Active Campaign Test
ActiveCampaign Form
@import url(https://fonts.bunny.net/css?family=albert-sans:400,700);
#_form_1_{font-size:14px;line-height:1.6;font-family:arial, helvetica, sans-serif;margin:0}._form_hide{display:none;visibility:hidden}._form_show{display:block;visibility:visible}#_form_1_._form-top{top:0}#_form_1_._form-bottom{bottom:0}#_form_1_._form-left{left:0}#_form_1_._form-right{right:0}#_form_1_ input[type="text"],#_form_1_ input[type="tel"],#_form_1_ input[type="date"],#_form_1_ textarea{padding:6px;height:auto;border:#979797 1px solid;border-radius:4px;color:#000 !important;font-size:14px;-webkit-box-sizing:border-box;-moz-box-sizing:border-box;box-sizing:border-box}#_form_1_ textarea{resize:none}#_form_1_ ._submit{-webkit-appearance:none;cursor:pointer;font-family:arial, sans-serif;font-size:14px;text-align:center;background:#004CFF !important;border:0 !important;-moz-border-radius:4px !important;-webkit-border-radius:4px !important;border-radius:4px !important;color:#FFFFFF !important;padding:10px !important}#_form_1_ ._submit:disabled{cursor:not-allowed;opacity:0.4}#_form_1_ ._submit.processing{position:relative}#_form_1_ ._submit.processing::before{content:"";width:1em;height:1em;position:absolute;z-index:1;top:50%;left:50%;border:double 3px transparent;border-radius:50%;background-image:linear-gradient(#004CFF, #004CFF), conic-gradient(#004CFF, #FFFFFF);background-origin:border-box;background-clip:content-box, border-box;animation:1200ms ease 0s infinite normal none running _spin}#_form_1_ ._submit.processing::after{content:"";position:absolute;top:0;bottom:0;left:0;right:0;background:#004CFF !important;border:0 !important;-moz-border-radius:4px !important;-webkit-border-radius:4px !important;border-radius:4px !important;color:#FFFFFF !important;padding:10px !important}@keyframes _spin{0%{transform:translate(-50%, -50%) rotate(90deg)}100%{transform:translate(-50%, -50%) rotate(450deg)}}#_form_1_ ._close-icon{cursor:pointer;background-image:url("https://d226aj4ao1t61q.cloudfront.net/esfkyjh1u_forms-close-dark.png");background-repeat:no-repeat;background-size:14.2px 14.2px;position:absolute;display:block;top:11px;right:9px;overflow:hidden;width:16.2px;height:16.2px}#_form_1_ ._close-icon:before{position:relative}#_form_1_ ._form-body{margin-bottom:30px}#_form_1_ ._form-image-left{width:150px;float:left}#_form_1_ ._form-content-right{margin-left:164px}#_form_1_ ._form-branding{color:#fff;font-size:10px;clear:both;text-align:left;margin-top:30px;font-weight:100}#_form_1_ ._form-branding ._logo{display:block;width:130px;height:14px;margin-top:6px;background-image:url("https://d226aj4ao1t61q.cloudfront.net/hh9ujqgv5_aclogo_li.png");background-size:130px auto;background-repeat:no-repeat}#_form_1_ .form-sr-only{position:absolute;width:1px;height:1px;padding:0;margin:-1px;overflow:hidden;clip:rect(0, 0, 0, 0);border:0}#_form_1_ ._form-label,#_form_1_ ._form_element ._form-label{font-weight:bold;margin-bottom:5px;display:block}#_form_1_._dark ._form-branding{color:#333}#_form_1_._dark ._form-branding ._logo{background-image:url("https://d226aj4ao1t61q.cloudfront.net/jftq2c8s_aclogo_dk.png")}#_form_1_ ._form_element{position:relative;margin-bottom:10px;font-size:0;max-width:100%}#_form_1_ ._form_element *{font-size:14px}#_form_1_ ._form_element._clear{clear:both;width:100%;float:none}#_form_1_ ._form_element._clear:after{clear:left}#_form_1_ ._form_element input[type="text"],#_form_1_ ._form_element input[type="date"],#_form_1_ ._form_element select,#_form_1_ ._form_element textarea:not(.g-recaptcha-response){display:block;width:100%;-webkit-box-sizing:border-box;-moz-box-sizing:border-box;box-sizing:border-box;font-family:inherit}#_form_1_ ._field-wrapper{position:relative}#_form_1_ ._inline-style{float:left}#_form_1_ ._inline-style input[type="text"]{width:150px}#_form_1_ ._inline-style:not(._clear){margin-right:20px}#_form_1_ ._form_element img._form-image{max-width:100%}#_form_1_ ._form_element ._form-fieldset{border:0;padding:0.01em 0 0 0;margin:0;min-width:0}#_form_1_ ._clear-element{clear:left}#_form_1_ ._full_width{width:100%}#_form_1_ ._form_full_field{display:block;width:100%;margin-bottom:10px}#_form_1_ input[type="text"]._has_error,#_form_1_ textarea._has_error{border:#F37C7B 1px solid}#_form_1_ input[type="checkbox"]._has_error{outline:#F37C7B 1px solid}#_form_1_ ._show_be_error{float:left}#_form_1_ ._error{display:block;position:absolute;font-size:14px;z-index:10000001}#_form_1_ ._error._above{padding-bottom:4px;bottom:39px;right:0}#_form_1_ ._error._below{padding-top:8px;top:100%;right:0}#_form_1_ ._error._above ._error-arrow{bottom:-4px;right:15px;border-left:8px solid transparent;border-right:8px solid transparent;border-top:8px solid #FFDDDD}#_form_1_ ._error._below ._error-arrow{top:0;right:15px;border-left:8px solid transparent;border-right:8px solid transparent;border-bottom:8px solid #FFDDDD}#_form_1_ ._error-inner{padding:12px 12px 12px 36px;background-color:#FFDDDD;background-image:url("data:image/svg+xml,%3Csvg width='16' height='16' viewBox='0 0 16 16' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M16 8C16 12.4183 12.4183 16 8 16C3.58172 16 0 12.4183 0 8C0 3.58172 3.58172 0 8 0C12.4183 0 16 3.58172 16 8ZM9 3V9H7V3H9ZM9 13V11H7V13H9Z' fill='%23CA0000'/%3E%3C/svg%3E");background-repeat:no-repeat;background-position:12px center;font-size:14px;font-family:arial, sans-serif;font-weight:600;line-height:16px;color:#000;text-align:center;text-decoration:none;-webkit-border-radius:4px;-moz-border-radius:4px;border-radius:4px;box-shadow:0 1px 4px rgba(31, 33, 41, 0.298295)}@media only screen and (max-width:319px){#_form_1_ ._error-inner{padding:7px 7px 7px 25px;font-size:12px;line-height:12px;background-position:4px center;max-width:100px;white-space:nowrap;overflow:hidden;text-overflow:ellipsis}}#_form_1_ ._error-inner._form_error{margin-bottom:5px;text-align:left}#_form_1_ ._button-wrapper ._error-inner._form_error{position:static}#_form_1_ ._error-inner._no_arrow{margin-bottom:10px}#_form_1_ ._error-arrow{position:absolute;width:0;height:0}#_form_1_ ._error-html{margin-bottom:10px}.pika-single{z-index:10000001 !important}#_form_1_ input[type="text"].datetime_date{width:69%;display:inline}#_form_1_ select.datetime_time{width:29%;display:inline;height:32px}#_form_1_ input[type="date"].datetime_date{width:69%;display:inline-flex}#_form_1_ input[type="time"].datetime_time{width:29%;display:inline-flex}@media (min-width:320px) and (max-width:667px){::-webkit-scrollbar{display:none}#_form_1_{margin:0;width:100%;min-width:100%;max-width:100%;box-sizing:border-box}#_form_1_ *{-webkit-box-sizing:border-box;-moz-box-sizing:border-box;box-sizing:border-box;font-size:1em}#_form_1_ ._form-content{margin:0;width:100%}#_form_1_ ._form-inner{display:block;min-width:100%}#_form_1_ ._form-title,#_form_1_ ._inline-style{margin-top:0;margin-right:0;margin-left:0}#_form_1_ ._form-title{font-size:1.2em}#_form_1_ ._form_element{margin:0 0 20px;padding:0;width:100%}#_form_1_ ._form-element,#_form_1_ ._inline-style,#_form_1_ input[type="text"],#_form_1_ label,#_form_1_ p,#_form_1_ textarea:not(.g-recaptcha-response){float:none;display:block;width:100%}#_form_1_ ._row._checkbox-radio label{display:inline}#_form_1_ ._row,#_form_1_ p,#_form_1_ label{margin-bottom:0.7em;width:100%}#_form_1_ ._row input[type="checkbox"],#_form_1_ ._row input[type="radio"]{margin:0 !important;vertical-align:middle !important}#_form_1_ ._row input[type="checkbox"]+span label{display:inline}#_form_1_ ._row span label{margin:0 !important;width:initial !important;vertical-align:middle !important}#_form_1_ ._form-image{max-width:100%;height:auto !important}#_form_1_ input[type="text"]{padding-left:10px;padding-right:10px;font-size:16px;line-height:1.3em;-webkit-appearance:none}#_form_1_ input[type="radio"],#_form_1_ input[type="checkbox"]{display:inline-block;width:1.3em;height:1.3em;font-size:1em;margin:0 0.3em 0 0;vertical-align:baseline}#_form_1_ button[type="submit"]{padding:20px;font-size:1.5em}#_form_1_ ._inline-style{margin:20px 0 0 !important}#_form_1_ ._inline-style input[type="text"]{width:100%}}#_form_1_ .sms_consent_checkbox{position:relative;width:100%;display:flex;align-items:flex-start;padding:20px 0}#_form_1_ .sms_consent_checkbox input[type="checkbox"]{float:left;margin:5px 10px 10px 0}#_form_1_ .sms_consent_checkbox .sms_consent_message{display:inline;float:left;text-align:left;margin-bottom:10px;font-size:14px;color:#7D8799}#_form_1_ .sms_consent_checkbox .sms_consent_message.sms_consent_mini{width:90%}#_form_1_ .sms_consent_checkbox ._error._above{right:auto;bottom:0}#_form_1_ .sms_consent_checkbox ._error._above ._error-arrow{right:auto;left:5px}@media (min-width:320px) and (max-width:667px){#_form_1_ .sms_consent_checkbox ._error._above{top:-30px;left:0;bottom:auto}}#_form_1_ .field-required{color:#FF0000}#_form_1_{position:relative;text-align:left;margin:25px auto 0;padding-top:20px;padding-right:20px;padding-bottom:20px;padding-left:20px;-webkit-box-sizing:border-box;-moz-box-sizing:border-box;box-sizing:border-box;background:#f4f4f4 !important;border:0;max-width:500px;-moz-border-radius:0px !important;-webkit-border-radius:0px !important;border-radius:0px !important;color:#000000}#_form_1_ ._show_be_error{min-width:100%}#_form_1_._inline-form,#_form_1_._inline-form ._form-content{font-family:Albert Sans;font-size:14px;font-weight:400}#_form_1_._inline-form ._row span:not(.field-required),#_form_1_._inline-form ._row label{font-family:Albert Sans;font-size:14px;font-weight:400;line-height:1.6em;color:black !important}#_form_1__inlineform input[type="text"],#_form_1__inlineform input[type="date"],#_form_1__inlineform input[type="tel"],#_form_1__inlineform select,#_form_1__inlineform textarea:not(.g-recaptcha-response){font-family:Albert Sans;font-size:14px;font-weight:400;font-color:#000000;line-height:1.6em}#_form_1_._inline-form ._html-code *:not(h1, h2, h3, h4, h5, h6),#_form_1_._inline-form .sms_consent_message,#_form_1_._inline-form ._form-thank-you{font-family:Albert Sans;font-size:14px;font-weight:400;color:black !important}#_form_1_._inline-form ._form-label,#_form_1_._inline-form ._form-emailidentifier,#_form_1_._inline-form ._form-checkbox-option-label{font-family:Albert Sans;font-size:14px;font-weight:700;line-height:1.6em;color:black !important}#_form_1_._inline-form ._submit{margin-top:12px;font-family:Albert Sans;font-size:14px;font-weight:400}#_form_1_._inline-form ._html-code h1,#_form_1_._inline-form ._html-code h2,#_form_1_._inline-form ._html-code h3,#_form_1_._inline-form ._html-code h4,#_form_1_._inline-form ._html-code h5,#_form_1_._inline-form ._html-code h6,#_form_1_._inline-form ._form-title{font-family:Albert Sans;font-size:22px;line-height:normal;font-weight:400;color:black;margin-bottom:0;display:block}#_form_1_._inline-form ._form-branding{font-family:"IBM Plex