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<!-- Note :

   - You can modify the font style and form style to suit your website.

   - 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.

   - The Mandatory check script can modified as to suit your business needs.

   - It is important that you test the modified form before going live.-->

<div id='crmWebToEntityForm' class='zcwf_lblLeft crmWebToEntityForm' style='background-color: #E0FCFF;color: black;max-width: 600px;'>

  <meta name='viewport' content='width=device-width, initial-scale=1.0'>

   <META HTTP-EQUIV ='content-type' CONTENT='text/html;charset=UTF-8'>

   <form action='https://crm.zoho.com/crm/WebToLeadForm' name=WebToLeads366325000037219046 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory366325000037219046()' accept-charset='UTF-8'>

<input type='text' style='display:none;' name='xnQsjsdp' value='ab400fd33fdb2a5667561697a125636a818d6e8161458c17ef8b933c4e4cbd34'></input>

 <input type='hidden' name='zc_gad' id='zc_gad' value=''></input>

<input type='text' style='display:none;' name='xmIwtLD' value='21f91c6cae701275e5ad144a0eeee243aa6a682a26de0d7fb378abaf9d0fce8a'></input>

 <input type='text'  style='display:none;' name='actionType' value='TGVhZHM='></input>

<input type='text' style='display:none;' name='returnURL' value='https&#x3a;&#x2f;&#x2f;korenpub.com&#x2f;' > </input>

              <!-- Do not remove this code. -->

<style>

html,body{

              margin: 0px;

}

#crmWebToEntityForm.zcwf_lblLeft {

              width:100%;

              padding: 25px;

              margin: 0 auto;

              box-sizing: border-box;

}

#crmWebToEntityForm.zcwf_lblLeft * {

              box-sizing: border-box;

}

#crmWebToEntityForm{text-align: left;}

#crmWebToEntityForm * {

              direction: ltr;

}

.zcwf_lblLeft .zcwf_title {

              word-wrap: break-word;

              padding: 0px 6px 10px;

              font-weight:bold }.zcwf_lblLeft.cpT_primaryBtn:hover{

              background: linear-gradient(#02acff 0,#006be4 100%) no-repeat padding-box !important;

              box-shadow: 0 -2px 0 0 #0159b9 inset !important;

              border: 0 !important;

              color: #fff !important;

              outline: 0 !important;

}.zcwf_lblLeft .zcwf_col_fld input[type=text], input[type=password], .zcwf_lblLeft .zcwf_col_fld textarea {

              width: 60%;

              border: 1px solid #c0c6cc !important;

              resize: vertical;

              border-radius: 2px;

              float: left;

}

.zcwf_lblLeft .zcwf_col_lab {

              width: 30%;

              word-break: break-word;

              padding: 0px 6px 0px;

              margin-right: 10px;

              margin-top: 5px;

              float: left;

              min-height: 1px;

}

.zcwf_lblLeft .zcwf_col_fld {

              float: left;

              width: 68%;

              padding: 0px 6px 0px;

              position: relative;

              margin-top: 5px;

}

.zcwf_lblLeft .zcwf_privacy{padding: 6px;}

.zcwf_lblLeft .wfrm_fld_dpNn{display: none;}

.dIB{display: inline-block;}

.zcwf_lblLeft .zcwf_col_fld_slt {

              width: 60%;

              border: 1px solid #ccc;

              background: #fff;

              border-radius: 4px;

              font-size: 12px;

              float: left;

              resize: vertical;

              padding: 2px 5px;

}

.zcwf_lblLeft .zcwf_row:after, .zcwf_lblLeft .zcwf_col_fld:after {

              content: '';

              display: table;

              clear: both;

}

.zcwf_lblLeft .zcwf_col_help {

              float: left;

              margin-left: 7px;

              font-size: 12px;

              max-width: 35%;

              word-break: break-word;

}

.zcwf_lblLeft .zcwf_help_icon {

              cursor: pointer;

              width: 16px;

              height: 16px;

              display: inline-block;

              background: #fff;

              border: 1px solid #c0c6cc;

              color: #c1c1c1;

              text-align: center;

              font-size: 11px;

              line-height: 16px;

              font-weight: bold;

              border-radius: 50%;

