2 Replies Latest reply on Sep 20, 2016 9:43 AM by Nancy OShea

    Contact Form

    carolyn@10541 Level 1

      I created the following contact form in Adobe Dreamweaver and am trying to figure out how to make it work. I do not know php and thought of using one of those website like jotform.com, but would really like to learn php (on my list of things to learn). In the meantime I was hoping one of my helpful Dreamweaver buddies could help me. Below is my code.

       

      Thank you in advance.

       

      Carolyn

       

      <!DOCTYPE html>

      <html lang="en">

        <head>

          <meta charset="UTF-8">

        <meta http-equiv="X-UA-Compatible" content="IE=edge">

        <meta name="viewport" content="width=device-width, initial-scale=1">

          <title>Temple Israel of South Merrick</title>

          <!-- Bootstrap -->

        <link href="css/bootstrap.css" rel="stylesheet">

       

       

        <!-- HTML5 shim and Respond.js for IE8 support of HTML5 elements and media queries -->

        <!-- WARNING: Respond.js doesn't work if you view the page via file:// -->

        <!--[if lt IE 9]>

         <script src="https://oss.maxcdn.com/html5shiv/3.7.2/html5shiv.min.js"></script>

         <script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>

        <![endif]-->

        </head>

      <body>

       

       

      <div class="container-fluid"></div>

              <!-- Brand and toggle get grouped for better mobile display -->

              <!-- Brand and toggle get grouped for better mobile display -->

      <div class="container-fluid">

                <ul class="nav navbar-nav">

               <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Home<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">History of Temple Israel</a></li>

               </ul>

                  </li>

                  <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">About Us<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">The Temple</a></li>

                      <li><a href="#">Rabbi & Staff</a></li>

                      <li><a href="#">Hebrew School Principal</a></li>

                    </ul>

                  </li>

                    <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Membership<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Membership @ TIOSM</a></li>

                      <li><a href="#">Executive Board</a></li>

                    </ul>

                  </li>

                     <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Community<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Sisterhood</a></li>

                      <li><a href="#">Men's Club</a></li>

                      <li><a href="#">Tikkun Olam</a></li>

                    </ul>

                  </li>

                     <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Education<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Sunday School</a></li>

                      <li><a href="#">Hebrew School</a></li>

                      <li><a href="#">Bar/Bat Mitzvah</a></li>

                      <li><a href="#">Adult Education</a></li>

                    </ul>

                  </li>

                     <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Holidays & Festivals<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Daily Minyan</a></li>

                      <li><a href="#">Shabbat</a></li>

                      <li><a href="#">High Holidays</a></li>

                      <li><a href="#">Sukkot</a></li>

                      <li><a href="#">Simchat Torah</a></li>

                      <li><a href="#">Chanukkah</a></li>

                      <li><a href="#">Purim</a></li>

                      <li><a href="#">Passover</a></li>

                    </ul>

                  </li>

                     <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Fundraising<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Fundraisers for Temple Israel of South Merrick</a></li>

                    </ul>

                  </li>

                  <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Upcoming Events<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                      <li><a href="#">Upcoming Events for Temple Israel of South Merrick</a></li>

                      <li><a href="#"></a></li>

                      <li><a href="#"></a></li>

                      <li><a href="#"></a></li>

                    </ul>

                  </li>

               <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Calendar<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

      <iframe src="https://calendar.google.com/calendar/embed?src=2040oqg3rl1llujf6aaurm68uk%40group.calendar .google.com&ctz=America/New_York" style="border: 0" width="800" height="600" frameborder="0" scrolling="no"></iframe>

                    </ul>

                  </li>

                  <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Photo Gallery<span class="caret"></span></a>

                    <ul class="dropdown-menu" role="menu">

                     <li><a href="#">Temple Israel of South Merrick 50th Anniversary Celebration</a></li>

                     <li><a href="#">Mel Polay 2016 Purim Carnival</a></li>

                     <li><a href="#">Temple Israel of South Merrick 2016 Moving Up Day</a></li>

                    </ul>

                  </li>

                   <li class="dropdown">

                  <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false">Contact Us<span class="caret"></span></a></li>

