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  • <p>1122/26 Quang Trung, Phường 8, Quận Gò Vấp, TP.HCM</p> <p>.......................................................................</p> <div id="crmWebToEntityForm" style="width: 600px; margin: auto;"><meta http-equiv='content-type' content='text/html;charset=UTF-8'> <form accept-charset="UTF-8" action="https://openapi.amis.vn/WebForm/savecollection" method="POST" name="WebToContactscf1b50598517469f32b40431472159e4" onsubmit="javascript:document.charset="UTF-8"; return checkMandatorycf1b50598517469f32b40431472159e4()"><input name="ID" style="display: none;" type="text" value="cf1b5059-8517-469f-32b4-0431472159e4" /> <input name="Companycode" style="display: none;" type="text" value="FXQD2BVK" /> <input name="AllowURL" style="display: none;" type="text" value="*" /> <input name="FormKey" style="display: none;" type="text" value="QtIPQy7sNddjhWjQT2AqGgDFV5GFh/Dj2BCNnjXgeb0=" /> <input name="RedirectURL" style="display: none;" type="text" value="https://htvlab.com/" /> <style type="text/css">tr, td { padding: 6px; border-spacing: 0px; border-width: 0px; } </style> <br />   <table style="width: 600px; background-color: white; color: #212121"> <tbody> <tr> <td align="left" colspan="2" style="color: #212121; font-family: Roboto; font-size: 13px;"><strong>Hãy gửi yêu cầu cùa bạn- HTV LAB hân hạnh báo giá</strong></td> </tr> <tr> <td style="nowrap: nowrap; text-align: left; font-size: 14px; font-family: Roboto; width: 200px;">Xưng hô</td> <td style="width: 250px;"><select name="SalutationID" style="width:250px;"><option value="1">Anh</option><option value="2">Chị</option><option value="3">Ông</option><option value="4">Bà</option></select></td> </tr> <tr> <td style="nowrap: nowrap; text-align: left; font-size: 14px; font-family: Roboto; width: 200px;">Tên<span style="color:red;">*</span></td> <td style="width: 250px;"><input name="LastName" style="width:250px;" type="text" /></td> </tr> <tr> <td style="nowrap: nowrap; text-align: left; font-size: 14px; font-family: Roboto; width: 200px;">ĐT di động<span style="color:red;">*</span></td> <td style="width: 250px;"><input name="Mobile" style="width:250px;" type="text" /></td> </tr> <tr> <td style="nowrap: nowrap; text-align: left; font-size: 14px; font-family: Roboto; width: 200px;">Email cá nhân</td> <td style="width: 250px;"><input name="Email" style="width:250px;" type="text" /></td> </tr> <tr> <td style="nowrap: nowrap; text-align: left; font-size: 14px; font-family: Roboto; width: 200px;">Yêu Cấu</td> <td style="width: 250px;"><input name="Description" style="width:250px;" type="text" /></td> </tr> <tr> <td align="center" colspan="2" style="text-align: left; padding-top: 15px; font-size: 13px;"><input id="formsubmit" style=" font-size: 13px; color: #212121" type="submit" value="Gửi" /> <input name="reset" style="font-size: 13px; color: #212121" type="reset" value="Đặt lại" /></td> </tr> </tbody> </table> <script> var mndFileds = new Array('LastName','Mobile');var fldLangVal = new Array('Tên','ĐT di động'); var name = ''; var email = ''; function checkMandatorycf1b50598517469f32b40431472159e4() { for (i = 0; i < mndFileds.length; i++) { var fieldObj = document.forms['WebToContactscf1b50598517469f32b40431472159e4'][mndFileds[i]]; if (fieldObj) { if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length == 0) { if (fieldObj.type == 'file') { alert('Bạn phải chọn file upload.'); fieldObj.focus(); return false; } alert(fldLangVal[i] + ' không được để trống.'); fieldObj.focus(); return false; } else if (fieldObj.nodeName == 'SELECT') { if (fieldObj.options[fieldObj.selectedIndex].value == '-None-') { alert(fldLangVal[i] + ' không được để trống.'); fieldObj.focus(); return false; } } else if (fieldObj.type == 'checkbox') { if (fieldObj.checked == false) { alert('Vui lòng chọn ' + fldLangVal[i]); fieldObj.focus(); return false; } } try { if (fieldObj.name == 'Last Name') { name = fieldObj.value; } } catch (e) { } } } document.getElementById('formsubmit').disabled = true; } </script></form> </div>

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