}

.zcwf_lblLeft .zcwf_row {margin: 15px 0px;}

.zcwf_lblLeft .formsubmit {

              margin-right: 5px;

              cursor: pointer;

              color: var(--baseColor);

              font-size: 12px;

}

.zcwf_lblLeft .zcwf_privacy_txt {

              width: 90%;

              color: rgb(0, 0, 0);

              font-size: 12px;

              font-family: Georgia;

              display: inline-block;

              vertical-align: top;

              color: var(--baseColor);

              padding-top: 2px;

              margin-left: 6px;

}

.zcwf_lblLeft .zcwf_button {

              font-size: 12px;

              color: var(--baseColor);

              border: 1px solid #c0c6cc;

              padding: 3px 9px;

              border-radius: 4px;

              cursor: pointer;

              max-width: 120px;

              overflow: hidden;

              text-overflow: ellipsis;

              white-space: nowrap;

}

.zcwf_lblLeft .zcwf_tooltip_over{

              position: relative;

}

.zcwf_lblLeft .zcwf_tooltip_ctn{

              position: absolute;

              background: #dedede;

              padding: 3px 6px;

              top: 3px;

              border-radius: 4px;word-break: break-word;

              min-width: 100px;

              max-width: 150px;

              color: var(--baseColor);

              z-index: 100;

}

.zcwf_lblLeft .zcwf_ckbox{

              float: left;

}

.zcwf_lblLeft .zcwf_file{

              width: 55%;

              box-sizing: border-box;

              float: left;

}

.clearB:after{

              content:'';

              display: block;

              clear: both;

}

@media all and (max-width: 600px) {

              .zcwf_lblLeft .zcwf_col_lab, .zcwf_lblLeft .zcwf_col_fld {

                             width: auto;

                             float: none !important;

              }

              .zcwf_lblLeft .zcwf_col_help {width: 40%;}

}

</style>

<div class='zcwf_title' style='max-width: 600px;color: black; font-family:Georgia;'>Koren Signup for the Chabad Kinnus 5784</div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='First_Name'>First Name<span style='color:red;'>*</span></label></div><div class='zcwf_col_fld'><input type='text' id='First_Name' name='First Name' maxlength='40'></input><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='Last_Name'>Last Name<span style='color:red;'>*</span></label></div><div class='zcwf_col_fld'><input type='text' id='Last_Name' name='Last Name' maxlength='80'></input><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='Email'>Email<span style='color:red;'>*</span></label></div><div class='zcwf_col_fld'><input type='text' ftype='email' autocomplete='false' id='Email' name='Email' maxlength='100'></input><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='Phone'>Phone</label></div><div class='zcwf_col_fld'><input type='text' id='Phone' name='Phone' maxlength='30'></input><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='LEADCF4'>Position<span style='color:red;'>*</span></label></div><div class='zcwf_col_fld'><input type='text' id='LEADCF4' name='LEADCF4' maxlength='100'></input><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_col_lab' style='font-size:12px; font-family: Georgia;'><label for='Description'>Description</label></div><div class='zcwf_col_fld'><textarea id='Description' name='Description'></textarea><div class='zcwf_col_help'></div></div></div><div class='zcwf_row'><div class='zcwf_privacy'><div class='dIB vat' align='left'><div class='displayPurpose  f13'><label class='newCustomchkbox-md dIB w100per'><input autocomplete='off' id='privacyTool366325000037219046' type='checkbox' name='privacyTool' onclick='disableErr366325000037219046()'></label></div></div><div class='dIB zcwf_privacy_txt' style='font-size: 12px;font-family:Georgia;color: black;'>I agree to the Koren Publishers <a href='https://korenpub.com/policies/privacy-policy' title='https://korenpub.com/policies/privacy-policy' target='_blank'>Privacy Policy</a> and <a href='https://korenpub.com/policies/terms-of-service' title='https://korenpub.com/policies/terms-of-service' target='_blank'>Terms of Service.</a><div>And agree to join the curated Chabad Koren Mailing list for new releases and sales.&nbsp;</div></div> <div  id='privacyErr366325000037219046' style='font-size:12px;color:red;padding-left: 5px;visibility:hidden;'>Please accept this</div></div></div><div class='zcwf_row'><div class='zcwf_col_lab'></div><div class='zcwf_col_fld'><input type='submit' id='formsubmit' class='formsubmit zcwf_button' value='Submit' title='Submit'><input type='reset' class='zcwf_button' name='reset' value='Reset' title='Reset'></div></div>

