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	<title>MFG Members Prospect Contact Form | North Texas NTMA Chapter</title>


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			<p class="form-instructions"><p>Thank you for your interest in learning more about becoming a Manufacturing Member of the National Tooling &amp; Machining Association. Please complete this form and we will contact you to get started.&nbsp;</p>
</p>
		

	<form action="index.cfm?id=1&popup=false" method="POST" id="iform" name="iform" enctype="multipart/form-data">
		
		<input type="hidden" id="num_questions" name="num_questions" value="12">
		<input type="hidden" name="form_id" value="1">
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			<input type="hidden" name="formtitle" value="MFG Members Prospect Contact Form">
		
	
<script>
	$(function () {
		// reset payment token in case user clicked Back button in browser
		$('#paymentToken').val('');
		
		//$('#business_radio').trigger('change');
		
		
	});
	
	function limitText(limitField, limitCount, limitNum) {
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	var validForm = false;
	var sent = 0;
	
	// Thibault 2/11/06 added init function called at page load, plus validation that required fields are completed before submit.  should help with problems with the back button and credit cards,  issue 30102
	function init() {
		frm = document.iform;

		
	}

	window.onload = new Function("init()"); //set init function to run at page load

	function lcase(mystring)  {
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				FoundIdx= i+1;
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		// this will kick off validation, but since we need to validate the captcha
		// we have to wait for that to finish first...
		var iForm = document.getElementById('iform');
		var fld_ss_form_testid = document.getElementById('fld_ss_form_testid');
		var mainV = validateFrm();
		fld_ss_form_testid.value = 1;
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					iForm.submit();
				
			
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		if(!sent) sent = 0;  //make sure we have this!
		if (!validForm) validForm = false;
		arrReqMissing = new Array();
		
			
			var jsDesc = "First Name";
			
				obj = document.iform.response_1;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "Last Name";
			
				obj = document.iform.response_2;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "Company Name";
			
				obj = document.iform.response_3;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "Title";
			
				obj = document.iform.response_4;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "Email";
			
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				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "Phone Number";
			
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				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
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			var jsDesc = "How many employees do you have?";
			
			
			var jsDesc = "Address 1";
			
			
			var jsDesc = "Address 2";
			
			
			var jsDesc = "City";
			
			
			var jsDesc = "State";
			
			
			var jsDesc = "Zip Code";
			
			
		if(arrReqMissing.length > 0) {
			//errStr = "We're sorry, but the following fields are required before you can submit this form. Please click OK, then correct these entries.<br>";
			errStr = "";
			for(i=0; i<arrReqMissing.length; i++) {
				errStr += arrReqMissing[i] + "<br>";
			}
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	  			title: 'Missing required fields',
	  			html: true,
	  			text: errStr,
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
			return false;
		}

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		 		if (document.iform.elements[i].value.length > 2147483647) {
		 			swal({
			  			title: 'Maximum allowable length',
			  			html: true,
			  			text: "One or more field responses exceeds the maximum allowable length of 2147483647 characters. Please adjust your responses and re-submit.",
			  			animation: 'slide-from-top',
			  			type: 'info',
			  			confirmButtonText: 'Ok',
			  			confirmButtonColor: '#337ab7'
			  		});
		 			return false;
		 		}
		 	}
		}

		if (sent == 1) {
	          swal({
	  			title: 'Processing..',
	  			html: true,
	  			text: "Your request is processing. Please do not click Submit more than once.",
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		  });
	          return false;
	    }
		
			bOK = true;
		
		if (bOK) {
			var btn = $('#submitBtn');
			btn.button('loading');
			btn.prop('disabled', true);
			sent = 1;
			validForm = true;
			return true;
		}
		else {
			return false;
		}
	}

	function IsNumeric(sText) {
	   var ValidChars = "0123456789.";
	   var IsNumber=true;
	   var Char;