                    <ul class="dropdown-menu" role="menu">

        <script src="https://cdn.jotfor.ms/static/prototype.forms.js" type="text/javascript"></script>

      <script src="https://cdn.jotfor.ms/static/jotform.forms.js?3.3.14191" type="text/javascript"></script>

      <script src="js/jquery-1.11.2.min.js" type="text/javascript"></script>

      <script src="js/bootstrap.js" type="text/javascript"></script>

      <script type="text/javascript">

         JotForm.init(function(){

            setTimeout(function() {

                $('input_16').hint('ex: myname@example.com');

             }, 20);

        JotForm.clearFieldOnHide="disable";

        JotForm.onSubmissionError="jumpToFirstError";

         });

      </script>

      <link href="https://cdn.jotfor.ms/static/formCss.css?3.3.14191" rel="stylesheet" type="text/css" />

      <link type="text/css" rel="stylesheet" href="https://cdn.jotfor.ms/css/styles/nova.css?3.3.14191" />

      <link type="text/css" media="print" rel="stylesheet" href="https://cdn.jotfor.ms/css/printForm.css?3.3.14191" />

      <style type="text/css">

          .form-label-left{

              width:150px !important;

          }

          .form-line{

              padding-top:12px;

              padding-bottom:12px;

          }

          .form-label-right{

              width:150px !important;

          }

          .form-all{

              width:590px;

              color:#555 !important;

              font-family:"Lucida Grande", "Lucida Sans Unicode", "Lucida Sans", Verdana, sans-serif;

              font-size:14px;

          }

          .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{

              color: #555;

          }

       

       

      </style>

       

       

      <link type="text/css" rel="stylesheet" href="https://cdn.jotfor.ms/css/styles/buttons/form-submit-button-light_rounded.css?3.3.14191"/>

      <form class="jotform-form" action="https://submit.jotform.us/submit/61996126060154/" method="post" name="form_61996126060154" id="61996126060154" accept-charset="utf-8">

        <input type="hidden" name="formID" value="61996126060154" />

        <div class="form-all">

          <ul class="form-section page-section">

            <li id="cid_24" class="form-input-wide" data-type="control_head">

              <div class="form-header-group">

                <div class="header-text httal htvam">

                  <h2 id="header_24" class="form-header">

                    Contact Form

                  </h2>

                </div>

              </div>

            </li>

            <li class="form-line jf-required" data-type="control_fullname" id="id_15">

              <label class="form-label form-label-top form-label-auto" id="label_15" for="input_15">

                Your Name

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_15" class="form-input-wide jf-required">

                <span class="form-sub-label-container" style="vertical-align: top">

                  <input class="form-textbox validate[required]" type="text" size="10" name="q15_yourName[first]" id="first_15" />

                  <label class="form-sub-label" for="first_15" id="sublabel_first" style="min-height: 13px;"> First Name </label>

                </span>

                <span class="form-sub-label-container" style="vertical-align: top">

                  <input class="form-textbox validate[required]" type="text" size="15" name="q15_yourName[last]" id="last_15" />

                  <label class="form-sub-label" for="last_15" id="sublabel_last" style="min-height: 13px;"> Last Name </label>

                </span>

              </div>

            </li>

            <li class="form-line jf-required" data-type="control_address" id="id_25">

              <label class="form-label form-label-top form-label-auto" id="label_25" for="input_25">

                Address

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_25" class="form-input-wide jf-required">

                <table summary="" undefined class="form-address-table" border="0" cellpadding="0" cellspacing="0">

                  <tr>

                    <td colspan="2">

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <input class="form-textbox validate[required] form-address-line" type="text" name="q25_address[addr_line1]" id="input_25_addr_line1" />

                        <label class="form-sub-label" for="input_25_addr_line1" id="sublabel_25_addr_line1" style="min-height: 13px;"> Street Address </label>

                      </span>

                    </td>

                  </tr>

                  <tr>

                    <td colspan="2">

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <input class="form-textbox form-address-line" type="text" name="q25_address[addr_line2]" id="input_25_addr_line2" size="46" />

