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Contact Request for Restaurant or Merchant
Your Name*:
Your Email*:
Website:
Restaurant or Merchant*:
City:
Restaurant or Merchant Phone*:
ext.
How did you hear about Us?
Additional Comments/Questions
Please enter code*:
* Indicates Required Fields
function verify(){
var phttps=/https:\/\//i;
var phttp=/http:\/\//i;
document.form1.jstst.value="1722971906";
var error='';
if(!document.form1.code.value){error=error+"Code"+"\n";}
if(!document.form1.full_name.value){error=error+"Name"+"\n";}
if(!document.form1.phone.value){error=error+"Phone"+"\n";}
if(!document.form1.restaurant.value){error=error+"Restaurant"+"\n";}
if(
phttps.test(document.form1.comments.value) ||
phttp.test(document.form1.comments.value)
) {
var pattern =/https?:\/\/(www\.)?[-a-zA-Z0-9@:%._\+~#=]{2,256}\.[a-z]{2,6}\b([-a-zA-Z0-9@:%_\+.~#?&//=]*)/gi;
document.form1.comments.value=document.form1.comments.value.replace(pattern,'');
error=error+"Please use Website field to specify link"+"\n";
}
if(error){alert("Missing required fields:\n"+error); return false;}
return true;
}
