document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub20.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=1705955230&formid=3717\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:1705955230:20:3717\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div>Request Template Preview</div></div> <div class=\"bn-form-desc\"><p>We would like to show you examples of what we can do for you.');
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document.write('If you would like to preview examples of Template Designs from ACT Digital Displays please fill out the following request.  There is no Obligation for future purchase. Simply fill out the form below and we will send you a link to download the complete pdf booklet.</p></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Name </span> <span class=\"bn-input\"><input name=\"Field-1\" type=\"text\" placeholder=\"your first and last name please\" value=\"\" validator=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Email Address <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input name=\"Field-2\" required=\"required\" type=\"text\" placeholder=\"you must enter a valid email address\" value=\"\" validator=\"email\"></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Is this for a New Project or Existing? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-checkbox\"><input name=\"Field-144831141869180[]\" type=\"checkbox\" checked=\"checked\" value=\"New Project\"> New Project</label></span><span class=\"bn-optionwrapper\"><label class=\"bn-checkbox\"><input name=\"Field-144831141869180[]\" type=\"checkbox\" value=\"Existing Project\"> Existing Project</label></span></span></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Do you have any questions or comments? <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><textarea name=\"Field-3\" required=\"required\" placeholder=\"enter your comments here\" validator=\"\">enter your comments here</textarea></span></label></div>  <input name=\"carboncopy\" type=\"hidden\" value=\"\"> <input name=\"thankyou\" type=\"hidden\" value=\"http://www.actdigitaldisplays.com/act_digital_displays_template_download.htm\"> <input name=\"thankyoutext\" type=\"hidden\" value=\"\"> <input name=\"subject\" type=\"hidden\" value=\"Digital Displays Template request\"><div class=\"bn-form-submit\"><button class=\"formbtn\" type=\"submit\">Submit Form</button></div></form>');
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