<!-- Note :<!-- [et_pb_line_break_holder] --> - You can modify the font style and form style to suit your website.<!-- [et_pb_line_break_holder] --> - 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.<!-- [et_pb_line_break_holder] --> - The Mandatory check script can modified as to suit your business needs.<!-- [et_pb_line_break_holder] --> - It is important that you test the modified form before going live.<!-- [et_pb_line_break_holder] --> - Do not remove captcha and other form elements that are necessary for the form to work. --><!-- [et_pb_line_break_holder] --><div id='crmWebToEntityForm'><!-- [et_pb_line_break_holder] --> <META HTTP-EQUIV='content-type' CONTENT='text/html;charset=UTF-8'><!-- [et_pb_line_break_holder] --> <form action='https://crm.zoho.com/crm/WebToLeadForm' name=WebToLeads3253228000002447023 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory3253228000002447023()' accept-charset='UTF-8'><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xnQsjsdp' value='70de2e64bd90b5a727631b6f3210f2c2079ff29b518f3c4649f0dc17377ee33e' /><!-- [et_pb_line_break_holder] --> <input type='hidden' name='zc_gad' id='zc_gad' value='' /><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xmIwtLD' value='91124034d986a550274b9d410066ec95f43fb707dae5271bcbfa2af89b7dfff3' /><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='actionType' value='TGVhZHM=' /><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='returnURL' value='https://www.puttiapps.com/thankyou' /><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <style><!-- [et_pb_line_break_holder] --> tr , td {<!-- [et_pb_line_break_holder] --> border-spacing:0px;<!-- [et_pb_line_break_holder] --> border-width:0px;<!-- [et_pb_line_break_holder] --> padding: 0px;<!-- [et_pb_line_break_holder] --> border: none!important;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> input.zoho-form-input {<!-- [et_pb_line_break_holder] --> padding: 16px;<!-- [et_pb_line_break_holder] --> width: 100%;<!-- [et_pb_line_break_holder] --> background-color: rgba(255,255,255,0.2);<!-- [et_pb_line_break_holder] --> border: 0px;<!-- [et_pb_line_break_holder] --> color: #fff;<!-- [et_pb_line_break_holder] --> font-size: 14px;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> textarea.zoho-form-input {<!-- [et_pb_line_break_holder] --> padding: 16px;<!-- [et_pb_line_break_holder] --> width: 100%;<!-- [et_pb_line_break_holder] --> background-color: rgba(255,255,255,0.2);<!-- [et_pb_line_break_holder] --> border: 0px;<!-- [et_pb_line_break_holder] --> min-height: 150px;<!-- [et_pb_line_break_holder] --> color: #fff;<!-- [et_pb_line_break_holder] --> font-size: 14px;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> input:focus.zoho-form-input {<!-- [et_pb_line_break_holder] --> color: #fff;<!-- [et_pb_line_break_holder] --> font-size: 14px;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> td.zoho-form-label {<!-- [et_pb_line_break_holder] --> color: #fff;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> input.zoho-form-button {<!-- [et_pb_line_break_holder] --> font-size: 16px;<!-- [et_pb_line_break_holder] --> padding: 10px 25px;<!-- [et_pb_line_break_holder] --> background-color: rgba(0, 0, 0, 0);<!-- [et_pb_line_break_holder] --> color: #fff;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> </style><!-- [et_pb_line_break_holder] --> <table style="border: none;"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr style='display:none;'><!-- [et_pb_line_break_holder] --> <td>Lead Source</td><!-- [et_pb_line_break_holder] --> <td><!-- [et_pb_line_break_holder] --> <select name='Lead Source'><!-- [et_pb_line_break_holder] --> <option selected value='Putti Apps Website'>Putti Apps Website</option><!-- [et_pb_line_break_holder] --> </select></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr style='display:none;'><!-- [et_pb_line_break_holder] --> <td>Assign Using Active Assignment Rule </td><!-- [et_pb_line_break_holder] --> <td><input type='checkbox' name='LEADCF102' checked='true' /> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="zoho-form-label">Name<span style='color:red;'>*</span></td><!