document.write(' <form action=\"http://zenplanner.com/zenplanner/api/prospect/index.cfm?PartitionId=df473822-ff22-06e6-f8cf-809fd18aa3ae\" method=\"post\" onsubmit=\"return __zpCheckProspectForm(this)\"> <input type=\"hidden\" name=\"SourceId\" value=\"df48861f-ff22-06e6-f81f-7bfe00f42fd7\"> <input type=\"hidden\" name=\"RTN\" value=\"http://gojukent.com/thankyou.html\"> <table style=\"font-family:Arial; font-size:10pt;\"> <tr> <td>First Name &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"FirstName\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Last Name &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"LastName\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td>Email Address &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"EmailAddress\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Phone Number &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"TelephoneNumber\" class=\"textInput\" maxlength=\"50\"> <img src=\"http://zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td>Address &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"Address\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>City &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"City\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>State &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"State\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr> <td>Zip Code &nbsp;</td> <td nowrap=\"true\"> <input type=\"text\" name=\"Zip\" class=\"textInput\" maxlength=\"50\"> </td> </tr> <tr><td>&nbsp;</td></tr> <tr> <td valign=\"top\">Interested In &nbsp;</td> <td valign=\"top\"> <select name=\"ProgramId\"> <option value=\"\">(Please Select One)</option> <option value=\"0250D191-FF22-06E6-F879-954A58D2212B\">Adults</option> <option value=\"DF488B3F-FF22-06E6-F83C-E59B1CA82029\">Juniors</option> <option value=\"DF48914A-FF22-06E6-F845-33545E0A9A94\">Tiny Tigers</option> </select> <img src=\"http://zenplanner.com/zenplanner/api/images/required.png\" title=\"This field is required.\"> </td> </tr> <tr> <td>Reason for Interest &nbsp;</td> <td> <select name=\"InterestId\"> <option value=\"\">(Please Select One)</option> <option value=\"DF488573-FF22-06E6-F854-2E372096430D\">Child\'s Performance In School / Grades</option> <option value=\"DF488582-FF22-06E6-F862-A66824178B05\">Competition</option> <option value=\"DF488592-FF22-06E6-F877-1A993696FD2F\">Physical Fitness</option> <option value=\"DF4885A2-FF22-06E6-F845-076D2329E9FD\">Mental Discipline</option> <option value=\"DF4885B1-FF22-06E6-F837-CA20803F2551\">Self Defense</option> <option value=\"DF4885C1-FF22-06E6-F887-DF63DB38AFAA\">Other</option> </select> </td> </tr> </table> <br> <input name=\"submitButton\" type=\"submit\" value=\"Submit\"> </form> ');

__zpCheckProspectForm = function(form)
{
	var require = function(field, label)
	{
		if (field.value == '')
		{
			alert('Please enter your ' + label + ' before submitting this form.');
			field.focus();
			return false;
		}
		return true
	}

	if (!require(form.FirstName, 'First Name')) {return false};
	if (!require(form.LastName, 'Last Name')) {return false};

	if (!require(form.EmailAddress, 'Email Address')) {return false};
	if (!require(form.TelephoneNumber, 'Phone Number')) {return false};

	
		if (form.ProgramId.selectedIndex == 0)
		{
			alert('Please select a program that you are interested in.');
			return false;
		}

	

	form.submitButton.disabled = true;
	return true;
};