Sans", Helvetica, sans-serif;font-size:13px;font-weight:100;font-style:normal;text-decoration:none}#_form_1_:before,#_form_1_:after{content:" ";display:table}#_form_1_:after{clear:both}#_form_1_._inline-style{width:auto;display:inline-block}#_form_1_._inline-style input[type="text"],#_form_1_._inline-style input[type="date"]{padding:10px 12px}#_form_1_._inline-style button._inline-style{position:relative;top:27px}#_form_1_._inline-style p{margin:0}#_form_1_._inline-style ._button-wrapper{position:relative;margin:16px 12.5px 0 20px}#_form_1_ ._form-thank-you{position:relative;left:0;right:0;text-align:center;font-size:18px}#_form_1_ ._form-pc-confirmation ._submit{margin-top:16px}@media (min-width:320px) and (max-width:667px){#_form_1_._inline-form._inline-style ._inline-style._button-wrapper{margin-top:20px !important;margin-left:0 !important}}#_form_1_ .iti{width:100%}#_form_1_ .iti.iti--allow-dropdown.iti--separate-dial-code{width:100%}#_form_1_ .iti input{width:100%;border:#979797 1px solid;border-radius:4px}#_form_1_ .iti--separate-dial-code .iti__selected-flag{background-color:#FFFFFF;border-radius:4px}#_form_1_ .iti--separate-dial-code .iti__selected-flag:hover{background-color:rgba(0, 0, 0, 0.05)}#_form_1_ .iti__country-list{border-radius:4px;margin-top:4px;min-width:460px}#_form_1_ .iti__country-list--dropup{margin-bottom:4px}#_form_1_ .phone-error-hidden{display:none}#_form_1_ .phone-error{color:#E40E49}#_form_1_ .phone-input-error{border:1px solid #E40E49 !important}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field fieldset{margin:0;margin-bottom:1.1428571429em;border:none;padding:0}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field fieldset:last-child{margin-bottom:0}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field legend{margin-bottom:1.1428571429em}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field label{display:flex;align-items:flex-start;justify-content:flex-start;margin-bottom:0.8571428571em}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field label:last-child{margin-bottom:0}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field input{margin:0;margin-right:8px}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field ._form-checkbox-option-label{display:block;font-weight:400;margin-top:-4px}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field ._form-checkbox-option-label-with-description{display:block;font-weight:700;margin-top:-4px}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field ._form-checkbox-option-description{margin:0;font-size:0.8571428571em}#_form_1_._inline-form ._form-content ._form-list-subscriptions-field ._form-subscriptions-unsubscribe-all-description{line-height:normal;margin-top:-2px}
#_form_1_ .ac-field input{font-family:"Open Sans", sans-serif;border:1px solid #ccc;border-radius:4px;padding:10px}#_form_1_ .ac-button{background-color:#004aad;color:#fff;font-weight:600;border-radius:4px;padding:12px 20px}#_form_1_ .ac-button:hover{background-color:#003080}
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window.cfields = [];
window._show_thank_you = function(id, message, trackcmp_url, email) {
var form = document.getElementById('_form_' + id + '_'), thank_you = form.querySelector('._form-thank-you');
form.querySelector('._form-content').style.display = 'none';
thank_you.innerHTML = message;
thank_you.style.display = 'block';
const vgoAlias = typeof visitorGlobalObjectAlias === 'undefined' ? 'vgo' : visitorGlobalObjectAlias;
var visitorObject = window[vgoAlias];
if (email && typeof visitorObject !== 'undefined') {
visitorObject('setEmail', email);
visitorObject('update');
} else if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) {
// Site tracking URL to use after inline form submission.