                        <label class="form-sub-label" for="input_25_addr_line2" id="sublabel_25_addr_line2" style="min-height: 13px;"> Street Address Line 2 </label>

                      </span>

                    </td>

                  </tr>

                  <tr>

                    <td width="50%">

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <input class="form-textbox validate[required] form-address-city" type="text" name="q25_address[city]" id="input_25_city" size="21" />

                        <label class="form-sub-label" for="input_25_city" id="sublabel_25_city" style="min-height: 13px;"> City </label>

                      </span>

                    </td>

                    <td>

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <input class="form-textbox validate[required] form-address-state" type="text" name="q25_address[state]" id="input_25_state" size="22" />

                        <label class="form-sub-label" for="input_25_state" id="sublabel_25_state" style="min-height: 13px;"> State / Province </label>

                      </span>

                    </td>

                  </tr>

                  <tr>

                    <td width="50%">

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <input class="form-textbox validate[required] form-address-postal" type="text" name="q25_address[postal]" id="input_25_postal" size="10" />

                        <label class="form-sub-label" for="input_25_postal" id="sublabel_25_postal" style="min-height: 13px;"> Postal / Zip Code </label>

                      </span>

                    </td>

                    <td>

                      <span class="form-sub-label-container" style="vertical-align: top">

                        <select class="form-dropdown validate[required] form-address-country" defaultcountry="" name="q25_address[country]" id="input_25_country">

                          <option value="" selected> Please Select </option>

                          <option value="United States"> United States </option>

                          <option value="Afghanistan"> Afghanistan </option>

                          <option value="Albania"> Albania </option>

                          <option value="Algeria"> Algeria </option>

                          <option value="American Samoa"> American Samoa </option>

                          <option value="Andorra"> Andorra </option>

                          <option value="Angola"> Angola </option>

                          <option value="Anguilla"> Anguilla </option>

                          <option value="Antigua and Barbuda"> Antigua and Barbuda </option>

                          <option value="Argentina"> Argentina </option>

                          <option value="Armenia"> Armenia </option>

                          <option value="Aruba"> Aruba </option>

                          <option value="Australia"> Australia </option>

                          <option value="Austria"> Austria </option>

                          <option value="Azerbaijan"> Azerbaijan </option>

                          <option value="The Bahamas"> The Bahamas </option>

                          <option value="Bahrain"> Bahrain </option>

                          <option value="Bangladesh"> Bangladesh </option>

                          <option value="Barbados"> Barbados </option>

                          <option value="Belarus"> Belarus </option>

                          <option value="Belgium"> Belgium </option>

                          <option value="Belize"> Belize </option>

                          <option value="Benin"> Benin </option>

                          <option value="Bermuda"> Bermuda </option>

                          <option value="Bhutan"> Bhutan </option>

                          <option value="Bolivia"> Bolivia </option>

                          <option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>

                          <option value="Botswana"> Botswana </option>

                          <option value="Brazil"> Brazil </option>

                          <option value="Brunei"> Brunei </option>

                          <option value="Bulgaria"> Bulgaria </option>

                          <option value="Burkina Faso"> Burkina Faso </option>

                          <option value="Burundi"> Burundi </option>

                          <option value="Cambodia"> Cambodia </option>

                          <option value="Cameroon"> Cameroon </option>

                          <option value="Canada"> Canada </option>

                          <option value="Cape Verde"> Cape Verde </option>

                          <option value="Cayman Islands"> Cayman Islands </option>

                          <option value="Central African Republic"> Central African Republic </option>

                          <option value="Chad"> Chad </option>

                          <option value="Chile"> Chile </option>

                          <option value="People's Republic of China"> People's Republic of China </option>

                          <option value="Republic of China"> Republic of China </option>

                          <option value="Christmas Island"> Christmas Island </option>

                          <option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>

                          <option value="Colombia"> Colombia </option>

                          <option value="Comoros"> Comoros </option>

                          <option value="Congo"> Congo </option>

                          <option value="Cook Islands"> Cook Islands </option>

                          <option value="Costa Rica"> Costa Rica </option>

                          <option value="Cote d'Ivoire"> Cote d'Ivoire </option>

                          <option value="Croatia"> Croatia </option>

                          <option value="Cuba"> Cuba </option>

                          <option value="Cyprus"> Cyprus </option>

                          <option value="Czech Republic"> Czech Republic </option>

                          <option value="Democratic Republic of the Congo"> Democratic Republic of the Congo </option>

