ThinkMoney - Long Form

In this example below you will see how to do a ThinkMoney - Long Form with some HTML / CSS and Javascript

Thumbnail
This awesome code was written by etienneatcofoundry, you can see more from this user in the personal repository.
You can find the original code on Codepen.io
Copyright etienneatcofoundry ©

Technologies

  • HTML
  • CSS
<!DOCTYPE html>
<html lang="en" >

<head>
  <meta charset="UTF-8">
  <title>ThinkMoney - Long Form</title>
  
  
  
      <link rel="stylesheet" href="css/style.css">

  
</head>

<body>

  <html xmlns="http://www.w3.org/1999/xhtml"><head><title>
    Long Form Test - Cofoundry
</title><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0">
    <script async="" src="//rum-static.pingdom.net/prum.min.js"></script><script type="text/javascript" src="/scripts/jquery-1.4.4.min.js"></script>
    <style>
        .error {
            color: Red;
        }

        .lmtform.bod {
            font-family: sans-serif;background-color: #ffe548;max-width: 100%;border-style: none;font-weight: normal;text-align: left;padding-left:10px;padding-right:10px;letter-spacing:3px;;
        }

        .lmtform .sectionname {
            color: #0a0907;font-size: 16px;font-family: Arial;border-style: none;margin-bottom: 20px;margin-top: 30px;font-weight: bold;padding-left: 10px;;
        }

        .lmtform .fieldname {
            color: #7e6f32;font-size: 13px;border-style: none;margin-bottom: 3px;font-weight: 120%;margin-left: 10px;text-align: left;width:250px;;
        }

        .lmtform .field {
            color: #0a0907;font-size: 14px;background-color: #eed642;height: 35px;border-style: solid;border: none;margin-top: 7px;padding-left: 10px;text-align: left;width:200px;border-radius:2px;margin-bottom: 10px;;
        }
        .lmtform .field:focus
        {
            box-shadow: 0 0 10px #9ecaed;
            outline: none;
        }

        .lftform .fieldtable {
            width: 100%;
        }


        /* Portrait phones and smaller */
        @media (max-device-width: 767px) {
            table, tbody, td, tr {
                display: block;
            }

            tbody, tr, td, input, .lmtform .field {
                width: 100%;
            }
            .lmtform input[type="checkbox"]
            {
                width: auto;
                float: right;
            }

            .lmtform .field {
                width: 90%;
            }
        }
    </style>

    <!-- Pingdom Monitoring -->
    <script>
        var _prum = [['id', '522ad398abe53dfb7c000000'],
              ['mark', 'firstbyte', (new Date()).getTime()]];
        (function () {
            var s = document.getElementsByTagName('script')[0]
       , p = document.createElement('script');
            p.async = 'async';
            p.src = '//rum-static.pingdom.net/prum.min.js';
            s.parentNode.insertBefore(p, s);
        })();
    </script>
<link href="/WebResource.axd?d=thNRow1FA6sdLqeevOLEeys15qOIgPXMIVa3kuTxr2GHJfuE8AaFqMpmIcVZ6m2ZpaSIENpwtX-3cPS8ex6ul-hOpLP7OnNjpqs-Ulnf0zclCC0iLZ8MKh5c5_e6dC09ljno8jtQe3dR7_Hm6yZfnDZH0DKp1jA7ofX4Olint0E1&amp;t=635295291340000000" type="text/css" rel="stylesheet"></head>
<body>
    <script type="text/javascript">
        function checkCheckbox(source, args) {

            if (source.checked) {
                args.IsValid = true;
            }
            else {
                args.IsValid = false;
            }          

            return;

        }
                
        function CheckValidSAIDNumber(source, args)
        {
            var idnumber = args.Value;
                               
            $.ajax({
                type: "POST",
                async: false,
                timeout: 500,
                contentType: "application/json",
                dataType: "json",
                url: "generateleadform.aspx/IsValidIDNumber",
                data: '{"idnumber":"'+idnumber+'"}',
                success: function(result){
                    args.IsValid = result.d;
                }
            });
        }

        $(document).ready(function () {

            $(".firstbutton").click(function() {
                
                if ($("#myDuplicateCheck").val() == "clicked")
                {                    
                    return false;
                }
                else
                {
                    if (Page_ClientValidate())
                    {
                        $("#myDuplicateCheck").val("clicked");
                    }
                }
            });