_load_script(trackcmp_url);
}
if (typeof window._form_callback !== 'undefined') window._form_callback(id);
thank_you.setAttribute('tabindex', '-1');
thank_you.focus();
};
window._show_unsubscribe = function(id, message, trackcmp_url, email) {
var form = document.getElementById('_form_' + id + '_'), unsub = form.querySelector('._form-thank-you');
var branding = form.querySelector('._form-branding');
if (branding) {
branding.style.display = 'none';
}
form.querySelector('._form-content').style.display = 'none';
unsub.style.display = 'block';
form.insertAdjacentHTML('afterend', message)
const vgoAlias = typeof visitorGlobalObjectAlias === 'undefined' ? 'vgo' : visitorGlobalObjectAlias;
var visitorObject = window[vgoAlias];
if (email && typeof visitorObject !== 'undefined') {
visitorObject('setEmail', email);
visitorObject('update');
} else if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) {
// Site tracking URL to use after inline form submission.
_load_script(trackcmp_url);
}
if (typeof window._form_callback !== 'undefined') window._form_callback(id);
};
window._show_error = function(id, message, html) {
var form = document.getElementById('_form_' + id + '_'),
err = document.createElement('div'),
button = form.querySelector('button[type="submit"]'),
old_error = form.querySelector('._form_error');
if (old_error) old_error.parentNode.removeChild(old_error);
err.innerHTML = message;
err.className = '_error-inner _form_error _no_arrow';
var wrapper = document.createElement('div');
wrapper.className = '_form-inner _show_be_error';
wrapper.appendChild(err);
button.parentNode.insertBefore(wrapper, button);
var submitButton = form.querySelector('[id^="_form"][id$="_submit"]');
submitButton.disabled = false;
submitButton.classList.remove('processing');
if (html) {
var div = document.createElement('div');
div.className = '_error-html';
div.innerHTML = html;
err.appendChild(div);
}
};
window._show_pc_confirmation = function(id, header, detail, show, email) {
var form = document.getElementById('_form_' + id + '_'), pc_confirmation = form.querySelector('._form-pc-confirmation');
if (pc_confirmation.style.display === 'none') {
form.querySelector('._form-content').style.display = 'none';
pc_confirmation.innerHTML = "
" + "
" + detail + "
" +
"";
pc_confirmation.style.display = 'block';
var mp = document.querySelector('input[name="mp"]');
mp.value = '0';
} else {
form.querySelector('._form-content').style.display = 'inline';
pc_confirmation.style.display = 'none';
}
var hideButton = document.getElementById('hideButton');
// Add event listener to the button
hideButton.addEventListener('click', function() {
var submitButton = document.querySelector('#_form_1_submit');
submitButton.disabled = false;
submitButton.classList.remove('processing');
var mp = document.querySelector('input[name="mp"]');
mp.value = '1';
const cacheBuster = new URL(window.location.href);
cacheBuster.searchParams.set('v', new Date().getTime());
window.location.href = cacheBuster.toString();
});
const vgoAlias = typeof visitorGlobalObjectAlias === 'undefined' ? 'vgo' : visitorGlobalObjectAlias;
var visitorObject = window[vgoAlias];
if (email && typeof visitorObject !== 'undefined') {
visitorObject('setEmail', email);
visitorObject('update');
} else if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) {
// Site tracking URL to use after inline form submission.
_load_script(trackcmp_url);
}
if (typeof window._form_callback !== 'undefined') window._form_callback(id);
};
window._load_script = function(url, callback, isSubmit) {
var head = document.querySelector('head'), script = document.createElement('script'), r = false;
var submitButton = document.querySelector('#_form_1_submit');
script.charset = 'utf-8';
script.src = url;
if (callback) {
script.onload = script.onreadystatechange = function() {
if (!r && (!this.readyState || this.readyState == 'complete')) {
r = true;
callback();
}
};
}
script.onerror = function() {
if (isSubmit) {
if (script.src.length > 10000) {
_show_error("1", "Sorry, your submission failed. Please shorten your responses and try again.");