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	      Char = sText.charAt(i);
	      if (ValidChars.indexOf(Char) == -1) {
	         IsNumber = false;
	      }
	   }
	   return IsNumber;
	}

	function setButtonVal(el, itemID, price) {
		// first set the price attribute on the element
		el.price = price;
		// now set the value of a hidden field for the associated radio button
		document.getElementById(itemID).price = price;
		document.getElementById(itemID).value = 1;
		// now call the calcTotalFix function to recaculate the total amount due
		calcTotalFix();
	}

	function getRadioButtonValForTotal(radioName){
		var rads = document.getElementsByName(radioName);
		var selectedPrice = 0;
		for(i=0; i < rads.length; i++) {
		  if(rads[i].checked == true){
		    selectedPrice = rads[i].getAttribute('price');
		  }
		}

		selectedPrice = parseFloat(selectedPrice);
		return selectedPrice;
	}

	function calcTotalFix() {
		var priceFields = $(".calculateTotal");
		// console.log('priceFields length: ' + priceFields.length);
		var updateTotal = 0; // initialize total before looping over array
		var processedRadioButtons = [];	/// reset array every time this function is called
		for (var i=0; i < priceFields.length; i++) {
			myFieldObj = priceFields[i];
			if (myFieldObj.value == '') { myFieldObj.value = 0; }
			fieldName = myFieldObj.name;
			value = myFieldObj.value;
			fieldID = myFieldObj.getAttribute('id');
			price = myFieldObj.getAttribute('price');

			// check to see if this is a radioVal by the item id
			if(fieldID != undefined){
				var nRadioVal = fieldID.indexOf("radioVal");
				if(nRadioVal > -1){
					fieldtype = 'radioval';
				} else {
					fieldtype = 'notradioval';
				}
			} else {
				fieldtype = 'nofieldid';
			}

			// if this is just an open price field, there is no notion of quantity times price, so the price to the value of the field
			if(fieldtype === 'radioval'){
				// radio price field - use "price" attribute since we have funky stuff in the "value" attribute that we can't parse easily
				arrNum = $.inArray(fieldName, processedRadioButtons);
				if(arrNum > -1) {
					// set price and calcualted value to zero for the rest of the checkboxes in this array because don't want to keep adding to price
					price = 0;
					calculatedValue = parseFloat(0);
				} else {
					price = getRadioButtonValForTotal(fieldName);
					calculatedValue = parseFloat(price);
					// add radio button field name to array of radio fields processed so we don't check again
					processedRadioButtons.push(fieldName);
				}
				// console.log('fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / calculatedValue: ' + calculatedValue);
			} else {
				if (price === undefined || price === null) {
				// check to see if it's a radio price field first
					// open price field - use "value" attribute
					if (!IsNumeric(value)) {
						//alert("Open Prices must be numbers only, no formatting is allowed.");
						swal({
				  			title: 'Numbers only',
				  			html: true,
				  			text: "Open Prices must be numbers only, no formatting is allowed.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					calculatedValue = parseFloat(value);
					// console.log('fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / calculatedValue: ' + calculatedValue);
				} else {
					if (!IsNumeric(value)) {
						//alert("Price fields only allow numbers.");
						swal({
				  			title: 'Price fields',
				  			html: true,
				  			text: "Price fields only allow numbers.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					myVal = parseFloat(value);
					// console.log('in parseint with 10 - fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / myVal: ' + myVal);
					calculatedValue = myVal * parseFloat(price);

				}
			}


			// console.log('Field id: ' + fieldID + ' / Fieldtype: ' + fieldtype + ' / Field name: ' + fieldName + ' / value: ' + value + ' / Price: ' + price + ' / Calculated Field Total: ' + calculatedValue);
			updateTotal = updateTotal + calculatedValue;
		}

		// update hidden total amount
		if (document.iform.hiddentotal) { document.iform.hiddentotal.value = updateTotal; }
		// console.log('The updateTotal is now: ' + updateTotal);
		