            $("#btnNext").click(function () {

                var maxselections = 0;

                var recipientcount = 0;

                if ($("input:checkbox:checked").length > maxselections)
                {
                    alert("Too many selected! You may select up to " + maxselections + " providers to send your details to!");
                    return false;
                }

                if ($("input:checkbox:checked").length == 1 && recipientcount > 1 && maxselections > 1)
                {
                    return window.confirm("You can apply to " + maxselections + " providers with this form! Are you sure you want to apply to just one?");
                }
                
                if ($("input:checkbox:checked").length > 0) {
                    return true;
                }
                else {
                    
                    alert("You have selected no products! Please select at least 1 provider and then continue.");
                    return false;
                }

            });

            var toemail = '';

            $("#btnReferNext").click(function () {

                var bContainsOwnEmail = false;

                var bIsUnique = true;

                var vals = "";
                        
                $(".referemail").each(function (index) {
                            
                    if ($(this).val() == toemail) {
                        bContainsOwnEmail = true;
                    }

                });

                if (bContainsOwnEmail) {
                    alert("You cannot refer yourself. Please refer a unique person and email address.");

                    return false;
                }

                $(".referemail").each(function (index) {

                    var email = $(this).val();
                            
                    if (email.length > 0)
                    {
                        if (vals.indexOf(email) > -1)
                        {                               
                            bIsUnique = false;   
                        }
                        //alert(vals.indexOf(email) + " " + email);

                        vals += email;
                    }
                            

                });

                if (!bIsUnique)
                {
                    alert("Please ensure all the email addresses you entered are unique")
                    return false;
                }

            });

        });
    </script>
    <div id="bod" style="overflow: hidden;" class="lmtform bod">
        <form method="post" action="./generateleadform.aspx?guid=1039c977-00ca-4628-a8bf-f341b3ed991a" onsubmit="javascript:return WebForm_OnSubmit();" id="form1">
<div class="aspNetHidden">
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUJLTIzMjc0MjQyD2QWBGYPZBYCAgIPFQSyAWZvbnQtZmFtaWx5OiBzYW5zLXNlcmlmO2JhY2tncm91bmQtY29sb3I6ICNmZmU1NDg7bWF4LXdpZHRoOiAxMDAlO2JvcmRlci1zdHlsZTogbm9uZTtmb250LXdlaWdodDogbm9ybWFsO3RleHQtYWxpZ246IGxlZnQ7cGFkZGluZy1sZWZ0OjEwcHg7cGFkZGluZy1yaWdodDoxMHB4O2xldHRlci1zcGFjaW5nOjNweDuPAWNvbG9yOiAjMGEwOTA3O2ZvbnQtc2l6ZTogMTZweDtmb250LWZhbWlseTogQXJpYWw7Ym9yZGVyLXN0eWxlOiBub25lO21hcmdpbi1ib3R0b206IDIwcHg7bWFyZ2luLXRvcDogMzBweDtmb250LXdlaWdodDogYm9sZDtwYWRkaW5nLWxlZnQ6IDEwcHg7hgFjb2xvcjogIzdlNmYzMjtmb250LXNpemU6IDEzcHg7Ym9yZGVyLXN0eWxlOiBub25lO21hcmdpbi1ib3R0b206IDNweDtmb250LXdlaWdodDogMTIwJTttYXJnaW4tbGVmdDogMTBweDt0ZXh0LWFsaWduOiBsZWZ0O3dpZHRoOjI1MHB4O80BY29sb3I6ICMwYTA5MDc7Zm9udC1zaXplOiAxNHB4O2JhY2tncm91bmQtY29sb3I6ICNlZWQ2NDI7aGVpZ2h0OiAzNXB4O2JvcmRlci1zdHlsZTogc29saWQ7Ym9yZGVyOiBub25lO21hcmdpbi10b3A6IDdweDtwYWRkaW5nLWxlZnQ6IDEwcHg7dGV4dC1hbGlnbjogbGVmdDt3aWR0aDoyMDBweDtib3JkZXItcmFkaXVzOjJweDttYXJnaW4tYm90dG9tOiAxMHB4O2QCAQ9kFgICBw9kFgJmD2QWBgIBDxYCHgRUZXh0ZWQCAw8WAh4LXyFJdGVtQ291bnQCAhYEZg9kFgRmDxUBFFBFUlNPTkFMIElORk9STUFUSU9OZAIBDxYCHwECCRYSZg9kFgICAQ8WAh8ABQVUSVRMRWQCAQ9kFgICAQ8WAh8ABQROQU1FZAICD2QWAgIBDxYCHwAFB1NVUk5BTUVkAgMPZBYCAgEPFgIfAAUFRU1BSUxkAgQPZBYCAgEPFgIfAAULQ0VMTCBOVU1CRVJkAgUPZBYCAgEPFgIfAAUOTUFSSVRBTCBTVEFUVVNkAgYPZBYCAgEPFgIfAAUDQUdFZAIHD2QWAgIBDxYCHwAFBENJVFlkAggPZBYCAgEPFgIfAAUVRU1QTE9ZTUVOVCBPQ0NVUEFUSU9OZAIBD2QWBGYPFQEUVEVSTVMgQU5EIENPTkRJVElPTlNkAgEPFgIfAQIBFgJmD2QWAgIBDxYCHwAFGlRFUk1TIEFORCBDT05ESVRJT05TIEFQUExZZAIFDxYCHwFmZBgCBR5fX0NvbnRyb2xzUmVxdWlyZVBvc3RCYWNrS2V5X18WAQUqcnB0U2VjdGlvbnMkY3RsMDEkcnB0RmllbGRzJGN0bDAwJGNoay03NTkxBQptdkxlYWRGb3JtDw9kZmTQl9fYN/ogbqPfeVAu9vRwlgg5zapxIbfas3w8vD67UQ==">
</div>