} else {
_show_error("1", "Sorry, your submission failed. Please try again.");
}
submitButton.disabled = false;
submitButton.classList.remove('processing');
}
}
head.appendChild(script);
};
(function() {
var iti;
if (window.location.search.search("excludeform") !== -1) return false;
var getCookie = function(name) {
var match = document.cookie.match(new RegExp('(^|; )' + name + '=([^;]+)'));
return match ? match[2] : null;
}
var setCookie = function(name, value) {
var now = new Date();
var time = now.getTime();
var expireTime = time + 1000 * 60 * 60 * 24 * 365;
now.setTime(expireTime);
document.cookie = name + '=' + value + '; expires=' + now + ';path=/; Secure; SameSite=Lax;';
}
var addEvent = function(element, event, func) {
if (element.addEventListener) {
element.addEventListener(event, func);
} else {
var oldFunc = element['on' + event];
element['on' + event] = function() {
oldFunc.apply(this, arguments);
func.apply(this, arguments);
};
}
}
var _removed = false;
var form_to_submit = document.getElementById('_form_1_');
var allInputs = form_to_submit.querySelectorAll('input, select, textarea'), tooltips = [], submitted = false;
var getUrlParam = function(name) {
if (name.toLowerCase() !== 'email') {
var params = new URLSearchParams(window.location.search);
return params.get(name) || false;
}
// email is a special case because a plus is valid in the email address
var qString = window.location.search;
if (!qString) {
return false;
}
var parameters = qString.substr(1).split('&');
for (var i = 0; i < parameters.length; i++) {
var parameter = parameters[i].split('=');
if (parameter[0].toLowerCase() === 'email') {
return parameter[1] === undefined ? true : decodeURIComponent(parameter[1]);
}
}
return false;
};
var acctDateFormat = "%m/%d/%Y";
var getNormalizedDate = function(date, acctFormat) {
var decodedDate = decodeURIComponent(date);
if (acctFormat && acctFormat.match(/(%d|%e).*%m/gi) !== null) {
return decodedDate.replace(/(\d{2}).*(\d{2}).*(\d{4})/g, '$3-$2-$1');
} else if (Date.parse(decodedDate)) {
var dateObj = new Date(decodedDate);
var year = dateObj.getFullYear();
var month = dateObj.getMonth() + 1;
var day = dateObj.getDate();
return `${year}-${month < 10 ? `0${month}` : month}-${day < 10 ? `0${day}` : day}`;
}
return false;
};
var getNormalizedTime = function(time) {
var hour, minutes;
var decodedTime = decodeURIComponent(time);
var timeParts = Array.from(decodedTime.matchAll(/(\d{1,2}):(\d{1,2})\W*([AaPp][Mm])?/gm))[0];
if (timeParts[3]) { // 12 hour format
var isPM = timeParts[3].toLowerCase() === 'pm';
if (isPM) {
hour = parseInt(timeParts[1]) === 12 ? '12' : `${parseInt(timeParts[1]) + 12}`;
} else {
hour = parseInt(timeParts[1]) === 12 ? '0' : timeParts[1];
}
} else { // 24 hour format
hour = timeParts[1];
}
var normalizedHour = parseInt(hour) < 10 ? `0${parseInt(hour)}` : hour;
var minutes = timeParts[2];
return `${normalizedHour}:${minutes}`;
};
for (var i = 0; i < allInputs.length; i++) {
var regexStr = "field\\[(\\d+)\\]";
var results = new RegExp(regexStr).exec(allInputs[i].name);
if (results != undefined) {
allInputs[i].dataset.name = allInputs[i].name.match(/\[time\]$/)
? `${window.cfields[results[1]]}_time`
: window.cfields[results[1]];
} else {
allInputs[i].dataset.name = allInputs[i].name;
}
var fieldVal = getUrlParam(allInputs[i].dataset.name);
if (fieldVal) {
if (allInputs[i].dataset.autofill === "false") {
continue;
}
if (allInputs[i].type == "radio" || allInputs[i].type == "checkbox") {
if (allInputs[i].value == fieldVal) {
allInputs[i].checked = true;
}
} else if (allInputs[i].type == "date") {
allInputs[i].value = getNormalizedDate(fieldVal, acctDateFormat);
} else if (allInputs[i].type == "time") {
allInputs[i].value = getNormalizedTime(fieldVal);
} else {
allInputs[i].value = fieldVal;
}
}
}
var remove_tooltips = function() {
for (var i = 0; i < tooltips.length; i++) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
}
tooltips = [];
};
var remove_tooltip = function(elem) {
for (var i = 0; i < tooltips.length; i++) {
