OH\">Ohio</option><option value=\"OK\">Oklahoma</option><option value=\"OR\">Oregon</option><option value=\"PA\">Pennsylvania</option><option value=\"PR\">Puerto Rico</option><option value=\"PW\">Palau</option><option value=\"RI\">Rhode Island</option><option value=\"SC\">South Carolina</option><option value=\"SD\">South Dakota</option><option value=\"TN\">Tennessee</option><option value=\"TX\">Texas</option><option value=\"UT\">Utah</option><option value=\"VA\">Virginia</option><option value=\"VI\">Virgin Islands</option><option value=\"VT\">Vermont</option><option value=\"WA\">Washington</option><option value=\"WI\">Wisconsin</option><option value=\"WV\">West Virginia</option><option value=\"WY\">Wyoming</option><option value=\"AA\">Military Americas</option><option value=\"AE\">Military Europe/ME/Canada</option><option value=\"AP\">Military Pacific</option><option value=\"AB\">Alberta</option><option value=\"MB\">Manitoba</option><option value=\"BC\">British Columbia</option><option value=\"NB\">New Brunswick</option><option value=\"NL\">Newfoundland and Labrador</option><option value=\"NS\">Nova Scotia</option><option value=\"NT\">Northwest Territories</option><option value=\"NU\">Nunavut</option><option value=\"ON\">Ontario</option><option value=\"PE\">Prince Edward Island</option><option value=\"QC\">Quebec</option><option value=\"SK\">Saskatchewan</option><option value=\"YT\">Yukon Territory</option></select></div></div></div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_4\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement17\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1342\">Zip or Postal Code</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-4\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"zipPostal\" id=\"fe1342\" value=\"~~eloqua..type--emailfield..syntax--Zip_Postal~~\" style=\"width:100%;\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1342~~\"></div></div></div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp1_5\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement18\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1343\">Country</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-4\"><div class=\"field-control-wrapper\"><select class=\"elq-item-select\" id=\"fe1343\" name=\"country\" style=\"width:100%;\" data-value=\"~~eloqua..type--emailfield..syntax--Country~~\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1343~~\"><option value=\"\">Please select</option><option value=\"US\">United States</option><option value=\"GB\">United Kingdom</option><option value=\"CA\">Canada</option><option value=\"IN\">India</option><option value=\"NL\">Netherlands</option><option value=\"AU\">Australia</option><option value=\"ZA\">South Africa</option><option value=\"FR\">France</option><option value=\"DE\">Germany</option><option value=\"SG\">Singapore</option><option value=\"SE\">Sweden</option><option value=\"BR\">Brazil</option><option value=\"\">--------------</option><option value=\"AF\">Afghanistan</option><option value=\"AX\">Åland Islands</option><option value=\"AL\">Albania</option><option value=\"DZ\">Algeria</option><option value=\"AS\">American Samoa</option><option value=\"AD\">Andorra</option><option value=\"AO\">Angola</option><option value=\"AI\">Anguilla</option><option value=\"AQ\">Antarctica</option><option value=\"AG\">Antigua and Barbuda</option><option value=\"AR\">Argentina</option><option value=\"AM\">Armenia</option><option value=\"AW\">Aruba</option><option value=\"AU\">Australia</option><option value=\"AT\">Austria</option><option value=\"AZ\">Azerbaijan</option><option value=\"BS\">Bahamas</option><option value=\"BH\">Bahrain</option><option value=\"BD\">Bangladesh</option><option value=\"BB\">Barbados</option><option value=\"BY\">Belarus</option><option value=\"BE\">Belgium</option><option value=\"BZ\">Belize</option><option value=\"BJ\">Benin</option><option value=\"BM\">Bermuda</option><option value=\"BT\">Bhutan</option><option value=\"BO\">Bolivia</option><option value=\"BA\">Bosnia and Herzegovina</option><option value=\"BW\">Botswana</option><option value=\"BV\">Bouvet Island</option><option value=\"BR\">Brazil</option><option value=\"IO\">Brit/Indian Ocean Terr.