<script type="text/javascript">
//<![CDATA[
var theForm = document.forms['form1'];
if (!theForm) {
    theForm = document.form1;
}
function __doPostBack(eventTarget, eventArgument) {
    if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
        theForm.__EVENTTARGET.value = eventTarget;
        theForm.__EVENTARGUMENT.value = eventArgument;
        theForm.submit();
    }
}
//]]>
</script>


<script src="/WebResource.axd?d=sUdMS8w6_QHPrhP4HBe1JD9uiHQFYhwWhhVdFuPWcjLunolV37A7CJrRmi_UQPLKrebvkEuw3d1Ma-2WrIz1mL7TOBjch2iH7eBnXw2kNrA1&amp;t=636161530540000000" type="text/javascript"></script>


<script src="/ScriptResource.axd?d=S-spuEs3-wdicVpach8TpCYmifj5hcioAMOetFN37Dm2D0DNQh7WrwWmQZ6pn4kDLHHk5-MTzdPB_iFgQz_5072SLd8LU2SKOmmp9DwKzIHF0WmjZ_GA5o5YUo8FSX_vjjDVPgRdghef8ntD2sa8coxVBTQ-5-stUh1nihjuJgM1&amp;t=ffffffffccb3b105" type="text/javascript"></script><script language="javascript">function cb_verify(sender) {var cntrl = document.getElementById(sender.controltovalidate);return cntrl.checked;}</script>
<script src="/ScriptResource.axd?d=V-i4f0Jr1q44bC6K6T6VEtkuHTtgLS5upfvdtX3tqMQxuxkRE4NNGJSvPK39i5VCnkAr-6diFaZcZDlkVP1lCP3i-RFvQWCbh3dhu0cpXQ-8nf5p2IoIkFFtr7zrZhDd0&amp;t=f2cd5c5" type="text/javascript"></script>
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<script src="/ScriptResource.axd?d=LNjPDPcibZ3PzGKzjPFsWqK3fJoOBi3gJDYrTuIbuv93VrrsBExRl6_6xk8KH2yH0g84YkJ21fQ39dDJx31v31VlmWHRDVJLFxJmZn-kIb5iNUFnJyi4TlRzbu5xb3RK00jkwt-RH4cN2640ROP7UA2&amp;t=f2cd5c5" type="text/javascript"></script>
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<script src="/ScriptResource.axd?d=cObPwEBjAJvd_aDLJk1Vxi7_0gih1Q4GFhfWyz6-g6hLh7VSOIZ9GzkD-Z5JKEhsERQ03WQ01vy1ZoLFUlqCBT6tfk0EkhxBBYGqstxNpHb5vR_QUT4Ic3AskkeI4GhlL2OSgfaccAIG8kNZ3k4MUw2&amp;t=f2cd5c5" type="text/javascript"></script>
<script src="/ScriptResource.axd?d=iwzZ9JOe5J2nbFUSw8lNeN276DdQqQM3OStiNOl7D4ZH71WGeBp31mUJ8ctin04LFZ6-mbhu20z1m-h1Bl1eXRup1CtUZsPj5n0Gas66EbYZXolguNGf7haW7mVTtMbsfVjibLMjM73h1tmuRqcwQg2&amp;t=f2cd5c5" type="text/javascript"></script>
<script src="/ScriptResource.axd?d=boWkPrfFAPMRNGFe7wrZ6BPsNyJF2tUIoC7HrpWRYmMvNMT5r8XnVasQ0YoV-PoTLP1BXOCVKevY4aEEIgoxgglEMh4Hp5dPPz-A4x8Rq4Ep5x8a8OGyTP4tsbjzqvew0mnuqoeJvq2pRpMCkgeoD5iti6hTcJp18h5AsQgGcfM1&amp;t=f2cd5c5" type="text/javascript"></script>
<script type="text/javascript">
//<![CDATA[
var PageMethods = function() {
PageMethods.initializeBase(this);
this._timeout = 0;
this._userContext = null;
this._succeeded = null;
this._failed = null;
}
PageMethods.prototype = {
_get_path:function() {
 var p = this.get_path();
 if (p) return p;
 else return PageMethods._staticInstance.get_path();},
