function ap_validate_1043() {
   var form = document.ap_form_1043;
   var regexp_12021 = /^[a-zA-Z]+(([\'\,\.\-][a-zA-Z])?[a-zA-Z]*)*$/;
   var regexp_12022 = /^[a-zA-Z]+(([\'\,\.\-][a-zA-Z])?[a-zA-Z]*)*$/;
   var regexp_12023 = /^(\+?((0(\d{2})?)|1)?\s*[-\/\.]?)?(\((\d{3})\)|(\d{3}))?\s*[-\/\.]?\s*(\((\d{3})\)|(\d{3}))?[-\/\.]?\s*(\d{4})\s*(([xX]|[eE][xX][tT])\.?\s*(\d+))*/;
   var regexp_12020 = /^(([A-Za-z0-9]+_+)|([A-Za-z0-9]+\-+)|([A-Za-z0-9]+\.+)|([A-Za-z0-9]+\++))*[A-Za-z0-9]+@((\w+\-+)|(\w+\.))*\w{1,63}\.[a-zA-Z]{2,6}$/;
    if (form.name === ""){
      alert( "There was an error on this form." );
    } else if (form.ap_field_12021.value === ""){
      alert( "Please enter all required fields: First " );
    } else if (!regexp_12021.test(form.ap_field_12021.value)){
      form.ap_field_12021.focus();
      form.ap_field_12021.select();
      alert( "Please correct required field: First" );
    } else if (form.ap_field_12022.value === ""){
      alert( "Please enter all required fields: Last " );
    } else if (!regexp_12022.test(form.ap_field_12022.value)){
      form.ap_field_12022.focus();
      form.ap_field_12022.select();
      alert( "Please correct required field: Last" );
    } else if (form.ap_field_12023.value === ""){
      alert( "Please enter all required fields: Phone " );
    } else if (!regexp_12023.test(form.ap_field_12023.value)){
      form.ap_field_12023.focus();
      form.ap_field_12023.select();
      alert( "Please correct required field: Phone" );
    } else if (form.ap_field_12020.value === ""){
      alert( "Please enter all required fields: Email " );
    } else if (!regexp_12020.test(form.ap_field_12020.value)){
      form.ap_field_12020.focus();
      form.ap_field_12020.select();
      alert( "Please correct required field: Email" );
    } else {
      document.ap_form_1043.submit();
    }
 }

function showForm(){
var formHTML = '<div>       <div style="width:95%; float:left; clear:both;">            <span style="font: bold 1.5em helvetica;"></span>       </div>       <div style="width:95%;float:left; clear:both;margin:0px 0px 7px 0px;">            <span style="font: bold 1.25em helvetica;"></span>       </div>  <form name="ap_form_1043" ID="ap_form_1043" method="post" action="https://www.aimcrm.com/remote/form_post.php" enctype="multipart/form-data"><input type="hidden" name="action" value="feedback_visitor_add"><input type="hidden" name="org_id" value="343"><input type="hidden" name="f_id" value="1043"><div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 3px; ">                 <span style=" float: left;">First<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_12021" name="ap_field_12021" value="" style="width:115px;" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 3px; ">                 <span style=" float: left;">Last<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_12022" name="ap_field_12022" value="" style="width:115px;" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 3px; ">                 <span style=" float: left;">Phone<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_12023" name="ap_field_12023" value="" style="width:115px;" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 3px; ">                 <span style=" float: left;">Email<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_12020" name="ap_field_12020" value="" style="width:115px;" /></span>       </div>  <div>            <span><input name="Submit" type="button" value="Submit" onclick="ap_validate_1043()"><p><span style="font-size:8pt;color:red;">* Required Field</span><a href="http://www.aimcrm.com" style="text-decoration:none;border:none;" title="lead management"><div style="font-size:8pt;color:black;"></div></a></p></span>       </div>  </div></form>';
if(!formShown){
     document.writeln(formHTML);
}
formShown=true;
}
var formShown = false;
showForm();