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<meta http-equiv="Content-Type" content="text/html;charset=UTF-8"> | |
<form name="فرم ثبت نام از طریق وب سایت برای سازمانها" action="http://128.65.187.232:8008/modules/Webforms/capture.php" method="post" accept-charset="utf-8" enctype="multipart/form-data"> | |
<input type="hidden" name="__vtrftk" value="sid:63a0241ce00a15b84953e5433b8d75990e0be204,1438246857"> | |
<input type="hidden" name="publicid" value="5346ee9765259beabecb260dcaa1f68f"> | |
<input type="hidden" name="name" value="فرم ثبت نام از طریق وب سایت برای سازمانها"> | |
<input type="hidden" name="VTIGER_RECAPTCHA_PUBLIC_KEY" value="RECAPTCHA PUBLIC KEY FOR THIS DOMAIN"> | |
<table> | |
<tbody> | |
<tr> | |
<td> | |
<label>نام سازمان*</label> | |
</td> | |
<td> | |
<input type="text" name="accountname" value="" required=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>تلفن اصلی*</label> | |
</td> | |
<td> | |
<input type="text" name="phone" value="" required=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>وب سايت</label> | |
</td> | |
<td> | |
<input type="text" name="website" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>فکس</label> | |
</td> | |
<td> | |
<input type="text" name="fax" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>تعداد پرسنل</label> | |
</td> | |
<td> | |
<input type="number" name="employees" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>ايميل اصلی*</label> | |
</td> | |
<td> | |
<input type="email" name="email1" value="" required=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>رتبه</label> | |
</td> | |
<td> | |
<select name="rating"> | |
<option value="">--انتخاب مقدار--</option> | |
<option value="Acquired">خریداری شده</option> | |
<option value="Active">فعال</option> | |
<option value="Market Failed">شکست در بازار</option> | |
<option value="Project Cancelled">پروژه کنسل شد</option> | |
<option value="Shutdown">تعطیل شد</option> | |
</select> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>صنعت</label> | |
</td> | |
<td> | |
<select name="industry"> | |
<option value="">--انتخاب مقدار--</option> | |
<option value="Apparel">پوشاک</option> | |
<option value="Banking">بانکداری</option> | |
<option value="Biotechnology">بیوتکنولوژی</option> | |
<option value="Chemicals">مواد شیمیایی</option> | |
<option value="Communications">ارتباطات</option> | |
<option value="Construction">ساختمانی</option> | |
<option value="Consulting">مشاوره</option> | |
<option value="Education">آموزش و پرورش</option> | |
<option value="Electronics">الکترونیک</option> | |
<option value="Energy">انرژی</option> | |
<option value="Engineering">مهندسی</option> | |
<option value="Entertainment">سرگمی</option> | |
<option value="Environmental">محیطی</option> | |
<option value="Finance">سرمایه گذاری</option> | |
<option value="Food & Beverage">Food & Beverage</option> | |
<option value="Government">دولتی</option> | |
<option value="Healthcare">سلامت</option> | |
<option value="Hospitality">میزبانی</option> | |
<option value="Insurance">بیمه</option> | |
<option value="Machinery">ماشین آلات</option> | |
<option value="Manufacturing">تولید کننده</option> | |
<option value="Media">رسانه</option> | |
<option value="Not For Profit">غیرانتفاعی</option> | |
<option value="Recreation">خلق مجدد</option> | |
<option value="Retail">خرده فروشی</option> | |
<option value="Shipping">حمل</option> | |
<option value="Technology">تکنولوژی</option> | |
<option value="Telecommunications">مخابرات</option> | |
<option value="Transportation">ترابری</option> | |
<option value="Utilities">صنایع همگانی</option> | |
<option value="Other">سایر</option> | |
</select> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>کد اقتصادی*</label> | |
</td> | |
<td> | |
<input type="text" name="siccode" value="" required=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>استان</label> | |
</td> | |
<td> | |
<input type="text" name="bill_state" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>شهر</label> | |
</td> | |
<td> | |
<input type="text" name="bill_city" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>کد پستی</label> | |
</td> | |
<td> | |
<input type="text" name="ship_code" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>توضیحات</label> | |
</td> | |
<td> | |
<textarea name="description"></textarea> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>کشور</label> | |
</td> | |
<td> | |
<input type="text" name="bill_country" value=""> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>آدرس حمل و نقل</label> | |
</td> | |
<td> | |
<textarea name="ship_street"></textarea> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>نوع مشتری</label> | |
</td> | |
<td> | |
<select name="label:نوع_مشتری"> | |
<option value="">--انتخاب مقدار--</option> | |
<option value="مشترکین فعلی">مشترکین فعلی</option> | |
<option value="مشترکین جدید">مشترکین جدید</option> | |
<option value="بیمه حقوقی">بیمه حقوقی</option> | |
</select> | |
</td> | |
</tr> | |
<tr> | |
<td> | |
<label>contactCode</label> | |
</td> | |
<td> | |
<input type="text" name="label:contactCode" value=""> | |
</td> | |
</tr> | |
</tbody> | |
</table> | |
<input type="submit" value="Submit"> | |
</form> | |
<script type="text/javascript">window.onload = function() { var N=navigator.appName, ua=navigator.userAgent, tem;var M=ua.match(/(opera|chrome|safari|firefox|msie)\/?\s*(\.?\d+(\.\d+)*)/i);if(M && (tem= ua.match(/version\/([\.\d]+)/i))!= null) M[2]= tem[1];M=M? [M[1], M[2]]: [N, navigator.appVersion, "-?"];var browserName = M[0];var form = document.forms[0], inputs = form.elements; form.onsubmit = function() { var required = [], att, val; for (var i = 0; i < inputs.length; i++) { att = inputs[i].getAttribute("required"); val = inputs[i].value; type = inputs[i].type; if(type == "email") {if(val != "") {var elemLabel = inputs[i].getAttribute("label");var emailFilter = /^[_/a-zA-Z0-9]+([!"#$%&()*+,./:;<=>?\^_`{|}~-]?[a-zA-Z0-9/_/-])*@[a-zA-Z0-9]+([\_\-\.]?[a-zA-Z0-9]+)*\.([\-\_]?[a-zA-Z0-9])+(\.?[a-zA-Z0-9]+)?$/;var illegalChars= /[\(\)\<\>\,\;\:\"\[\]]/ ;if (!emailFilter.test(val)) {alert("For "+ elemLabel +" field please enter valid email address"); return false;} else if (val.match(illegalChars)) {alert(elemLabel +" field contains illegal characters");return false;}}}if (att != null) { if (val.replace(/^\s+|\s+$/g, "") == "") { required.push(inputs[i].getAttribute("label")); } } } if (required.length > 0) { alert("The following fields are required: " + required.join()); return false; } var numberTypeInputs = document.querySelectorAll("input[type=number]");for (var i = 0; i < numberTypeInputs.length; i++) { val = numberTypeInputs[i].value;var elemLabel = numberTypeInputs[i].getAttribute("label");if(val != "") {var intRegex = /^[+-]?\d+$/;if (!intRegex.test(val)) {alert("For "+ elemLabel +" field please enter valid number"); return false;}}}}; } | |
</script> |
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