IsValidIDNumber:function(idnumber,succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'IsValidIDNumber',false,{idnumber:idnumber},succeededCallback,failedCallback,userContext); }}
PageMethods.registerClass('PageMethods',Sys.Net.WebServiceProxy);
PageMethods._staticInstance = new PageMethods();
PageMethods.set_path = function(value) { PageMethods._staticInstance.set_path(value); }
PageMethods.get_path = function() { return PageMethods._staticInstance.get_path(); }
PageMethods.set_timeout = function(value) { PageMethods._staticInstance.set_timeout(value); }
PageMethods.get_timeout = function() { return PageMethods._staticInstance.get_timeout(); }
PageMethods.set_defaultUserContext = function(value) { PageMethods._staticInstance.set_defaultUserContext(value); }
PageMethods.get_defaultUserContext = function() { return PageMethods._staticInstance.get_defaultUserContext(); }
PageMethods.set_defaultSucceededCallback = function(value) { PageMethods._staticInstance.set_defaultSucceededCallback(value); }
PageMethods.get_defaultSucceededCallback = function() { return PageMethods._staticInstance.get_defaultSucceededCallback(); }
PageMethods.set_defaultFailedCallback = function(value) { PageMethods._staticInstance.set_defaultFailedCallback(value); }
PageMethods.get_defaultFailedCallback = function() { return PageMethods._staticInstance.get_defaultFailedCallback(); }
PageMethods.set_enableJsonp = function(value) { PageMethods._staticInstance.set_enableJsonp(value); }
PageMethods.get_enableJsonp = function() { return PageMethods._staticInstance.get_enableJsonp(); }
PageMethods.set_jsonpCallbackParameter = function(value) { PageMethods._staticInstance.set_jsonpCallbackParameter(value); }
PageMethods.get_jsonpCallbackParameter = function() { return PageMethods._staticInstance.get_jsonpCallbackParameter(); }
PageMethods.set_path("generateleadform.aspx");
PageMethods.IsValidIDNumber= function(idnumber,onSuccess,onFailed,userContext) {PageMethods._staticInstance.IsValidIDNumber(idnumber,onSuccess,onFailed,userContext); }
function WebForm_OnSubmit() {
if (typeof(ValidatorOnSubmit) == "function" && ValidatorOnSubmit() == false) return false;
return true;
}
//]]>
</script>

<div class="aspNetHidden">

    <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="0C504E56">
    <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="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">
</div>
            <script type="text/javascript">
//<![CDATA[
Sys.WebForms.PageRequestManager._initialize('ScriptManager1', 'form1', [], [], [], 90, '');
//]]>
</script>


            <input type="hidden" name="myDuplicateCheck" id="myDuplicateCheck">

            
            

                    <!-- Header start -->
                    
                    <!-- Header End -->

                    