		
		// update total value with formatted amount
		if (typeof(formatCurrency) == "function") { document.iform.total.value = formatCurrency(updateTotal); }
		
		if ($('#ordertotal_work').length > 0) {
            $('#ordertotal_work').val(updateTotal.toFixed(2));
        }
        
        if ($('#pmt_method').length > 0) {
        	$('#pmt_method').val('');
        }
        $('.paymentProfileRadio').prop('checked', false);
        $('.card').removeClass('active');
        
		// need to update the cc_info tag fields...
		if (typeof(checkTotal) == "function") { checkTotal(); }
	}

	/* remove after confirming ok without it - 8/8/13 CJV */
	function calcTotal(myField){
		thisVal = myField.value;
		// alert(thisVal);
		if (thisVal == '') {
			thisVal = 0;
			myField.value = 0;
			}
			if (!IsNumeric(myField.value)) {
				//alert('Please enter only numbers or decimal points in a price field');
				swal({
		  			title: 'Price field',
		  			html: true,
		  			text: "Please enter only numbers or decimal points in a price field.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				myField.value = 0;
				thisVal = 0;
				}
				// get the current total
				var origTotal = document.iform.hiddentotal.value;
				// now backout the prior value from the total
				var priorTotal = origTotal - myField.priorval;
				if(priorTotal == ''){
					priorTotal = 0;
					}
				// add the open price to the total
				updateTotal = parseFloat(eval(priorTotal)) + parseFloat(eval(thisVal));
				// update hidden total amount
				document.iform.hiddentotal.value = updateTotal;
				
					
				// update total value with formatted amount
				document.iform.total.value = formatCurrency(updateTotal);
		checkTotal(); // need to update the cc_info tag fields...
	}
	/* */

	function setOpenPriceInput(thisField,thisPrice){
		if(thisPrice == ''){
			thisField.priorval = 0;
		} else {
			thisField.priorval = thisPrice;
		}
	}

	
		var div_bottom_moved = false;

		function addLoadEvent(func) {
 			var oldonload = window.onload;
  			if (typeof window.onload != 'function') {
    			window.onload = func;
  			}
  			else {
    			window.onload = function() {
      				if (oldonload) {
        				oldonload();
      				}
      				func();
    			}
  			}
 		}

		addLoadEvent(calcTotalFix);
	
</script>

	
<style>
.has-error {
	color: #f70404 !important;
}
.has-error input {
	border: 1px solid #f70404 !important;
}
</style>


<script>
	function checkInvalidCharacter(objName){
		var obj = document.iform[objName];
		var strFileName = obj.value.replace('C:\\fakepath\\','');
		iTemp = strFileName.indexOf(":");
		
		if (iTemp > -1) {
			swal({
	  			title: 'Invalid character',
	  			html: true,
	  			text: "Invalid character ':' found in file name. Please change the file name before attempting to upload this file.",
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
			obj.value = '';
			return false;
		}
		else {
			iTemp = obj.value.indexOf(",");
			if (iTemp > -1) {
				swal({
		  			title: 'Invalid character',
		  			html: true,
		  			text: "Invalid character ',' found in file name. Please change the file name before attempting to upload this file.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				obj.value = '';
				return false;
			}
		}
	}
	function clearRadio(rd) {
		if (document.iform) {
			var v;
			var ln;
			var ev;
			submitted = 0;
			v = "document.iform." + rd + ".length";
			ln = eval(v);
			// This will ensure we uncheck if there is only 1 radio button..
			v = "document.iform." + rd + ".checked = false;";
			ev = eval(v);
			// Now loop through the list of radio buttons and uncheck them all
			for (i=0;i<ln;i++) {
				v = "document.iform." + rd + "[" + i + "].checked = false;";
				//console.log(v);
				ev = eval(v);
			}
			calcTotalFix();
		}
	}
</script>