                          <option value="Denmark"> Denmark </option>

                          <option value="Djibouti"> Djibouti </option>

                          <option value="Dominica"> Dominica </option>

                          <option value="Dominican Republic"> Dominican Republic </option>

                          <option value="Ecuador"> Ecuador </option>

                          <option value="Egypt"> Egypt </option>

                          <option value="El Salvador"> El Salvador </option>

                          <option value="Equatorial Guinea"> Equatorial Guinea </option>

                          <option value="Eritrea"> Eritrea </option>

                          <option value="Estonia"> Estonia </option>

                          <option value="Ethiopia"> Ethiopia </option>

                          <option value="Falkland Islands"> Falkland Islands </option>

                          <option value="Faroe Islands"> Faroe Islands </option>

                          <option value="Fiji"> Fiji </option>

                          <option value="Finland"> Finland </option>

                          <option value="France"> France </option>

                          <option value="French Polynesia"> French Polynesia </option>

                          <option value="Gabon"> Gabon </option>

                          <option value="The Gambia"> The Gambia </option>

                          <option value="Georgia"> Georgia </option>

                          <option value="Germany"> Germany </option>

                          <option value="Ghana"> Ghana </option>

                          <option value="Gibraltar"> Gibraltar </option>

                          <option value="Greece"> Greece </option>

                          <option value="Greenland"> Greenland </option>

                          <option value="Grenada"> Grenada </option>

                          <option value="Guadeloupe"> Guadeloupe </option>

                          <option value="Guam"> Guam </option>

                          <option value="Guatemala"> Guatemala </option>

                          <option value="Guernsey"> Guernsey </option>

                          <option value="Guinea"> Guinea </option>

                          <option value="Guinea-Bissau"> Guinea-Bissau </option>

                          <option value="Guyana"> Guyana </option>

                          <option value="Haiti"> Haiti </option>

                          <option value="Honduras"> Honduras </option>

                          <option value="Hong Kong"> Hong Kong </option>

                          <option value="Hungary"> Hungary </option>

                          <option value="Iceland"> Iceland </option>

                          <option value="India"> India </option>

                          <option value="Indonesia"> Indonesia </option>

                          <option value="Iran"> Iran </option>

                          <option value="Iraq"> Iraq </option>

                          <option value="Ireland"> Ireland </option>

                          <option value="Israel"> Israel </option>

                          <option value="Italy"> Italy </option>

                          <option value="Jamaica"> Jamaica </option>

                          <option value="Japan"> Japan </option>

                          <option value="Jersey"> Jersey </option>

                          <option value="Jordan"> Jordan </option>

                          <option value="Kazakhstan"> Kazakhstan </option>

                          <option value="Kenya"> Kenya </option>

                          <option value="Kiribati"> Kiribati </option>

                          <option value="North Korea"> North Korea </option>

                          <option value="South Korea"> South Korea </option>

                          <option value="Kosovo"> Kosovo </option>

                          <option value="Kuwait"> Kuwait </option>

                          <option value="Kyrgyzstan"> Kyrgyzstan </option>

                          <option value="Laos"> Laos </option>

                          <option value="Latvia"> Latvia </option>

                          <option value="Lebanon"> Lebanon </option>

                          <option value="Lesotho"> Lesotho </option>

                          <option value="Liberia"> Liberia </option>

                          <option value="Libya"> Libya </option>

                          <option value="Liechtenstein"> Liechtenstein </option>

                          <option value="Lithuania"> Lithuania </option>

                          <option value="Luxembourg"> Luxembourg </option>

                          <option value="Macau"> Macau </option>