</option><option value=\"BN\">Brunei Darussalam</option><option value=\"BG\">Bulgaria</option><option value=\"BF\">Burkina Faso</option><option value=\"BI\">Burundi</option><option value=\"KH\">Cambodia</option><option value=\"CM\">Cameroon</option><option value=\"CA\">Canada</option><option value=\"CV\">Cape Verde</option><option value=\"KY\">Cayman Islands</option><option value=\"CF\">Central African Republic</option><option value=\"TD\">Chad</option><option value=\"CL\">Chile</option><option value=\"CN\">China</option><option value=\"CX\">Christmas Island</option><option value=\"CC\">Cocos (Keeling) Islands</option><option value=\"CO\">Colombia</option><option value=\"KM\">Comoros</option><option value=\"CG\">Congo</option><option value=\"CD\">Congo, The Dem. Republic Of</option><option value=\"CK\">Cook Islands</option><option value=\"CR\">Costa Rica</option><option value=\"CI\">Côte d'Ivoire</option><option value=\"HR\">Croatia</option><option value=\"CU\">Cuba</option><option value=\"CY\">Cyprus</option><option value=\"CZ\">Czech Republic</option><option value=\"DK\">Denmark</option><option value=\"DJ\">Djibouti</option><option value=\"DM\">Dominica</option><option value=\"DO\">Dominican Republic</option><option value=\"EC\">Ecuador</option><option value=\"EG\">Egypt</option><option value=\"SV\">El Salvador</option><option value=\"GQ\">Equatorial Guinea</option><option value=\"ER\">Eritrea</option><option value=\"EE\">Estonia</option><option value=\"ET\">Ethiopia</option><option value=\"FK\">Falkland Islands</option><option value=\"FO\">Faroe Islands</option><option value=\"FJ\">Fiji</option><option value=\"FI\">Finland</option><option value=\"FR\">France</option><option value=\"GF\">French Guiana</option><option value=\"PF\">French Polynesia</option><option value=\"TF\">French Southern Terr.</option><option value=\"GA\">Gabon</option><option value=\"GM\">Gambia</option><option value=\"GE\">Georgia</option><option value=\"DE\">Germany</option><option value=\"GH\">Ghana</option><option value=\"GI\">Gibraltar</option><option value=\"GB\">United Kingdom</option><option value=\"GR\">Greece</option><option value=\"GL\">Greenland</option><option value=\"GD\">Grenada</option><option value=\"GP\">Guadeloupe</option><option value=\"GU\">Guam</option><option value=\"GT\">Guatemala</option><option value=\"GN\">Guinea</option><option value=\"GW\">Guinea-Bissau</option><option value=\"GY\">Guyana</option><option value=\"HT\">Haiti</option><option value=\"HM\">Heard/McDonald Isls.</option><option value=\"HN\">Honduras</option><option value=\"HK\">Hong Kong</option><option value=\"HU\">Hungary</option><option value=\"IS\">Iceland</option><option value=\"IN\">India</option><option value=\"ID\">Indonesia</option><option value=\"IR\">Iran</option><option value=\"IQ\">Iraq</option><option value=\"IE\">Ireland</option><option value=\"IL\">Israel</option><option value=\"IT\">Italy</option><option value=\"JM\">Jamaica</option><option value=\"JP\">Japan</option><option value=\"JO\">Jordan</option><option value=\"KZ\">Kazakhstan</option><option value=\"KE\">Kenya</option><option value=\"KI\">Kiribati</option><option value=\"KP\">Korea (North)</option><option value=\"KR\">Korea (South)</option><option value=\"KW\">Kuwait</option><option value=\"KG\">Kyrgyzstan</option><option value=\"LA\">Laos</option><option value=\"LV\">Latvia</option><option value=\"LB\">Lebanon</option><option value=\"LS\">Lesotho</option><option value=\"LR\">Liberia</option><option value=\"LY\">Libya</option><option value=\"LI\">Liechtenstein</option><option value=\"LT\">Lithuania</option><option value=\"LU\">Luxembourg</option><option value=\"MO\">Macau</option><option value=\"MK\">Macedonia</option><option value=\"MG\">Madagascar</option><option value=\"MW\">Malawi</option><option value=\"MY\">Malaysia</option><option value=\"MV\">Maldives</option><option value=\"ML\">Mali</option><option value=\"MT\">Malta</option><option value=\"MH\">Marshall Islands</option><option value=\"MQ\">Martinique</option><option value=\"MR\">Mauritania</option><option value=\"MU\">Mauritius</option><option value=\"YT\">Mayotte</option><option value=\"MX\">Mexico</option><option value=\"FM\">Micronesia</option><option value=\"MD\">Moldova</option><option value=\"MC\">Monaco</option><option value=\"MN\">Mongolia</option><option value=\"MS\">Montserrat</option><option value=\"MA\">Morocco</option><option value=\"MZ\">Mozambique</option><option value=\"MM\">Myanmar</option><option value=\"MP\">N. Mariana Isls.