if (tooltips[i].elem === elem) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
tooltips.splice(i, 1);
return;
}
}
};
var create_tooltip = function(elem, text) {
var tooltip = document.createElement('div'),
arrow = document.createElement('div'),
inner = document.createElement('div'), new_tooltip = {};
tooltip.id = `${elem.id}-error`;
tooltip.setAttribute('role', 'alert')
if (elem.type != 'radio' && (elem.type != 'checkbox' || elem.name === 'sms_consent')) {
tooltip.className = '_error';
arrow.className = '_error-arrow';
inner.className = '_error-inner';
inner.innerHTML = text;
tooltip.appendChild(arrow);
tooltip.appendChild(inner);
elem.parentNode.appendChild(tooltip);
} else {
tooltip.className = '_error-inner _no_arrow';
tooltip.innerHTML = text;
elem.parentNode.insertBefore(tooltip, elem);
new_tooltip.no_arrow = true;
}
new_tooltip.tip = tooltip;
new_tooltip.elem = elem;
tooltips.push(new_tooltip);
return new_tooltip;
};
var resize_tooltip = function(tooltip) {
var rect = tooltip.elem.getBoundingClientRect();
var doc = document.documentElement,
scrollPosition = rect.top - ((window.pageYOffset || doc.scrollTop) - (doc.clientTop || 0));
if (scrollPosition < 40) {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _below';
} else {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _above';
}
};
var resize_tooltips = function() {
if (_removed) return;
for (var i = 0; i < tooltips.length; i++) {
if (!tooltips[i].no_arrow) resize_tooltip(tooltips[i]);
}
};
var validate_field = function(elem, remove) {
var tooltip = null, value = elem.value, no_error = true;
remove ? remove_tooltip(elem) : false;
elem.removeAttribute('aria-invalid');
elem.removeAttribute('aria-describedby');
if (elem.type != 'checkbox') elem.className = elem.className.replace(/ ?_has_error ?/g, '');
if (elem.getAttribute('required') !== null) {
if (elem.type == 'radio' || (elem.type == 'checkbox' && /any/.test(elem.className))) {
var elems = form_to_submit.elements[elem.name];
if (!(elems instanceof NodeList || elems instanceof HTMLCollection) || elems.length <= 1) {
no_error = elem.checked;
}
else {
no_error = false;
for (var i = 0; i < elems.length; i++) {
if (elems[i].checked) no_error = true;
}
}
if (!no_error) {
tooltip = create_tooltip(elem, "Please select an option.");
}
} else if (elem.type =='checkbox') {
var elems = form_to_submit.elements[elem.name], found = false, err = [];
no_error = true;
for (var i = 0; i < elems.length; i++) {
if (elems[i].getAttribute('required') === null) continue;
if (!found && elems[i] !== elem) return true;
found = true;
elems[i].className = elems[i].className.replace(/ ?_has_error ?/g, '');
if (!elems[i].checked) {
no_error = false;
elems[i].className = elems[i].className + ' _has_error';
err.push("Checking %s is required".replace("%s", elems[i].value));
}
}
if (!no_error) {
tooltip = create_tooltip(elem, err.join('
'));
}
} else if (elem.tagName == 'SELECT') {
var selected = true;
if (elem.multiple) {
selected = false;
for (var i = 0; i < elem.options.length; i++) {
if (elem.options[i].selected) {
selected = true;
break;
}
}
} else {
for (var i = 0; i 0;
const showError = (consentRequired || !!elem.attributes.required) && !elem.checked;
if (showError) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Please check this box to continue");
} else {
elem.className = elem.className.replace(/ ?_has_error ?/g, '');
}
}
tooltip ? resize_tooltip(tooltip) : false;
if (!no_error && elem.hasAttribute('id')) {
elem.setAttribute('aria-invalid', 'true');
elem.setAttribute('aria-describedby', `${elem.id}-error`);
}
return no_error;
};
var needs_validate = function(el) {
if(el.getAttribute('required') !== null){
return true;
}
if((el.name === 'email' || el.id === 'phone' || el.id === 'sms_consent') && el.value !== ""){
return true;
}
return false;
};
var validate_form = function(e) {
var err = form_to_submit.querySelector('._form_error'), no_error = true;
if (!submitted) {
submitted = true;
for (var i = 0, len = allInputs.length; i < len; i++) {
var input = allInputs[i];
if (needs_validate(input)) {