-- [et_pb_line_break_holder] --> <td><input class="zoho-form-input" type='text' maxlength='80' name='Last Name' /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="zoho-form-label">Email<span style='color:red;'>*</span></td><!-- [et_pb_line_break_holder] --> <td><input class="zoho-form-input" type='text' maxlength='100' name='Email' /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="zoho-form-label">Phone</td><!-- [et_pb_line_break_holder] --> <td><input class="zoho-form-input" type='text' maxlength='30' name='Phone' /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="zoho-form-label">Message </td><!-- [et_pb_line_break_holder] --> <td> <textarea class="zoho-form-input" name='Description' maxlength='32000'> </textarea></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="zoho-form-label">Captcha</td><!-- [et_pb_line_break_holder] --> <td><input class="zoho-form-input" type='text' maxlength='80' name='enterdigest' /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <td class="zoho-form-input"><img alt="" id='imgid' style="height:50px; width:auto;" src='https://crm.zoho.com/crm/CaptchaServlet?formId=91124034d986a550274b9d410066ec95f43fb707dae5271bcbfa2af89b7dfff3&grpid=70de2e64bd90b5a727631b6f3210f2c2079ff29b518f3c4649f0dc17377ee33e'><!-- [et_pb_line_break_holder] --> <a href='javascript:;' onclick='reloadImg()'><img alt="" src="https://www.puttiapps.com/wp-content/uploads/2019/03/putti_reload-s.png"></a></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <td><!-- [et_pb_line_break_holder] --> <div class='dIB vat mT2' align='left' style='color: rgb(0, 0, 0); font-size: 12px; font-family: sans-serif;display: inline-block;vertical-align: top;'><!-- [et_pb_line_break_holder] --> <div class='displayPurpose f13'><label class='newCustomchkbox-md dIB w100per'><input autocomplete='off' onclick='disableSubmit()' id='privacyTool' type='checkbox' name='privacyTool'><span class='chkbxIcon'></span></label></div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class='fw200 dIB vat mL5' style='font-size:12px;color:#fff;nowrap:nowrap;text-align:left;vertical-align:top; margin-top:3px; line-height:14px;display: inline-block;'>I agree to the Putti <a href='https://www.puttiapps.com/privacy-policy/' title='https://www.puttiapps.com/privacy-policy/'<!-- [et_pb_line_break_holder] --> target='_blank'>Privacy Policy</a>.</div><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td colspan='2' style='text-align:center; padding-top:15px;'><!-- [et_pb_line_break_holder] --> <input class="zoho-form-button" onclick='disableSubmitwhileReset()' type='reset' style='' value='Reset' /><!-- [et_pb_line_break_holder] --> <input class="zoho-form-button" style='opacity:0.5;' disabled id='formsubmit' type='submit' value='Submit' /><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <script><!-- [et_pb_line_break_holder] --> var mndFileds = new Array('Last Name', 'Email');<!-- [et_pb_line_break_holder] --> var fldLangVal = new Array('Name', 'Email');<!-- [et_pb_line_break_holder] --> var name = '';<!-- [et_pb_line_break_holder] --> var email = '';<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> function disableSubmitwhileReset() {<!-- [et_pb_line_break_holder] --> var submitbutton = document.getElementById('formsubmit');<!-- [et_pb_line_break_holder] --> if (document.getElementById('privacyTool') != undefined || document.getElementById('consentTool') != undefined) {<!-- [et_pb_line_break_holder] --> submitbutton.setAttribute('disabled', true);<!-- [et_pb_line_break_holder] --> submitbutton.setAttribute('style', 'opacity:0.5;');<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('disabled');<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> function disableSubmit() {<!-- [et_pb_line_break_holder] --> var isprivacyToolAvail = false;<!-- [et_pb_line_break_holder] --> var isconsentToolAvail = false;<!-- [et_pb_line_break_holder] --> var bothtoolAvail = false;<!-- [et_pb_line_break_holder] --> var privacytool = '';<!-- [et_pb_line_break_holder] --> var consenttool = '';<!-- [et_pb_line_break_holder] --> var submitbutton = document.getElementById('formsubmit');<!-- [et_pb_line_break_holder] --> if (document.getElementById('privacyTool') != undefined && document.getElementById('consentTool') != undefined) {<!