                            <div class="sectionname">PERSONAL INFORMATION</div>



                            
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    TITLE:
                                                </div>
                                            </td>
                                            <td>
                                                <select name="rptSections$ctl00$rptFields$ctl00$ddl-7593" id="rptSections_rptFields_0_ddl-7593_0" class="field">
    <option value="-1">--Select one--</option>
    <option value="Adv">Adv</option>
    <option value="Dr">Dr</option>
    <option value="Ds">Ds</option>
    <option value="Mej">Mej</option>
    <option value="Me">Me</option>
    <option value="Mev">Mev</option>
    <option value="Miss">Miss</option>
    <option value="Mnr">Mnr</option>
    <option value="Mr">Mr</option>
    <option value="Mrs">Mrs</option>
    <option value="Ms">Ms</option>
    <option value="Prof">Prof</option>

</select><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7593_0" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl00$_ClientState" id="rptSections_rptFields_0__ClientState_0">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    NAME:
                                                </div>
                                            </td>
                                            <td>
                                                <input name="rptSections$ctl00$rptFields$ctl01$txt-7588" type="text" id="rptSections_rptFields_0_txt-7588_1" class="field" autocomplete="off" style="background-image: url(&quot;data:image/png;base64,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&quot;); background-repeat: no-repeat; background-attachment: scroll; background-size: 16px 18px; background-position: 98% 50%;"><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7588_1" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl01$extreq7588_ClientState" id="rptSections_rptFields_0_extreq7588_ClientState_1">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    SURNAME:
                                                </div>
                                            </td>
                                            <td>
                                                <input name="rptSections$ctl00$rptFields$ctl02$txt-7589" type="text" id="rptSections_rptFields_0_txt-7589_2" class="field"><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7589_2" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl02$extreq7589_ClientState" id="rptSections_rptFields_0_extreq7589_ClientState_2">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    EMAIL:
                                                </div>
                                            </td>
                                            <td>
                                                <input name="rptSections$ctl00$rptFields$ctl03$txt-7590" type="text" id="rptSections_rptFields_0_txt-7590_3" class="field"><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7590_3" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl03$extreq7590_ClientState" id="rptSections_rptFields_0_extreq7590_ClientState_3"><span id="rptSections_rptFields_0_rev7590_3" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl03$extreg7590_ClientState" id="rptSections_rptFields_0_extreg7590_ClientState_3">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    CELL NUMBER:
                                                </div>
                                            </td>
                                            <td>
                                                <input name="rptSections$ctl00$rptFields$ctl04$txt-7592" type="text" id="rptSections_rptFields_0_txt-7592_4" class="field"><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7592_4" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl04$extreq7592_ClientState" id="rptSections_rptFields_0_extreq7592_ClientState_4"><span id="rptSections_rptFields_0_rev7592_4" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl04$extreg7592_ClientState" id="rptSections_rptFields_0_extreg7592_ClientState_4">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    MARITAL STATUS:
                                                </div>
                                            </td>
                                            <td>
                                                <select name="rptSections$ctl00$rptFields$ctl05$ddl-7595" id="rptSections_rptFields_0_ddl-7595_5" class="field">
    <option value="-1">--Select one--</option>
    <option value="Married with children/dependants">Married with children/dependants</option>
    <option value="Married without children/dependants">Married without children/dependants</option>
    <option value="Single with children/dependants">Single with children/dependants</option>
    <option value="Single without children/dependants">Single without children/dependants</option>

</select><span style="color: #ff0000;font-size: 18px;border-style: none;">*</span><span id="rptSections_rptFields_0_val7595_5" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl00$rptFields$ctl05$_ClientState" id="rptSections_rptFields_0__ClientState_5">
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    AGE:
                                                </div>
                                            </td>
                                            <td>
                                                <select name="rptSections$ctl00$rptFields$ctl06$ddl-7596" id="rptSections_rptFields_0_ddl-7596_6" class="field">
    <option value="-1">--Select one--</option>
    <option value="0-17 years old">0-17 years old</option>
    <option value="18-20 years old">18-20 years old</option>
    <option value="21-24 years old">21-24 years old</option>
    <option value="25-54 years old">25-54 years old</option>
    <option value="55+ years old">55+ years old</option>

