function lpilm_validate() {
if (document.getElementById('fname').value == '') {
document.getElementById('fname').focus();
alert("First Name is a required field.");
return false;
}
if (document.getElementById('lname').value == '') {
document.getElementById('lname').focus();
alert("Last Name is a required field.");
return false;
}
if (document.getElementById('address').value == '') {
document.getElementById('address').focus();
alert("Address is a required field.");
return false;
}
if (document.getElementById('city').value == '') {
document.getElementById('city').focus();
alert("City is a required field.");
return false;
}
if (document.getElementById('state')[document.getElementById('state').selectedIndex].value == '') {
document.getElementById('state').focus();
alert("State is a required field.");
return false;
}
if (document.getElementById('zip').value == '') {
document.getElementById('zip').focus();
alert("Zip is a required field.");
return false;
}
if (document.getElementById('email').value == '') {
document.getElementById('email').focus();
alert("Email is a required field.");
return false;
}
if (document.getElementById('element_35_3')[document.getElementById('element_35_3').selectedIndex].value == '') {
document.getElementById('element_35_3').focus();
alert("Preferred Contact Number: is a required field.");
return false;
}
if (document.getElementById('element_35_5').value == '') {
document.getElementById('element_35_5').focus();
alert("Referrer's Name: is a required field.");
return false;
}
if (document.getElementById('element_35_7').value == '') {
document.getElementById('element_35_7').focus();
alert("Referrer's City: is a required field.");
return false;
}
if (document.getElementById('element_35_8').value == '') {
document.getElementById('element_35_8').focus();
alert("Referrer's Zip: is a required field.");
return false;
}
if (document.getElementById('element_35_9').value == '') {
document.getElementById('element_35_9').focus();
alert("Referrer's Phone: is a required field.");
return false;
}
if (document.getElementById('element_35_10').value == '') {
document.getElementById('element_35_10').focus();
alert("Referrer's E-Mail: is a required field.");
return false;
}
document.getElementById('submitbutton').disabled = true;
document.getElementById('submitbutton').value = 'Submitting Form Data...';
return true;
}
document.write("When you refer friends, family and neighbors to Kinetico, you give them the opportunity to provide their family with clean, healthy water. For each of your referrals that purchase a system from us, you will earn a credit on your account that can be used towards filters or service. Please complete the form below and we will contact the individual to set-up a free in-home consultation. Please note, this program is for Arizona residents in Maricopa, Pima and Pinal counties.
");
document.write("");