document.write(' <form action=\"http://www.zenplanner.com/zenplanner/api/prospect/index.cfm?PartitionId=bf53ada9-ff22-06e6-f8c4-822623d51d3e\" method=\"post\" onsubmit=\"return __zpCheckProspectForm(this)\"> <input type=\"hidden\" name=\"SourceId\" value=\"bf55a12d-ff22-06e6-f899-d266939398ca\"> <input type=\"hidden\" name=\"RTN\" value=\"http://www.oictheway.com/www/weblead-confirm\"> <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> <input type=\"hidden\" name=\"ProgramId\" value=\"FA2C43EA-FF22-06E6-F828-454939661725\"> </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;
};