if (input.type == 'text' || input.type == 'number' || input.type == 'time' || input.type == 'tel') {
addEvent(input, 'blur', function() {
this.value = this.value.trim();
validate_field(this, true);
});
addEvent(input, 'input', function() {
validate_field(this, true);
});
} else if (input.type == 'radio' || input.type == 'checkbox') {
(function(el) {
function getElementsArray(name){
const value = form_to_submit.elements[name];
if (Array.isArray(value)){
return value;
}
return [value];
}
var radios = getElementsArray(el.name);
for (var i = 0; i < radios.length; i++) {
addEvent(radios[i], 'change', function() {
validate_field(el, true);
});
}
})(input);
} else if (input.tagName == 'SELECT') {
addEvent(input, 'change', function() {
validate_field(this, true);
});
} else if (input.type == 'textarea'){
addEvent(input, 'input', function() {
validate_field(this, true);
});
}
}
}
}
remove_tooltips();
for (var i = 0, len = allInputs.length; i import('https://cdn.jsdelivr.net/npm/[email protected]/build/js/utils.js'),
hiddenInput: (telInputName) => ({
phone: 'phone'
}),
separateDialCode: true,
autoPlaceholder: 'aggressive',
initialCountry: 'auto',
geoIpLookup: (success) => {
fetch('https://disabilityinsuranceagency.activehosted.com/api/public/geo.php')
.then((res) => res.json())
.then((data) => success(data.country_code || 'US'))
.catch(() => success('US'));
}
});
}, false);
}
var inputPhone = form_to_submit.querySelector("#phone");
if(inputPhone) {
initializePhoneInput(inputPhone);
}
window['recaptcha_callback'] = function() {
// Get all recaptchas in the DOM (there may be more than one form on the page).
var recaptchas = document.getElementsByClassName("g-recaptcha");
for (var i in recaptchas) {
// Set the recaptcha element ID, so the recaptcha can be applied to each element.
var recaptcha_id = "recaptcha_" + i;
recaptchas[i].id = recaptcha_id;
var el = document.getElementById(recaptcha_id);
if (el != null) {
var sitekey = el.getAttribute("data-sitekey");
var stoken = el.getAttribute("data-stoken");
grecaptcha.render(recaptcha_id, {"sitekey":sitekey,"stoken":stoken});
}
}
}; _load_script("https://www.google.com/recaptcha/api.js?onload=recaptcha_callback&render=explicit");
var _form_serialize = function(form){if(!form||form.nodeName!=="FORM"){return }var i,j,q=[];for(i=0;i<form.elements.length;i++){if(form.elements[i].name===""){continue}switch(form.elements[i].nodeName){case"INPUT":switch(form.elements[i].type){case"tel":q.push(form.elements[i].name+"="+encodeURIComponent(form.elements[i].previousSibling.querySelector('div.iti__selected-dial-code').innerText)+encodeURIComponent(" ")+encodeURIComponent(form.elements[i].value));break;case"text":case"number":case"date":case"time":case"hidden":case"password":case"button":case"reset":case"submit":q.push(form.elements[i].name+"="+encodeURIComponent(form.elements[i].value));break;case"checkbox":case"radio":if(form.elements[i].checked){q.push(form.elements[i].name+"="+encodeURIComponent(form.elements[i].value))}break;case"file":break}break;case"TEXTAREA":q.push(form.elements[i].name+"="+encodeURIComponent(form.elements[i].value));break;case"SELECT":switch(form.elements[i].type){case"select-one":q.push(form.elements[i].name+"="+encodeURIComponent(form.elements[i].value));break;case"select-multiple":for(j=0;j {
if (key !== 'hideButton') {
formData.append(key, value);
}
});
let request = {
headers: {
"Accept": "application/json"
},
body: formData,
method: "POST"
};
let pageUrlParams = new URLSearchParams(window.location.search);
if (pageUrlParams.has('t')) {
request.headers.Authorization = 'Bearer ' + pageUrlParams.get('t');
}
const response = await fetch('https://disabilityinsuranceagency.activehosted.com/proc.php?jsonp=true', request);
return response.json();
}
if (formSupportsPost) {
submitForm().then((data) => {
eval(data.js);
}).catch(() => {
_show_error("1", "Sorry, your submission failed. Please try again.");
});
} else {
_load_script('https://disabilityinsuranceagency.activehosted.com/proc.php?' + serialized + '&jsonp=true', null, true);
}
}
return false;
};
addEvent(form_to_submit, 'submit', form_submit);
})();