-- [et_pb_line_break_holder] --> isprivacyToolAvail = true;<!-- [et_pb_line_break_holder] --> privacytool = document.getElementById('privacyTool');<!-- [et_pb_line_break_holder] --> isconsentToolAvail = true;<!-- [et_pb_line_break_holder] --> consenttool = document.getElementById('consentTool');<!-- [et_pb_line_break_holder] --> bothtoolAvail = true;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> if (document.getElementById('privacyTool') != undefined) {<!-- [et_pb_line_break_holder] --> isprivacyToolAvail = true;<!-- [et_pb_line_break_holder] --> privacytool = document.getElementById('privacyTool');<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (document.getElementById('consentTool') != undefined) {<!-- [et_pb_line_break_holder] --> isconsentToolAvail = true;<!-- [et_pb_line_break_holder] --> consenttool = document.getElementById('consentTool');<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (submitbutton.hasAttribute('disabled') && bothtoolAvail && consenttool.checked && privacytool.checked) {<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('disabled');<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('style', 'opacity: none;');<!-- [et_pb_line_break_holder] --> } else if (submitbutton.hasAttribute('disabled') && isprivacyToolAvail && privacytool.checked && consenttool == '') {<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('disabled');<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('style', 'opacity: none;');<!-- [et_pb_line_break_holder] --> } else if (submitbutton.hasAttribute('disabled') && isconsentToolAvail && consenttool.checked && privacytool == '') {<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('disabled');<!-- [et_pb_line_break_holder] --> submitbutton.removeAttribute('style', 'opacity: none;');<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> submitbutton.setAttribute('disabled', true);<!-- [et_pb_line_break_holder] --> submitbutton.setAttribute('style', 'opacity: 0.5;');<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> /* Do not remove this code. */<!-- [et_pb_line_break_holder] --> function reloadImg() {<!-- [et_pb_line_break_holder] --> if (document.getElementById('imgid').src.indexOf('&d') !== -1) {<!-- [et_pb_line_break_holder] --> document.getElementById('imgid').src = document.getElementById('imgid').src.substring(0, document.getElementById('imgid').src.indexOf('&d')) + '&d' + new Date().getTime();<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> document.getElementById('imgid').src = document.getElementById('imgid').src + '&d' + new Date().getTime();<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> function checkMandatory3253228000002447023() {<!-- [et_pb_line_break_holder] --> for (i = 0; i < mndFileds.length; i++) {<!-- [et_pb_line_break_holder] --> var fieldObj = document.forms['WebToLeads3253228000002447023'][mndFileds[i]];<!-- [et_pb_line_break_holder] --> if (fieldObj) {<!-- [et_pb_line_break_holder] --> if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length == 0) {<!-- [et_pb_line_break_holder] --> if (fieldObj.type == 'file') {<!-- [et_pb_line_break_holder] --> alert('Please select a file to upload.');<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] + ' cannot be empty.');<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } else if (fieldObj.nodeName == 'SELECT') {<!-- [et_pb_line_break_holder] --> if (fieldObj.options[fieldObj.selectedIndex].value == '-None-') {<!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] + ' cannot be none.');<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if (fieldObj.type == 'checkbox') {<!-- [et_pb_line_break_holder] --> if (fieldObj.checked == false) {<!-- [et_pb_line_break_holder] --> alert('Please accept ' + fldLangVal[i]);<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> try {<!-- [et_pb_line_break_holder] --> if (fieldObj.name == 'Last Name') {<!-- [et_pb_line_break_holder] --> name = fieldObj.value;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } catch (e) {}<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> </script><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <iframe name='captchaFrame' style='display:none;'></iframe><!-- [et_pb_line_break_holder] --></div>