|Email address to receive results
||type in the email address to send the completed information to
|Name to use when not available
||when the person does not provide a name, enter the default salutation to address this person by within the email marketing address list.
||Check this box to send the person an email to confirm the subscription. Upon receipt of the confirmation email for person, their information will be added to the list selected.
||Check this box to request their First Name and Last Name.
||Check this box to request their Company Name
||Check this box to request their Telephone Number.
||When the viewer does not complete the entire form, type the message to display.
|Thank You Message
||When the viewer completes the form, enter the message to display.