<div class="form_layout_wrapper" style="max-width:940px;" >

	
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-2" class="layout form item outer row-1 item-2 row_num-20 row_pos-20 rowlength-3 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							First Name<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_1"
									name="response_1"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-1 item-2"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_1_required"
							VALUE="The field First Name is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_1" value="First Name">
				<INPUT TYPE="hidden" NAME="response_1_question_id" VALUE="2">
				<INPUT TYPE="hidden" NAME="question_type_1" value="Text">
				<INPUT TYPE="hidden" NAME="label_1" value="First Name">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-6" class="layout form item outer row-2 item-6 row_num-20 row_pos-40 rowlength-3 type-Text" style=";position:relative;">

			<div class="inner">

				
							Last Name<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_2"
									name="response_2"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-2 item-6"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_2_required"
							VALUE="The field Last Name is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_2" value="Last Name">
				<INPUT TYPE="hidden" NAME="response_2_question_id" VALUE="6">
				<INPUT TYPE="hidden" NAME="question_type_2" value="Text">
				<INPUT TYPE="hidden" NAME="label_2" value="Last Name">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-12" class="layout form item outer row-3 item-12 row_num-20 row_pos-60 rowlength-3 type-Text" style=";position:relative;">

			<div class="inner">

				
							Company Name<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_3"
									name="response_3"
								
								
								 style="width:300px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-3 item-12"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_3_required"
							VALUE="The field Company Name is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_3" value="Company Name">
				<INPUT TYPE="hidden" NAME="response_3_question_id" VALUE="12">
				<INPUT TYPE="hidden" NAME="question_type_3" value="Text">
				<INPUT TYPE="hidden" NAME="label_3" value="Company Name">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13" class="layout form item outer row-4 item-13 row_num-40 row_pos-20 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Title<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_4"
									name="response_4"
								
								
								 style="width:250px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-4 item-13"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_4_required"
							VALUE="The field Title is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_4" value="Title">
				<INPUT TYPE="hidden" NAME="response_4_question_id" VALUE="13">
				<INPUT TYPE="hidden" NAME="question_type_4" value="Text">
				<INPUT TYPE="hidden" NAME="label_4" value="Title">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-1" class="layout form item outer row-5 item-1 row_num-60 row_pos-20 rowlength-2 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Email<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_5"
									name="response_5"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-5 item-1"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_5_required"
							VALUE="The field Email is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_5" value="Email">
				<INPUT TYPE="hidden" NAME="response_5_question_id" VALUE="1">
				<INPUT TYPE="hidden" NAME="question_type_5" value="Text">
				<INPUT TYPE="hidden" NAME="label_5" value="Email">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-5" class="layout form item outer row-6 item-5 row_num-60 row_pos-40 rowlength-2 type-Text" style=";position:relative;">

			<div class="inner">

				
							Phone Number<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_6"
									name="response_6"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-6 item-5"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_6_required"
							VALUE="The field Phone Number is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_6" value="Phone Number">
				<INPUT TYPE="hidden" NAME="response_6_question_id" VALUE="5">
				<INPUT TYPE="hidden" NAME="question_type_6" value="Text">
				<INPUT TYPE="hidden" NAME="label_6" value="Phone Number">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-14" class="layout form item outer row-7 item-14 row_num-80 row_pos-20 rowlength-1 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							How many employees do you have?
					

							<input type="text"
								
									id="response_7"
									name="response_7"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-7 item-14"
							><!-- input -->

							
				<input type="hidden" name="question_7" value="How many employees do you have?">
				<INPUT TYPE="hidden" NAME="response_7_question_id" VALUE="14">
				<INPUT TYPE="hidden" NAME="question_type_7" value="Text">
				<INPUT TYPE="hidden" NAME="label_7" value="Employees">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-7" class="layout form item outer row-8 item-7 row_num-100 row_pos-20 rowlength-2 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Address 1
					

							<input type="text"
								
									id="response_8"
									name="response_8"
								
								
								 style="width:350px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-8 item-7"
							><!-- input -->