                          <option value="Macedonia"> Macedonia </option>

                          <option value="Madagascar"> Madagascar </option>

                          <option value="Malawi"> Malawi </option>

                          <option value="Malaysia"> Malaysia </option>

                          <option value="Maldives"> Maldives </option>

                          <option value="Mali"> Mali </option>

                          <option value="Malta"> Malta </option>

                          <option value="Marshall Islands"> Marshall Islands </option>

                          <option value="Martinique"> Martinique </option>

                          <option value="Mauritania"> Mauritania </option>

                          <option value="Mauritius"> Mauritius </option>

                          <option value="Mayotte"> Mayotte </option>

                          <option value="Mexico"> Mexico </option>

                          <option value="Micronesia"> Micronesia </option>

                          <option value="Moldova"> Moldova </option>

                          <option value="Monaco"> Monaco </option>

                          <option value="Mongolia"> Mongolia </option>

                          <option value="Montenegro"> Montenegro </option>

                          <option value="Montserrat"> Montserrat </option>

                          <option value="Morocco"> Morocco </option>

                          <option value="Mozambique"> Mozambique </option>

                          <option value="Myanmar"> Myanmar </option>

                          <option value="Nagorno-Karabakh"> Nagorno-Karabakh </option>

                          <option value="Namibia"> Namibia </option>

                          <option value="Nauru"> Nauru </option>

                          <option value="Nepal"> Nepal </option>

                          <option value="Netherlands"> Netherlands </option>

                          <option value="Netherlands Antilles"> Netherlands Antilles </option>

                          <option value="New Caledonia"> New Caledonia </option>

                          <option value="New Zealand"> New Zealand </option>

                          <option value="Nicaragua"> Nicaragua </option>

                          <option value="Niger"> Niger </option>

                          <option value="Nigeria"> Nigeria </option>

                          <option value="Niue"> Niue </option>

                          <option value="Norfolk Island"> Norfolk Island </option>

                          <option value="Turkish Republic of Northern Cyprus"> Turkish Republic of Northern Cyprus </option>

                          <option value="Northern Mariana"> Northern Mariana </option>

                          <option value="Norway"> Norway </option>

                          <option value="Oman"> Oman </option>

                          <option value="Pakistan"> Pakistan </option>

                          <option value="Palau"> Palau </option>

                          <option value="Palestine"> Palestine </option>

                          <option value="Panama"> Panama </option>

                          <option value="Papua New Guinea"> Papua New Guinea </option>

                          <option value="Paraguay"> Paraguay </option>

                          <option value="Peru"> Peru </option>

                          <option value="Philippines"> Philippines </option>

                          <option value="Pitcairn Islands"> Pitcairn Islands </option>

                          <option value="Poland"> Poland </option>

                          <option value="Portugal"> Portugal </option>

                          <option value="Puerto Rico"> Puerto Rico </option>

                          <option value="Qatar"> Qatar </option>

                          <option value="Republic of the Congo"> Republic of the Congo </option>

                          <option value="Romania"> Romania </option>

                          <option value="Russia"> Russia </option>

                          <option value="Rwanda"> Rwanda </option>

                          <option value="Saint Barthelemy"> Saint Barthelemy </option>

                          <option value="Saint Helena"> Saint Helena </option>

                          <option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>

                          <option value="Saint Lucia"> Saint Lucia </option>

                          <option value="Saint Martin"> Saint Martin </option>

                          <option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>

                          <option value="Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines </option>

