document.write(' <form action=\"http://www.zenplanner.com/zenplanner/api/prospect/index.cfm?PartitionId=3ba7e0f8-ff22-06e6-f8b0-9d2e8a2f7377\" method=\"post\" onsubmit=\"return __zpCheckProspectForm(this)\"> <input type=\"hidden\" name=\"SourceId\" value=\"3baace1e-ff22-06e6-f89c-92668c7483fb\"> <input type=\"hidden\" name=\"RTN\" value=\"http://www.satoriwhitehouse.com/FreeWeekThanks.htm\"> <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 valign=\"top\">Interested In &nbsp;</td> <td valign=\"top\"> <select name=\"ProgramId\"> <option value=\"\">(Please Select One)</option> <option value=\"4002AA1E-FF22-06E6-F855-011AD86465A2\">Wellness Package</option> <option value=\"525D32D9-FF22-06E6-F8CA-3F0FC82A6BFD\">Satori Karate</option> <option value=\"525DA1DF-FF22-06E6-F858-F2857115E5EE\">Satori Jiu Jitsu</option> <option value=\"DDDBA39C-FF22-06E6-F84F-94DC5A6D4C60\">Satori\'s BYOB Women\'s Self Defense</option> <option value=\"4002A9C0-FF22-06E6-F8B0-F5BCF2E21AD8\">Restorative Therapies</option> <option value=\"FE553231-FF22-06E6-F8FD-80BCBAB4CA3F\">Summer Camps</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=\"3BAACC49-FF22-06E6-F8DF-4FDED26A6ABB\">Child\'s Performance In School / Grades</option> <option value=\"A7FC86CB-FF3B-C9DC-CDED-CC34235EFBA3\">Character Development</option> <option value=\"A7FC8767-FF3B-C9DC-CD0D-9336336B16FB\">Confidence</option> <option value=\"A7FC8719-FF3B-C9DC-CD05-7B1FFC3E9EA8\">Leadership Skills</option> <option value=\"3BAACC97-FF22-06E6-F80C-27A7B785019D\">Physical Fitness</option> <option value=\"BEDB08CA-FF22-06E6-F82B-BFBD35CEC2F0\">Flexibility</option> <option value=\"3BAACCB6-FF22-06E6-F8E9-324D640C5DAB\">Mental Discipline & Attention</option> <option value=\"3BAACCF5-FF22-06E6-F81C-6A71887FF40A\">Self Defense</option> <option value=\"C73F6E55-FF22-06E6-F8C3-56C908C8057A\">Special Event</option> <option value=\"3BAACD14-FF22-06E6-F84D-22B3510C2F81\">Other</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;
};