							
				<input type="hidden" name="question_8" value="Address 1">
				<INPUT TYPE="hidden" NAME="response_8_question_id" VALUE="7">
				<INPUT TYPE="hidden" NAME="question_type_8" value="Text">
				<INPUT TYPE="hidden" NAME="label_8" value="Address 1">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-8" class="layout form item outer row-9 item-8 row_num-100 row_pos-40 rowlength-2 type-Text" style=";position:relative;">

			<div class="inner">

				
							Address 2
					

							<input type="text"
								
									id="response_9"
									name="response_9"
								
								
								 style="width:350px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-9 item-8"
							><!-- input -->

							
				<input type="hidden" name="question_9" value="Address 2">
				<INPUT TYPE="hidden" NAME="response_9_question_id" VALUE="8">
				<INPUT TYPE="hidden" NAME="question_type_9" value="Text">
				<INPUT TYPE="hidden" NAME="label_9" value="Address 2">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-9" class="layout form item outer row-10 item-9 row_num-120 row_pos-20 rowlength-3 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							City
					

							<input type="text"
								
									id="response_10"
									name="response_10"
								
								
								 style="width:250px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-10 item-9"
							><!-- input -->

							
				<input type="hidden" name="question_10" value="City">
				<INPUT TYPE="hidden" NAME="response_10_question_id" VALUE="9">
				<INPUT TYPE="hidden" NAME="question_type_10" value="Text">
				<INPUT TYPE="hidden" NAME="label_10" value="City">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-10" class="layout form item outer row-11 item-10 row_num-120 row_pos-40 rowlength-3 type-StateSelect" style="max-width:33%;position:relative;">

			<div class="inner">

				
							State
					

								<select
									id="response_11"
									name="response_11"
									