                          <option value="Samoa"> Samoa </option>

                          <option value="San Marino"> San Marino </option>

                          <option value="Sao Tome and Principe"> Sao Tome and Principe </option>

                          <option value="Saudi Arabia"> Saudi Arabia </option>

                          <option value="Senegal"> Senegal </option>

                          <option value="Serbia"> Serbia </option>

                          <option value="Seychelles"> Seychelles </option>

                          <option value="Sierra Leone"> Sierra Leone </option>

                          <option value="Singapore"> Singapore </option>

                          <option value="Slovakia"> Slovakia </option>

                          <option value="Slovenia"> Slovenia </option>

                          <option value="Solomon Islands"> Solomon Islands </option>

                          <option value="Somalia"> Somalia </option>

                          <option value="Somaliland"> Somaliland </option>

                          <option value="South Africa"> South Africa </option>

                          <option value="South Ossetia"> South Ossetia </option>

                          <option value="South Sudan"> South Sudan </option>

                          <option value="Spain"> Spain </option>

                          <option value="Sri Lanka"> Sri Lanka </option>

                          <option value="Sudan"> Sudan </option>

                          <option value="Suriname"> Suriname </option>

                          <option value="Svalbard"> Svalbard </option>

                          <option value="Swaziland"> Swaziland </option>

                          <option value="Sweden"> Sweden </option>

                          <option value="Switzerland"> Switzerland </option>

                          <option value="Syria"> Syria </option>

                          <option value="Taiwan"> Taiwan </option>

                          <option value="Tajikistan"> Tajikistan </option>

                          <option value="Tanzania"> Tanzania </option>

                          <option value="Thailand"> Thailand </option>

                          <option value="Timor-Leste"> Timor-Leste </option>

                          <option value="Togo"> Togo </option>

                          <option value="Tokelau"> Tokelau </option>

                          <option value="Tonga"> Tonga </option>

                          <option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option>

                          <option value="Trinidad and Tobago"> Trinidad and Tobago </option>

                          <option value="Tristan da Cunha"> Tristan da Cunha </option>

                          <option value="Tunisia"> Tunisia </option>

                          <option value="Turkey"> Turkey </option>

                          <option value="Turkmenistan"> Turkmenistan </option>

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                          <option value="Tuvalu"> Tuvalu </option>

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                          <option value="Ukraine"> Ukraine </option>

                          <option value="United Arab Emirates"> United Arab Emirates </option>

                          <option value="United Kingdom"> United Kingdom </option>

                          <option value="Uruguay"> Uruguay </option>

                          <option value="Uzbekistan"> Uzbekistan </option>

                          <option value="Vanuatu"> Vanuatu </option>

                          <option value="Vatican City"> Vatican City </option>

                          <option value="Venezuela"> Venezuela </option>

                          <option value="Vietnam"> Vietnam </option>

                          <option value="British Virgin Islands"> British Virgin Islands </option>

                          <option value="Isle of Man"> Isle of Man </option>

                          <option value="US Virgin Islands"> US Virgin Islands </option>

                          <option value="Wallis and Futuna"> Wallis and Futuna </option>

                          <option value="Western Sahara"> Western Sahara </option>

                          <option value="Yemen"> Yemen </option>

                          <option value="Zambia"> Zambia </option>

                          <option value="Zimbabwe"> Zimbabwe </option>

                          <option value="other"> Other </option>

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                        <label class="form-sub-label" for="input_25_country" id="sublabel_25_country" style="min-height: 13px;"> Country </label>

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              <label class="form-label form-label-top form-label-auto" id="label_22" for="input_22">

                Phone Number

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_22" class="form-input-wide jf-required">

                <span class="form-sub-label-container" style="vertical-align: top">

                  <input class="form-textbox validate[required]" type="tel" name="q22_phoneNumber22[area]" id="input_22_area" size="3">

                  <span class="phone-separate">

                     -

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                  <label class="form-sub-label" for="input_22_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>

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                  <label class="form-sub-label" for="input_22_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>

                </span>

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            </li>

            <li class="form-line jf-required" data-type="control_email" id="id_16">

              <label class="form-label form-label-top form-label-auto" id="label_16" for="input_16">

                Your E-mail Address

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                  *

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              </label>

              <div id="cid_16" class="form-input-wide jf-required">

                <input type="email" class=" form-textbox validate[required, Email]" id="input_16" name="q16_yourEmail16" size="32" value="" />

              </div>

            </li>

            <li class="form-line jf-required" data-type="control_radio" id="id_23">

              <label class="form-label form-label-top form-label-auto" id="label_23" for="input_23">

                Preferred Contact:

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_23" class="form-input-wide jf-required">

                <div class="form-single-column">

                  <span class="form-radio-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="radio" class="form-radio validate[required]" id="input_23_0" name="q23_preferredContact" value="E-mail" />