</option><option value=\"NA\">Namibia</option><option value=\"NR\">Nauru</option><option value=\"NP\">Nepal</option><option value=\"NL\">Netherlands</option><option value=\"AN\">Netherlands Antilles</option><option value=\"NC\">New Caledonia</option><option value=\"NZ\">New Zealand</option><option value=\"NI\">Nicaragua</option><option value=\"NE\">Niger</option><option value=\"NG\">Nigeria</option><option value=\"NU\">Niue</option><option value=\"NF\">Norfolk Island</option><option value=\"NO\">Norway</option><option value=\"OM\">Oman</option><option value=\"PK\">Pakistan</option><option value=\"PW\">Palau</option><option value=\"PS\">Palestinian Territory, Occupied</option><option value=\"PA\">Panama</option><option value=\"PG\">Papua New Guinea</option><option value=\"PY\">Paraguay</option><option value=\"PE\">Peru</option><option value=\"PH\">Philippines</option><option value=\"PN\">Pitcairn</option><option value=\"PL\">Poland</option><option value=\"PT\">Portugal</option><option value=\"PR\">Puerto Rico</option><option value=\"QA\">Qatar</option><option value=\"RE\">Reunion</option><option value=\"RO\">Romania</option><option value=\"RU\">Russian Federation</option><option value=\"RW\">Rwanda</option><option value=\"KN\">Saint Kitts and Nevis</option><option value=\"LC\">Saint Lucia</option><option value=\"WS\">Samoa</option><option value=\"SM\">San Marino</option><option value=\"ST\">Sao Tome/Principe</option><option value=\"SA\">Saudi Arabia</option><option value=\"SN\">Senegal</option><option value=\"CS\">Serbia and Montenegro</option><option value=\"SC\">Seychelles</option><option value=\"SL\">Sierra Leone</option><option value=\"SG\">Singapore</option><option value=\"SK\">Slovak Republic</option><option value=\"SI\">Slovenia</option><option value=\"SB\">Solomon Islands</option><option value=\"SO\">Somalia</option><option value=\"ZA\">South Africa</option><option value=\"ES\">Spain</option><option value=\"LK\">Sri Lanka</option><option value=\"SH\">St. Helena</option><option value=\"PM\">St. Pierre and Miquelon</option><option value=\"VC\">St. Vincent and Grenadines</option><option value=\"SD\">Sudan</option><option value=\"SR\">Suriname</option><option value=\"SJ\">Svalbard/Jan Mayen Isls.</option><option value=\"SZ\">Swaziland</option><option value=\"SE\">Sweden</option><option value=\"CH\">Switzerland</option><option value=\"SY\">Syria</option><option value=\"TW\">Taiwan</option><option value=\"TJ\">Tajikistan</option><option value=\"TZ\">Tanzania</option><option value=\"TH\">Thailand</option><option value=\"TL\">Timor-Leste</option><option value=\"TG\">Togo</option><option value=\"TK\">Tokelau</option><option value=\"TO\">Tonga</option><option value=\"TT\">Trinidad and Tobago</option><option value=\"TN\">Tunisia</option><option value=\"TR\">Turkey</option><option value=\"TM\">Turkmenistan</option><option value=\"TC\">Turks/Caicos Isls.</option><option value=\"TV\">Tuvalu</option><option value=\"UG\">Uganda</option><option value=\"UA\">Ukraine</option><option value=\"AE\">United Arab Emirates</option><option value=\"US\">United States</option><option value=\"UM\">US Minor Outlying Is.</option><option value=\"UY\">Uruguay</option><option value=\"UZ\">Uzbekistan</option><option value=\"VU\">Vanuatu</option><option value=\"VA\">Vatican City</option><option value=\"VE\">Venezuela</option><option value=\"VN\">Viet Nam</option><option value=\"VG\">Virgin Islands (British)</option><option value=\"VI\">Virgin Islands (U.S.)</option><option value=\"WF\">Wallis/Futuna Isls.</option><option value=\"EH\">Western Sahara</option><option value=\"YE\">Yemen</option><option value=\"ZM\">Zambia</option><option value=\"ZW\">Zimbabwe</option></select></div></div></div></div></div></div></div></div><div id=\"pps2\" class=\"pp-stage\"><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp2_0\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement19\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1332\">Any special instructions?</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\"><input type=\"text\" class=\"elq-item-input\" name=\"singleLineText\" id=\"fe1332\" value=\"cut in squares, crust well done, etc.