</select><span style="color: #ff0000;font-size: 18px;border-style: none;">&nbsp;</span>
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    CITY:
                                                </div>
                                            </td>
                                            <td>
                                                <select name="rptSections$ctl00$rptFields$ctl07$ddl-7597" id="rptSections_rptFields_0_ddl-7597_7" class="field">
    <option value="-1">--Select one--</option>
    <option value="Johannesburg">Johannesburg</option>
    <option value="Pretoria">Pretoria</option>
    <option value="Cape Town">Cape Town</option>
    <option value="Durban">Durban</option>
    <option value="Nelspruit">Nelspruit</option>
    <option value="Bloemfontein">Bloemfontein</option>
    <option value="PE">PE</option>
    <option value="East London">East London</option>
    <option value="Other">Other</option>

</select><span style="color: #ff0000;font-size: 18px;border-style: none;">&nbsp;</span>
                                            </td>
                                        </tr>
                                    </tbody></table>
                                
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    EMPLOYMENT OCCUPATION:
                                                </div>
                                            </td>
                                            <td>
                                                <select name="rptSections$ctl00$rptFields$ctl08$ddl-7598" id="rptSections_rptFields_0_ddl-7598_8" class="field">
    <option value="-1">--Select one--</option>

</select><span style="color: #ff0000;font-size: 18px;border-style: none;">&nbsp;</span>
                                            </td>
                                        </tr>
                                    </tbody></table>
                                

                        


                            <div class="sectionname">TERMS AND CONDITIONS</div>



                            
                                    <table class="fieldtable" cellpadding="0" cellspacing="0">
                                        <tbody><tr>
                                            <td>
                                                <div class="fieldname">
                                                    
                                                    <!-- TERMS AND CONDITIONS APPLY:  -->
                                                </div>
                                            </td>
                                            <td>
                                                <input id="rptSections_rptFields_1_chk-7591_0" type="checkbox" name="rptSections$ctl01$rptFields$ctl00$chk-7591" checked="checked">
                                                <label for="rptSections_rptFields_1_chk-7591_0">TERMS AND CONDITIONS APPLY:</label> 
                                                <span id="rptSections_rptFields_1_val7591_0" class="error" style="display:none;"></span><input type="hidden" name="rptSections$ctl01$rptFields$ctl00$_ClientState" id="rptSections_rptFields_1__ClientState_0">

                                            </td>
                                        </tr>
                                    </tbody></table>
                                

                        

                    



                    <div style="margin-top: 10px; text-align: center;">
                        <input type="submit" name="ctl03" value="Submit" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions(&quot;ctl03&quot;, &quot;&quot;, true, &quot;form&quot;, &quot;&quot;, false, false))" class="firstbutton" style="color: #0a0907;font-size: 18px;font-family: Arial;background-color: #ffffff;width:200px;height: 45px;border-style: none;font-weight: bold;text-align: center;border-radius:2px;align:left;cursor:pointer;margin-bottom:20px;margin-top:30px;">
                    </div>
                    <!-- Footer start -->
                    
                    <!-- Footer end -->
                

            <!--<div style="width: 100%; text-align: center; margin-top: 50px;">
                <span id="siteseal">
                    <script type="text/javascript" src="https://seal.godaddy.com/getSeal?sealID=DNQdNni1wsHLuDMV9xEmRxLCbKVSrrkKEDPWyMBMGShMmbx7ktJY9"></script>
                    <br />
                    <a style="font-family: arial; font-size: 9px" href="http://www.godaddy.com/ssl/ssl-certificates.aspx" target="_blank">secure socket layer</a></span>
            </div> -->
        