              <script>

                             function privacyAlert366325000037219046()

                             {

                                           var privacyTool = document.getElementById('privacyTool366325000037219046');

                                           var privacyErr = document.getElementById('privacyErr366325000037219046');

                                           if(privacyTool !=undefined && !privacyTool.checked )

                                           {

                                                          privacyErr.style.visibility='visible';

                                                          privacyTool.focus();

                                                          return false;

                                           }

                                           return true;

                             }

                             function disableErr366325000037219046()

                             {

                                           var privacyTool = document.getElementById('privacyTool366325000037219046');

                                           var privacyErr = document.getElementById('privacyErr366325000037219046');

                                           if(privacyTool !=undefined && privacyTool.checked && privacyErr !=undefined )

                                           {

                                                          privacyErr.style.visibility='hidden';

                                           }

                             }

              function validateEmail366325000037219046()

              {

                             var form = document.forms['WebToLeads366325000037219046'];

                             var emailFld = form.querySelectorAll('[ftype=email]');

                             var i;

                             for (i = 0; i < emailFld.length; i++)

                             {

                                           var emailVal = emailFld[i].value;

                                           if((emailVal.replace(/^\s+|\s+$/g, '')).length!=0 )

                                           {

                                                          var atpos=emailVal.indexOf('@');

                                                          var dotpos=emailVal.lastIndexOf('.');

                                                          if (atpos<1 || dotpos<atpos+2 || dotpos+2>=emailVal.length)

                                                          {

                                                                        alert('Please enter a valid email address. ');

                                                                        emailFld[i].focus();

                                                                        return false;

                                                          }

                                           }

                             }

                             return true;

              }

 

               function checkMandatory366325000037219046() {

                             var mndFileds = new Array('First Name','Last Name','Email','LEADCF4');

                             var fldLangVal = new Array('First\x20Name','Last\x20Name','Email','Position');

                             for(i=0;i<mndFileds.length;i++) {

                               var fieldObj=document.forms['WebToLeads366325000037219046'][mndFileds[i]];

                               if(fieldObj) {

                                           if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0) {

                                           if(fieldObj.type =='file')

                                                          {

                                                           alert('Please select a file to upload.');

                                                           fieldObj.focus();

                                                           return false;

                                                          }

                                           alert(fldLangVal[i] +' cannot be empty.');

                                            fieldObj.focus();

                                            return false;

                                           }  else if(fieldObj.nodeName=='SELECT') {

                                           if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {

                                                          alert(fldLangVal[i] +' cannot be none.');

                                                          fieldObj.focus();

                                                          return false;

                                              }

                                           } else if(fieldObj.type =='checkbox'){

                                          if(fieldObj.checked == false){

                                                          alert('Please accept  '+fldLangVal[i]);

                                                          fieldObj.focus();

                                                          return false;

                                              }

                                            }

                                            try {

                                                if(fieldObj.name == 'Last Name') {

                                                          name = fieldObj.value;

                                             }

                                           } catch (e) {}

                                 }

                             }

                             if(!validateEmail366325000037219046()){return false;}

                            

                             if(!privacyAlert366325000037219046()){return false;}

                             document.querySelector('.crmWebToEntityForm .formsubmit').setAttribute('disabled', true);

              }

 

function tooltipShow366325000037219046(el){

              var tooltip = el.nextElementSibling;

              var tooltipDisplay = tooltip.style.display;

              if(tooltipDisplay == 'none'){

                             var allTooltip = document.getElementsByClassName('zcwf_tooltip_over');

                             for(i=0; i<allTooltip.length; i++){

                                           allTooltip[i].style.display='none';

                             }

                             tooltip.style.display = 'block';

              }else{

                             tooltip.style.display='none';

              }

}

</script>

              </form>

</div>