									
									class="form-control type-StateSelect row-11 item-10"
									>
									
									
										<option value="AB" >AB</option>
									
										<option value="AK" >AK</option>
									
										<option value="AL" >AL</option>
									
										<option value="AR" >AR</option>
									
										<option value="AZ" >AZ</option>
									
										<option value="BC" >BC</option>
									
										<option value="CA" >CA</option>
									
										<option value="CO" >CO</option>
									
										<option value="CT" >CT</option>
									
										<option value="DC" >DC</option>
									
										<option value="DE" >DE</option>
									
										<option value="FL" >FL</option>
									
										<option value="GA" >GA</option>
									
										<option value="HI" >HI</option>
									
										<option value="IA" >IA</option>
									
										<option value="ID" >ID</option>
									
										<option value="IL" >IL</option>
									
										<option value="IN" >IN</option>
									
										<option value="KS" >KS</option>
									
										<option value="KY" >KY</option>
									
										<option value="LA" >LA</option>
									
										<option value="MA" >MA</option>
									
										<option value="MB" >MB</option>
									
										<option value="MD" >MD</option>
									
										<option value="ME" >ME</option>
									
										<option value="MI" >MI</option>
									
										<option value="MN" >MN</option>
									
										<option value="MO" >MO</option>
									
										<option value="MS" >MS</option>
									
										<option value="MT" >MT</option>
									
										<option value="NB" >NB</option>
									
										<option value="NC" >NC</option>
									
										<option value="ND" >ND</option>
									
										<option value="NE" >NE</option>
									
										<option value="NF" >NF</option>
									
										<option value="NH" >NH</option>
									
										<option value="NJ" >NJ</option>
									
										<option value="NM" >NM</option>
									
										<option value="NS" >NS</option>
									
										<option value="NV" >NV</option>
									
										<option value="NY" >NY</option>
									
										<option value="OH" >OH</option>
									
										<option value="OK" >OK</option>
									
										<option value="ON" >ON</option>
									
										<option value="OR" >OR</option>
									
										<option value="PA" >PA</option>
									
										<option value="PE" >PE</option>
									
										<option value="PR" >PR</option>
									
										<option value="QC" >QC</option>
									
										<option value="RI" >RI</option>
									
										<option value="SC" >SC</option>
									
										<option value="SD" >SD</option>
									
										<option value="SK" >SK</option>
									
										<option value="TN" >TN</option>
									
										<option value="TX" SELECTED>TX</option>
									
										<option value="UT" >UT</option>
									
										<option value="VA" >VA</option>
									
										<option value="VT" >VT</option>
									
										<option value="WA" >WA</option>
									
										<option value="WI" >WI</option>
									
										<option value="WV" >WV</option>
									
										<option value="WY" >WY</option>
									
								</select>
							
							
				<input type="hidden" name="question_11" value="State">
				<INPUT TYPE="hidden" NAME="response_11_question_id" VALUE="10">
				<INPUT TYPE="hidden" NAME="question_type_11" value="StateSelect">
				<INPUT TYPE="hidden" NAME="label_11" value="State">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-11" class="layout form item outer row-12 item-11 row_num-120 row_pos-60 rowlength-3 type-Text" style=";position:relative;">

			<div class="inner">

				
							Zip Code
					

							<input type="text"
								
									id="response_12"
									name="response_12"
								
								
								 style="width:200px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-12 item-11"
							><!-- input -->

							
				<input type="hidden" name="question_12" value="Zip Code">
				<INPUT TYPE="hidden" NAME="response_12_question_id" VALUE="11">
				<INPUT TYPE="hidden" NAME="question_type_12" value="Text">
				<INPUT TYPE="hidden" NAME="label_12" value="Zip Code">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
	</div><!-- /The inner div, for the sake of IE -->

	
	<input type="hidden" id="hasOpenPriceField" name="hasOpenPriceField" value="0">

	
</div><!-- /form_layout_wrapper -->


		<div id="_ssdiv2" style="display:none">
			<input type="hidden" id="fld_uploadfields" name="UploadFields" value="">
			<input type="hidden" id="fld_id_column" name="id_column" value="ID">
			<input type="hidden" id="fld_id_value" name="id_value" value="">
			<input type="hidden" id="fld_form_overrideid" name="form_overrideID" value="0">
			
			<input type="hidden" id="fld_ss_form_testid" name="ss_form_testid" value="0" />
			<div id="_ssdiv">
				<p style="background-color: blue"><input type="text" name="ss_city" value="" /></p>
			</div>
		</div>
		
			<input type="hidden" name="form_isEdit" value="0">
		
	
		<div id="div_bottom" style="clear:both;">
			
			
				<br /><br />
				
					<style>
						iframe[title="reCAPTCHA"] {
							height: 78px !important;
							margin-top: 0px !important;
						}
					</style>
					

				<style>
				div.g-recaptcha > div > div > iframe {
					height: 78px !important;
				}
				
				@media screen and (max-width: 575px) {
					#rc-imageselect, .g-recaptcha  {
						transform:scale(0.77);
						-webkit-transform:scale(0.77);transform-origin:0 0;
						-webkit-transform-origin:0 0;
					}
				}
				</style>
				
				<script src="https://www.recaptcha.net/recaptcha/api.js" async defer></script>
				<div class="g-recaptcha" data-sitekey="6LdU2AIrAAAAAGVELuoAqOF-_sAc6cIcCPhX4u08"></div>
			
			
					<br/>
					<input type="hidden" name="use_ssl" value="1">
				
			
				<div class="checkbox">
					<label>
						<input type="checkbox" name="send_mail_ind" id="optout_chkbox" value="1">&nbsp; Yes! Please add me to your email list. I would like to receive relevant industry updates and event invitations.
					</label>
				</div>
			
	
			<div id="frm_submit_button">
				<br />
				<button class="btn btn-primary" type="button" data-loading-text="Please wait..." id="submitBtn"
					
						onclick="startValidate();"
					