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rptSections_rptFields_0_rev7590_3.focusOnError = "t";
rptSections_rptFields_0_rev7590_3.errormessage = "<br/>Please enter a valid email address";
rptSections_rptFields_0_rev7590_3.display = "None";
rptSections_rptFields_0_rev7590_3.validationGroup = "form";
rptSections_rptFields_0_rev7590_3.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
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rptSections_rptFields_0_val7592_4.display = "None";
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rptSections_rptFields_0_rev7592_4.focusOnError = "t";
rptSections_rptFields_0_rev7592_4.errormessage = "<br/>Please provide a valid cellphone number eg 0822345678";
rptSections_rptFields_0_rev7592_4.display = "None";
rptSections_rptFields_0_rev7592_4.validationGroup = "form";
rptSections_rptFields_0_rev7592_4.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
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rptSections_rptFields_0_val7595_5.focusOnError = "t";
rptSections_rptFields_0_val7595_5.errormessage = "<br/>Please provide your marital status";
rptSections_rptFields_0_val7595_5.display = "None";
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    $create(Sys.Extended.UI.ValidatorCalloutBehavior, {"ClientStateFieldID":"rptSections_rptFields_0_extreq7592_ClientState_4","closeImageUrl":"/WebResource.axd?d=owyKsU5R-B1LlMvaLf-0yKLKJz4D2thZzFuDTmMeUW2-hjavXJMyEZn2OyoFhHaPDxw-9AUQlY8ytKhWGk0XzNc2P5N_6NEAuqE9w-mWZLHxKKwSWj5oT_qUXJAwfz5Py-A67pOP9w443Me_Ej8PNQ2\u0026t=635295291340000000","id":"rptSections_rptFields_0_extreq7592_4","popupPosition":3,"warningIconImageUrl":"/WebResource.axd?d=ud7GZIhSsctZ5tB695FmsQxXF0cl_02TA-wSBt-gl9tl7co2G2QXqL6WlVnzBD4RsmIgFCR526ATa0JWaPL1YwNa5xFVajcGB1IWvISgIjYeEKs6_PEeuLCDWgOvTjy5j3-Tk3yP8vx_O2dLbW2UXw2\u0026t=635295291340000000"}, null, null, $get("rptSections_rptFields_0_val7592_4"));
});

document.getElementById('rptSections_rptFields_0_rev7592_4').dispose = function() {
    Array.remove(Page_Validators, document.getElementById('rptSections_rptFields_0_rev7592_4'));
}
Sys.Application.add_init(function() {
    $create(Sys.Extended.UI.ValidatorCalloutBehavior, {"ClientStateFieldID":"rptSections_rptFields_0_extreg7592_ClientState_4","closeImageUrl":"/WebResource.axd?d=owyKsU5R-B1LlMvaLf-0yKLKJz4D2thZzFuDTmMeUW2-hjavXJMyEZn2OyoFhHaPDxw-9AUQlY8ytKhWGk0XzNc2P5N_6NEAuqE9w-mWZLHxKKwSWj5oT_qUXJAwfz5Py-A67pOP9w443Me_Ej8PNQ2\u0026t=635295291340000000","id":"rptSections_rptFields_0_extreg7592_4","popupPosition":3,"warningIconImageUrl":"/WebResource.axd?d=ud7GZIhSsctZ5tB695FmsQxXF0cl_02TA-wSBt-gl9tl7co2G2QXqL6WlVnzBD4RsmIgFCR526ATa0JWaPL1YwNa5xFVajcGB1IWvISgIjYeEKs6_PEeuLCDWgOvTjy5j3-Tk3yP8vx_O2dLbW2UXw2\u0026t=635295291340000000"}, null, null, $get("rptSections_rptFields_0_rev7592_4"));
});

document.getElementById('rptSections_rptFields_0_val7595_5').dispose = function() {
    Array.remove(Page_Validators, document.getElementById('rptSections_rptFields_0_val7595_5'));
}
Sys.Application.add_init(function() {
    $create(Sys.Extended.UI.ValidatorCalloutBehavior, {"ClientStateFieldID":"rptSections_rptFields_0__ClientState_5","closeImageUrl":"/WebResource.axd?d=owyKsU5R-B1LlMvaLf-0yKLKJz4D2thZzFuDTmMeUW2-hjavXJMyEZn2OyoFhHaPDxw-9AUQlY8ytKhWGk0XzNc2P5N_6NEAuqE9w-mWZLHxKKwSWj5oT_qUXJAwfz5Py-A67pOP9w443Me_Ej8PNQ2\u0026t=635295291340000000","id":"rptSections_rptFields_0_ctl01_5","popupPosition":3,"warningIconImageUrl":"/WebResource.axd?d=ud7GZIhSsctZ5tB695FmsQxXF0cl_02TA-wSBt-gl9tl7co2G2QXqL6WlVnzBD4RsmIgFCR526ATa0JWaPL1YwNa5xFVajcGB1IWvISgIjYeEKs6_PEeuLCDWgOvTjy5j3-Tk3yP8vx_O2dLbW2UXw2\u0026t=635295291340000000"}, null, null, $get("rptSections_rptFields_0_val7595_5"));
});