                    <label id="label_input_23_0" for="input_23_0"> E-mail </label>

                  </span>

                  <span class="form-radio-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="radio" class="form-radio validate[required]" id="input_23_1" name="q23_preferredContact" value="Phone" />

                    <label id="label_input_23_1" for="input_23_1"> Phone </label>

                  </span>

                </div>

              </div>

            </li>

            <li class="form-line jf-required" data-type="control_checkbox" id="id_26">

              <label class="form-label form-label-top form-label-auto" id="label_26" for="input_26">

                I am interested in

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_26" class="form-input-wide jf-required">

                <div class="form-single-column">

                  <span class="form-checkbox-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="checkbox" class="form-checkbox validate[required]" id="input_26_0" name="q26_iAm[]" value="Membership" />

                    <label id="label_input_26_0" for="input_26_0"> Membership </label>

                  </span>

                  <span class="form-checkbox-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="checkbox" class="form-checkbox validate[required]" id="input_26_1" name="q26_iAm[]" value="Making a donation" />

                    <label id="label_input_26_1" for="input_26_1"> Making a donation </label>

                  </span>

                  <span class="form-checkbox-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="checkbox" class="form-checkbox validate[required]" id="input_26_2" name="q26_iAm[]" value="Volunteering for Monday Bingo" />

                    <label id="label_input_26_2" for="input_26_2"> Volunteering for Monday Bingo </label>

                  </span>

                  <span class="form-checkbox-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="checkbox" class="form-checkbox validate[required]" id="input_26_3" name="q26_iAm[]" value="Volunteering for Wednesday Bingo" />

                    <label id="label_input_26_3" for="input_26_3"> Volunteering for Wednesday Bingo </label>

                  </span>

                  <span class="form-checkbox-item" style="clear:left;">

                    <span class="dragger-item">

                    </span>

                    <input type="checkbox" class="form-checkbox validate[required]" id="input_26_4" name="q26_iAm[]" value="Volunteering for Special Events" />

                    <label id="label_input_26_4" for="input_26_4"> Volunteering for Special Events </label>

                  </span>

                </div>

              </div>

            </li>

            <li class="form-line jf-required" data-type="control_textarea" id="id_17">

              <label class="form-label form-label-top form-label-auto" id="label_17" for="input_17">

                Your Message

                <span class="form-required">

                  *

                </span>

              </label>

              <div id="cid_17" class="form-input-wide jf-required">

                <textarea id="input_17" class="form-textarea validate[required]" name="q17_yourMessage17" cols="25" rows="3"></textarea>

              </div>

            </li>

            <li class="form-line" data-type="control_button" id="id_14">

              <div id="cid_14" class="form-input-wide">

                <div style="text-align:center" class="form-buttons-wrapper">

                  <button id="input_14" type="submit" class="form-submit-button form-submit-button-light_rounded">

                    Submit

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                  <button id="input_reset_14" type="reset" class="form-submit-reset form-submit-button-light_rounded">

                    Clear Form

                  </button>

                </div>

              </div>

            </li>

            <li style="display:none">

              Should be Empty:

              <input type="text" name="website" value="" />

            </li>

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        JotForm.showJotFormPowered = true;

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        <input type="hidden" id="simple_spc" name="simple_spc" value="61996126060154" />

        <script type="text/javascript">

        document.getElementById("si" + "mple" + "_spc").value = "61996126060154-61996126060154";

        </script>

      </form>

      <script type="text/javascript">JotForm.ownerView=true;</script>

                  <li class="dropdown"><a href="#" class="dropdown-toggle" data-toggle="">

                

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              <!-- /.navbar-collapse -->

         

            <!-- /.container-fluid -->

          <br />

        

       

               <!-- Top content -->

              <div class="top-content">

           

                  <div class="inner-bg">

                      <div class="container <div class="row">

                <div class="form-box">

                              <div class="form-top">

                              <div class="form-top-left">

                              <h3><strong><p align="center">CONTACT US</p></strong></h3>

                                  <p>Fill in the form below to send us a message:</p>

                              </div>

                              <div class="form-top-right">

                              <i class="fa fa-envelope"></i>

                              </div>

                                  </div>

                                  <div class="form-bottom contact-form">

                           <form role="form" action="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/contact.php" method="post">