				>Submit Form</button>
				<br /><br />
			</div>
	
			
			<div id="frm_verisign_seal_box">
				
				
			</div>
			
	
				<div id="frm_required_copy_bottom">
					<p>Fields marked with <span class="text-danger">*</span> are required.</p>
				</div>
			
	
				<div id="frm_ssl_copy_bottom"><p>Your form submission WILL be encrypted using SSL to ensure your privacy.</p></div>
			
	
		</div><!-- div_bottom -->
	
		
	</form>
</div>


	</div>


				</div> 
    </div> 

	
  	<div class="row i4a_footer_row1">
    	<div class="col-md-12 i4a_footer_row1_col1 widgets" id="i4a_footer_row1_column1"></div>
  	</div>
  	<div class="row i4a_footer_row2">
		<div class="col-md-6 i4a_footer_row2_col1 widgets" id="i4a_footer_row2_column1"></div>
		<div class="col-md-6 text-right i4a_footer_row2_col2 widgets" id="i4a_footer_row2_column2"></div>
	</div>
	

</div> 
		
	
			<div id="i4awidget_interiorganalytics_265" class="interior G analytics"  >
				
					
			</div>
			
				
				<script type="text/javascript">
					
					_getComputedStyle = function(_elem, _style) {
  						var computedStyle;
  						if (typeof _elem.currentStyle != 'undefined') {
  							computedStyle = _elem.currentStyle; }
  						else {
  							computedStyle = document.defaultView.getComputedStyle(_elem, null);
  							}
						return computedStyle[_style];
						}
					
					var _widget_parentDiv = document.getElementById('Document');
					if (_widget_parentDiv) {
						var _wpdposition = _getComputedStyle(_widget_parentDiv,"position");
						if (_wpdposition == 'static') {
							_widget_parentDiv.style.position = 'relative';
						}
						_widget_parentDiv.appendChild(document.getElementById('i4awidget_interiorganalytics_265'));
					}
				</script>
				
			
			<div id="i4awidget_socialmediaicons_231" class="socialMediaIcons"  >
				
					<a href="https://www.facebook.com/NTXChapter#"><i class="fa fa-facebook-square fa-2x"></i></a>&nbsp;
<a href="https://www.linkedin.com/company/northtexas-ntma"><i class="fa fa-linkedin-square fa-2x"></i></a>
				
			</div>
			
				
				<script type="text/javascript">
					
					var _widget_parentDiv = document.getElementById('header_row1_column1');
					if (_widget_parentDiv) {
						var _wpdposition = _getComputedStyle(_widget_parentDiv,"position");
						if (_wpdposition == 'static') {
							_widget_parentDiv.style.position = 'relative';
						}
						_widget_parentDiv.appendChild(document.getElementById('i4awidget_socialmediaicons_231'));
					}
				</script>
				
			
			<div id="i4awidget_widget_responsivelogin_228" class="widget_responsivelogin"  >
				
					
<div class="login-wrapper">
	
		<style>
			.loginWidgetFormGroup {
				margin-bottom: 6px;
			}
		</style>

		
		<form name="lgn" action="https://ntmanorthtexas.org/i4a/ams/amslogin.cfm" method="POST"  class="form-inline">
			

			<div class="form-group loginWidgetFormGroup">
				
				<input type="text" class="form-control form-control-sm" name="username" id="loginWidgetUsername" placeholder="username" maxlength="50">
			</div>
			&nbsp;
			<div class="form-group loginWidgetFormGroup">
				
				<input type="password" class="form-control form-control-sm" name="password" id="loginWidgetPassword" placeholder="password" maxlength="50">
			</div>

			
					&nbsp;
					<button class="btn btn-primary btn-sm buttonSand" type="submit">Log In</button>
				
			
			<input type="hidden" name="nextPage" value="/i4a/ams/home">
			<input type="hidden" name="nextParams" value="controller=memberHome&action=index">
		</form>

		
</div>


			</div>
			
				
				<script type="text/javascript">
					
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