document.getElementById('rptSections_rptFields_1_val7591_0').dispose = function() {
    Array.remove(Page_Validators, document.getElementById('rptSections_rptFields_1_val7591_0'));
}
Sys.Application.add_init(function() {
    $create(Sys.Extended.UI.ValidatorCalloutBehavior, {"ClientStateFieldID":"rptSections_rptFields_1__ClientState_0","closeImageUrl":"/WebResource.axd?d=owyKsU5R-B1LlMvaLf-0yKLKJz4D2thZzFuDTmMeUW2-hjavXJMyEZn2OyoFhHaPDxw-9AUQlY8ytKhWGk0XzNc2P5N_6NEAuqE9w-mWZLHxKKwSWj5oT_qUXJAwfz5Py-A67pOP9w443Me_Ej8PNQ2\u0026t=635295291340000000","id":"rptSections_rptFields_1_ctl00_0","popupPosition":3,"warningIconImageUrl":"/WebResource.axd?d=ud7GZIhSsctZ5tB695FmsQxXF0cl_02TA-wSBt-gl9tl7co2G2QXqL6WlVnzBD4RsmIgFCR526ATa0JWaPL1YwNa5xFVajcGB1IWvISgIjYeEKs6_PEeuLCDWgOvTjy5j3-Tk3yP8vx_O2dLbW2UXw2\u0026t=635295291340000000"}, null, null, $get("rptSections_rptFields_1_val7591_0"));
});
//]]>
</script>
</form>
    </div>
  
  

</body>

</html>

/*Downloaded from https://www.codeseek.co/etienneatcofoundry/thinkmoney-long-form-oZbjzY */
body .lmtform .sectionname {
  font-family:"Asap-Italic";
  font-size:25px;
  color:#464646;
  margin-top:35px;
}

body .lmtform .fieldtable{
    margin:0;
    padding:0;
    width:100%;
    margin-bottom:26px;
}

body .lmtform .fieldtable td{
    display:block;
    float:left;
    width:100%;
}

body .lmtform .fieldtable .fieldname{
    width:100%;

    font-family:"Asap-Bold";
    font-size:14px;
    color:#464646;

    text-transform:uppercase;

    opacity:0.8;

    letter-spacing:3px;

    margin-bottom:2px;
}

body .lmtform .fieldtable .fieldname:last-of-type{
    width:auto;
}

body .lmtform .fieldtable:last-of-type td{
    width:auto;
}

body .lmtform .fieldtable .field{
    width:97%;
    margin-left:10px;
    margin-right:5px;
    margin-top:0px;

    border-radius:6px;

    font-family:"Asap-Italic";
    font-size:20px;
    color:#464646;

    min-height:40px;

    padding-top:0;

    padding-left:8px;
    padding-right:8px;
}

body .lmtform .fieldtable input.field{
    width:95.5%;
}

body .lmtform #form1 > div:last-of-type{
    text-align:left !important;
}

body .lmtform #form1 > div:last-of-type input{
    font-family: "Asap-Bold" !important;
    font-size: 13px !important;
    color: #666666 !important;
    border-radius: 6px !important;
    border: none !important;
    /*padding: 18px 33px 17px 33px !important;*/
    display: inline-block !important;
    margin-bottom: 35px !important;
    font-weight: normal !important;
    text-align: center !important;
    vertical-align: middle !important;
    touch-action: manipulation !important;
    cursor: pointer !important;
    background-image: none !important;
    white-space: nowrap !important;
    line-height: 1.42857 !important;
    box-sizing: border-box !important;
    margin-top:15px !important;
    margin-left:12px;
}

body .lmtform #form1 > div:last-of-type input:hover{
    background-color: #e6e6e6 !important;
}

/*CHECKBOX STYLES*/

body .lmtform .fieldtable td input[type="checkbox"]{
    display: none;
}

body .lmtform .fieldtable td input[type="checkbox"] + label:before {
    content: '\00a0';
    display: inline-block;
    width: 20px;
    height: 22px;
    font-size: 16px;
    font-family: 'Arial Unicode MS';
    background-color: #337ab7;
    border: 1px solid grey;
    color: white;
    text-align: right;
    cursor: pointer;

    margin-right:10px;

    border-radius:3px;

    margin-left:2px;
}

body .lmtform .fieldtable td input[type="checkbox"]:checked + label:before {
    content: '\2714';
}


body .lmtform .fieldtable td label{

    font-family:"Asap-Bold" !important;
    font-size:14px !important;
    color:#464646 !important;

    text-transform:uppercase !important;

    opacity:0.8 !important;

    letter-spacing:3px !important;

    margin-bottom:2px !important;
}

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