                            <div class="form-group">

                            <label class="sr-only" for="contact-email">Name</label>

                                <input type="text" name="name" placeholder="Name..." class="contact-name form-control" id="contact-name">

                               </div>

                            <div class="form-group">

                            <label class="sr-only" for="contact-Home Address">Home Address</label>

                                <input type="text" name="home address" placeholder="Home Address..." class="contact-home address form-control" id="contact-email">

                               </div>

                            <div class="form-group">

                            <label class="sr-only" for="contact-Phone #">Phone #</label>

                                <input type="text" name="phone #" placeholder="Phone #..." class="contact-Phone # form-control" id="contact-phone">

                               </div>

                            <div class="form-group">

                            <label class="sr-only" for="email">Email</label>

                                <input type="text" name="email" placeholder="email..." class="email form-control" id="email">

                               </div>

                            <div class="form-group">

                             <label class="sr-only" for="Preferred Method of Contact:">Preferred Method of Contact:</label>

                                <input type="text" name="Preferred Method of Contact:" placeholder="Preferred Method of Contact:..." class="Preferred Method of Contact: form-control" id="Preferred Method of Contact:">

                                            <p>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="Interests_0">

                                                  Email</label>

                                                <br>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="Interests_1">

                                                  Phone</label>

                                                <br>

                            <div class="form-group">

                             <label class="sr-only" for="I am interested in:">I am interested in:</label>

                                <input type="text" name="I am interested in:" placeholder="I am interested in:..." class="I am interested in: form-control" id="I am interested in:">

                                            <p>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="radio">

                                                  Membership</label>

                                                <br>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="radio_0">

                                                  Volunteering for Monday morning Bingo</label>

                                                <br>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="radio_1">

                                                  Volunteering for Wednesday evening Bingo</label>

                                                <br>

                                                <label>

                                                  <input type="radio" name="Interests" value="radio" id="radio_2">

                                                  Volunteering for Special Events</label>

                                                <br>

                                                  <label>

                                                  <input type="radio" name="Fundraising" value="radio" id="Fundraising_0">

                                                  Fundraising</label>

                                                <br>

                                            </p>

                                          </div>

                               <div class="form-group">

                                <label class="sr-only" for="contact-subject">Subject</label>

                                <input type="text" name="subject" placeholder="Subject..." class="contact-subject form-control" id="contact-subject">

                               </div>

                               <div class="form-group">

                                <label class="sr-only" for="contact-message">Message</label>

                                <textarea name="message" placeholder="Message..." class="contact-message form-control" id="contact-message"></textarea>

                               </div>

                               <button type="submit" class="btn">Send message</button>

                           </p></div></form><br />

                                              <h4><p align="center">Temple Israel of South Merrick<br />

              2655 Clubhouse Road<br />

              Merrick, NY 11566<br />

              (516) 378-1963<br />

              <a href="mailto[email address removed by Mod]</a><br />

              <a href="http://www.tisom.org">www.tisom.org</a></p></h4>

       

       

                           </div>

                              </div>

       

       

                      </div>

                  </div>

                

              <!-- Javascript -->

              <script src="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/js/jquery-1.11.1.mi n.js"></script>

              <script src="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/bootstrap/js/bootst rap.min.js"></script>

              <script src="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/js/jquery.backstret ch.min.js"></script>

              <script src="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/js/retina-1.1.0.min .js"></script>

              <script src="file:///Macintosh HD/Users/carolynjosephs/Desktop/bootstrap-contact-forms/form-1/assets/js/scripts.js"></sc ript>

            

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                  <script src="assets/js/placeholder.js"></script>

              <![endif]-->

       

       

       

       

          </div></body>

       

       

      </html>

      <!-- jQuery (necessary for Bootstrap's JavaScript plugins) -->

       

      Moderator note: This is the second time that I have had to remove and email address from your post Please have a look at Email signatures and personal information