\" style=\"width:100%;\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1332~~\"></div></div></div><div class=\"form-element-instruction\">Question type - Single Line Text</div></div></div></div></div><div class=\"pp-field grid-layout-col\" style=\"display:none;\" id=\"epp2_1\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement20\" class=\"elq-field-style form-element-layout row\"><div style=\"text-align:left;padding-right:15px;\" class=\"col-sm-4 col-xs-12\"><label class=\"elq-label \" for=\"fe1333\">Additional Comments</label></div><div class=\"col-sm-8 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"field-control-wrapper\"><textarea class=\"elq-item-textarea\" style=\"width:100%;\" name=\"paragraphText\" id=\"fe1333\" data-previous=\"~~eloqua..type--FormFieldValue..fieldId--1333~~\"></textarea></div></div></div><div class=\"form-element-instruction\">Question type - Paragraph Text</div></div></div></div></div></div></div><div class=\"row\"><div class=\"grid-layout-col\"><div class=\"layout-col col-sm-12 col-xs-12\"><div id=\"formElement21\" class=\"elq-field-style form-element-layout row\"><div class=\"col-sm-12 col-xs-12\"><div class=\"row\"><div class=\"col-xs-12\"><div style=\"text-align:center;\"><input type=\"Submit\" class=\"submit-button-style \" value=\"Submit\" id=\"fe1328\"></div></div></div></div></div></div></div></div><input type=\"hidden\" name=\"hiddenField\" id=\"fe1334\" value=\"\"></div></form><script type=\"text/javascript\" src=\"https://img04.en25.com/i/livevalidation_standalone.compressed.js\"></script><script>function handleFormSubmit(ele) { var submitButton = ele.querySelector('input[type=submit]'); var spinner = document.createElement('span'); spinner.setAttribute('class', 'loader'); submitButton.setAttribute('disabled', true); submitButton.style.cursor = 'wait'; submitButton.parentNode.appendChild(spinner); return true; }function resetSubmitButton(e){ var submitButtons = e.target.form.getElementsByClassName('submit-button'); for(var i=0;i<submitButtons.length;i++){ submitButtons[i].disabled = false; } }function addChangeHandler(elements){ for(var i=0; i<elements.length; i++){ elements[i].addEventListener('change', resetSubmitButton); } }var form = document.getElementById('form139'); addChangeHandler(form.getElementsByTagName('input')); addChangeHandler(form.getElementsByTagName('select')); addChangeHandler(form.getElementsByTagName('textarea'));var nodes = document.querySelectorAll('#form139 input[data-subscription]'); if (nodes) { for (var i = 0, len = nodes.length; i < len; i++) {var status = nodes[i].dataset ? nodes[i].dataset.subscription : nodes[i].getAttribute('data-subscription'); if(status ==='true') {nodes[i].checked = true;}}};var nodes = document.querySelectorAll('#form139 select[data-value]'); if (nodes) { for (var i = 0; i < nodes.length; i++) { var node = nodes[i]; var selectedValue = node.dataset ? node.dataset.value : node.getAttribute('data-value'); if (selectedValue) { for (var j = 0; j < node.options.length; j++) { if(node.options[j].value === selectedValue) { node.options[j].selected = 'selected';break;}}}}}this.getParentElement = function(list) { return list[list.length-1].parentElement};var dom1 = document.querySelector('#form139 #fe1321');var fe1321 = new LiveValidation(dom1, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1321.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1321.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1321.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});var dom2 = document.querySelector('#form139 #fe1322');var fe1322 = new LiveValidation(dom2, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1322.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1322.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1322.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});var dom3 = document.querySelector('#form139 #fe1323');var fe1323 = new LiveValidation(dom3, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1323.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1323.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1323.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});var dom4 = document.querySelector('#form139 #fe1324');var fe1324 = new LiveValidation(dom4, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1324.add(Validate.Presence, {failureMessage:\"This field is required\"});fe1324.add(Validate.Format, {pattern: /(^[A-Z0-9!#\\$%&'\\*\\+\\-\\/=\\?\\^_`\\{\\|\\}~][A-Z0-9!#\\$%&'\\*\\+\\-\\/=\\?\\^_`\\{\\|\\}~\\.]{0,62}@(([A-Z0-9](?:[A-Z0-9\\-]{0,61}[A-Z0-9])?)(\\.[A-Z0-9](?:[A-Z0-9\\-]{0,61}[A-Z0-9])?)+)$)/i, failureMessage: \"A valid email address is required\"});fe1324.add(Validate.Format, {pattern: /\\.\\.|\\.