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Here is a small sample of the code that I am using. It is a large form so I won't incude it all.
<input type="hidden" name="recipient" value="myemail@email.com" />
<input type=hidden name="return_link_url" value="http://www.kiinsurance.com/thankyou/">
<input type=hidden name="sort" value="order:Insured Name,DBA,FEIN/SSN,Yrs with Comp,Effective Date,ZIP,W/C Class Code1,Annual Payrol1,#FT Empl1,#PT Empl1,">
<label><strong>Insured Name:<br />
<input name="Insured Name" type="text" onblur="MM_validateForm('Insured Name','','R');return document.MM_returnValue" size="50" maxlength="50" />
</strong></label>
<p><strong>
<label>DBA:<br />
<input name="DBA" type="text" onblur="MM_validateForm('DBA','','R');return document.MM_returnValue" size="50" maxlength="50" />
</label>
</strong></p>
<p><strong>
<label>FEIN/SSN:<br />
<input name="FEIN/SSN" type="text" onblur="MM_validateForm('FEIN/SSN','','RisNum');return document.MM_returnValue" size="11" maxlength="11" />
</label>
<label><br />
<br />
Any lapse in coverage?<br />
Yes:
<input name="Lapse in cov." type="radio" value="Yes" />
No:
<input name="Lapse in cov." type="radio" value="No" />
<br />
<br />
If yes how long? (in/yrs) <br />
<input name="How Long" type="text" size="6" maxlength="6" />
<br />
<br />
3 Year Company Verified Loss Data Will Be Required To<br />
Bind Coverage <br />
<br />
Current Year Insurance Carrier:<br />
<input name="Current Year Ins. Carrier" type="text" onblur="MM_validateForm(' Carrier','','R');return document.MM_returnValue" size="50" maxlength="50" />
<br />
<br />
</label>
Right now not all of the information is being sent. Only parts.
Any help is appreciated.
Thanks
Task
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