document.write(' <form action=\"http://www.zenplanner.com/zenplanner/api/prospect/index.cfm?PartitionId=36832B8B-0A4F-466B-878B-541B0ED2D5FF\" method=\"post\" onsubmit=\"return __zpCheckProspectForm(this)\"> <input type=\"hidden\" name=\"SourceId\" value=\"B8A78FA5-D93D-4806-BA86-36FFB6BAB3D6\"> <input type=\"hidden\" name=\"RTN\" value=\"http://www.hrksf.com/appthankyou/appthankyou.html\"> <table style=\"font-family:Arial; font-size:10pt;\"> <tr> <td>First Name &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"FirstName\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://www.zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Last Name &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"LastName\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://www.zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td>Email Address &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"EmailAddress\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://www.zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Phone Number &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"TelephoneNumber\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://www.zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td>Address &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"Address\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>City &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"City\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>State &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"State\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>Zip Code &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"Zip\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td valign=\"top\">Interested In &nbsp;</td> <td valign=\"top\"> <select name=\"ProgramId\"> <option value=\"\">(Please Select One)</option> <option value=\"27C0A4CA-8B7C-4913-90C4-FFD3B94330FD\">Taekwondo</option> <option value=\"4AE09C46-49B6-4036-A028-2A81FF3B8E10\">Kickboxing</option> <option value=\"9CCA80FB-FD6D-4547-A60E-72B744729380\">Tiger Tots</option> <option value=\"99028E59-BC5F-41B9-8AD5-BAC0C715A197\">Childrens Taekwondo</option> <option value=\"76A218D2-AA7B-49F0-AC5F-D7B1DD20673D\">Private Lessons</option> </select> <img src=\"http://www.zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Reason for Interest &nbsp;</td> <td> <select name=\"InterestId\"> <option value=\"\">(Please Select One)</option> <option value=\"62E2D669-0D7E-4D0E-9EE6-05B53D6BC185\">Self Defense</option> <option value=\"81CE20AF-9FC1-4CFF-9481-FEA286B11FCD\">Self Confidence</option> <option value=\"EB0CCDE8-6496-4B71-A59E-85BE6D90EBF9\">Weight Loss</option> <option value=\"024F37C9-E447-42B3-BBE4-65D968AD5FAE\">Physical Fitness</option> <option value=\"A339A511-4F9B-427E-A1F8-7D059AE51729\">Mental Discipline</option> <option value=\"039797D7-E134-4E76-B813-A9BA317A8642\">Child\'s Performance In School / Grades</option> </select> </td> </tr> </table> <br> <input name=\"submitButton\" type=\"submit\" value=\"Submit\"> </form> ');

__zpCheckProspectForm = function(form)
{
	var require = function(field, label)
	{
		if (field.value == '')
		{
			alert('Please enter your ' + label + ' before submitting this form.');
			field.focus();
			return false;
		}
		return true
	}

	if (!require(form.FirstName, 'First Name')) {return false};
	if (!require(form.LastName, 'Last Name')) {return false};

	if (!require(form.EmailAddress, 'Email Address')) {return false};
	if (!require(form.TelephoneNumber, 'Phone Number')) {return false};

	
		if (form.ProgramId.selectedIndex == 0)
		{
			alert('Please select a program that you are interested in.');
			return false;
		}

	

	form.submitButton.disabled = true;
	return true;
};