@/i, failureMessage: \"A valid email address is required\", negate: \"true\"});var dom6 = document.querySelector('#form139 #fe1325');var fe1325 = new LiveValidation(dom6, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});var dom7 = document.querySelectorAll('#form139 [name=\"radioButtons\"]');var fe1326 = new LiveValidation(dom7, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false, insertAfterWhatNode :this.getParentElement(dom7), isGroup: true}, true);fe1326.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1326.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});var dom8 = document.querySelector('#form139 #fe1327');var fe1327 = new LiveValidation(dom8, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1327.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1327.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});var dom9 = document.querySelectorAll('#form139 [name=\"radioButtons2\"]');var fe1329 = new LiveValidation(dom9, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false, insertAfterWhatNode :this.getParentElement(dom9), isGroup: true}, true);fe1329.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1329.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});var dom10 = document.querySelectorAll('#form139 [name=\"checkboxes\"]');var fe1330 = new LiveValidation(dom10, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false, insertAfterWhatNode :this.getParentElement(dom10), isGroup: true}, true);fe1330.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1330.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});var ppv = {};ppv['0-0'] = function() {var dom13_0_0 = document.querySelector('#form139 #fe1331');var fe1331 = new LiveValidation(dom13_0_0, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1331.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1331.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});};ppv['1-0'] = function() {var dom13_1_0 = document.querySelector('#form139 #fe1338');var fe1338 = new LiveValidation(dom13_1_0, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1338.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1338.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1338.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});};ppv['1-1'] = function() {var dom13_1_1 = document.querySelector('#form139 #fe1339');var fe1339 = new LiveValidation(dom13_1_1, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1339.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1339.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1339.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});};ppv['1-2'] = function() {var dom13_1_2 = document.querySelector('#form139 #fe1340');var fe1340 = new LiveValidation(dom13_1_2, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1340.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1340.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1340.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});};ppv['1-3'] = function() {var dom13_1_3 = document.querySelector('#form139 #fe1341');var fe1341 = new LiveValidation(dom13_1_3, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});};ppv['1-4'] = function() {var dom13_1_4 = document.querySelector('#form139 #fe1342');var fe1342 = new LiveValidation(dom13_1_4, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});fe1342.add(Validate.Custom, {against: function(value) {return !value.match(/(telnet|ftp|https?):\\/\\/(?:[a-z0-9][a-z0-9-]{0,61}[a-z0-9]\\.|[a-z0-9]\\.)+[a-z]{2,63}/i);}, failureMessage: \"Value must not contain any URL's\"});fe1342.add(Validate.Custom, {against: function(value) {return !value.match(/(<([^>]+)>)/ig);}, failureMessage: \"Value must not contain any HTML\"});fe1342.add(Validate.Length, {tooShortMessage:\"Invalid length for field value\", tooLongMessage: \"Invalid length for field value\", minimum: 0, maximum: 35});};ppv['1-5'] = function() {var dom13_1_5 = document.querySelector('#form139 #fe1343');var fe1343 = new LiveValidation(dom13_1_5, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});};ppv['2-0'] = function() {var dom13_2_0 = document.querySelector('#form139 #fe1332');var fe1332 = new LiveValidation(dom13_2_0, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});};ppv['2-1'] = function() {var dom13_2_1 = document.querySelector('#form139 #fe1333');var fe1333 = new LiveValidation(dom13_2_1, {validMessage: \"\", onlyOnBlur: false, wait: 300, isPhoneField: false});};var config = { formId: '139', mode: 'staged', numStages: 3, numFields: 0, numToReveal: 9, randomize: false, onlyIncomplete: false };var revealed = [];var getPreviousValue = function(elem) {var prev;if (elem.dataset) {prev = elem.dataset.previous;} else {prev = elem.getAttribute('data-previous');}return prev;};var showField = function(field, index) {field.style.display = '';revealed.push(index + '');var vf = ppv[index];if (vf) vf();};var textHasValue = function(input, field, onlyPrev) {var prev;var hasValue = false;if (!input.value || onlyPrev) {prev = getPreviousValue(input);if (prev) {input.value = prev;hasValue = true;}} else {hasValue = true;}return hasValue;};var radioHasValue = function(input, field, onlyPrev) {var prev, i, len;var hasValue = false;var nodes = field.querySelectorAll('input');if (!onlyPrev) {for (i = 0, len = nodes.length; i < len; i++) {if (nodes[i].checked) hasValue = true;}}if (!hasValue) {prev = getPreviousValue(input);for (i = 0, len = nodes.length; i < len; i++) {if (nodes[i].value && nodes[i].value === prev) {nodes[i].checked = true;hasValue = true;}}}return hasValue;};var checkboxHasValue = function(input, field, onlyPrev) {var prev, prevVals, i, len;var hasValue = false;var nodes = field.querySelectorAll('input');if (!onlyPrev) {for (i = 0, len = nodes.length; i < len; i++) {if (nodes[i].checked) hasValue = true;}}if (!hasValue) {prev = getPreviousValue(input);prevVals = prev.split(',');for (i = 0, len = nodes.length; i < len; i++) {if (nodes[i].value && prevVals.indexOf(nodes[i].value) >= 0) {nodes[i].checked = true;hasValue = true;}}}return hasValue;};var selectHasValue = function(input, field, onlyPrev) {var prev, prevVals;var hasValue = false;var nodes = input.options;if (!onlyPrev) {for (i = 0, len = nodes.length; i < len; i++) {if (nodes[i].value && nodes[i].selected) hasValue = true;}}if(!hasValue){prev = getPreviousValue(input);prevVals = prev.split(',');for (var i = 0, len = nodes.length; i < len; i++) {if (nodes[i].value && prevVals.indexOf(nodes[i].value) >= 0) {nodes[i].selected = \"selected\";hasValue = true;}}}return hasValue;};var fieldHasValue = function(field, onlyPrev) {var input, textarea, select, hasValue;hasValue = false;input = field.querySelector('input');textarea = field.querySelector('textarea');select = field.querySelector('select');if (input) {if (input.type.indexOf('text') >= 0) {hasValue = textHasValue(input, field, onlyPrev);} else if (input.type.indexOf('radio') >= 0) {hasValue = radioHasValue(input, field, onlyPrev);} else if (input.type.indexOf('checkbox') >= 0) {hasValue = checkboxHasValue(input, field, onlyPrev);}} else if (textarea) {hasValue = textHasValue(textarea, field, onlyPrev);} else if (select) {hasValue = selectHasValue(select, field, onlyPrev);}return hasValue;};var groupHasPreviousValues = function(group) {var fields = group.querySelectorAll('.pp-field');for(var i=0;i<fields.length;i++) {if (fieldHasValue(fields[i], true)) return true;}return false;};var showGroup = function(group, index) {var fields = [];fields = group.querySelectorAll('.pp-field');for(var i=0;i<fields.length;i++) {showField(fields[i], index + '-' + i);}};if (config.mode === 'list') {var li, i, lookup = [];for(i=0;i<config.numFields;i++) {lookup[i]=i;}if (config.randomize) {var x,t;for(i=0;i<config.numFields;i++) {x=Math.floor(Math.random()*config.numFields);t=lookup[i];lookup[i] = lookup[x];lookup[x] = t;}}for (i = 0; i < config.numFields; i++) {li = lookup[i];if (revealed.length === config.numToReveal) break;if (revealed.indexOf(li + '') >= 0) continue;pField = document.querySelector('#form' + config.formId + ' #epp' + li);if (!fieldHasValue(pField)) showField(pField, li);}if (revealed.length < config.numToReveal) {for (i = 0; i < config.numFields; i++) {li = lookup[i];if (revealed.length === config.numToReveal) break;if (revealed.indexOf(li + '') >= 0) continue;pField = document.querySelector('#form' + config.formId + ' #epp' + li);if (!fieldHasValue(pField)) showField(pField, li);}}if (revealed.length < config.numToReveal) {for (i = 0; i < config.numFields; i++) {li = lookup[i];if (revealed.length === config.numToReveal) break;if (revealed.indexOf(li + '') >= 0) continue;pField = document.querySelector('#form' + config.formId + ' #epp' + li);if (!config.onlyIncomplete) showField(pField, li);}}} else {var group;for (var i = 0; i < config.numStages; i++) {group = document.querySelector('#form' + config.formId + ' #pps' + i);if (!groupHasPreviousValues(group) || (i === (config.numStages - 1))) {showGroup(group, i);break;}}}</script>";
