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('phone').value == '') {
				document.getElementById('phone').focus();
				alert("Phone 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_64_0').value == '') {
				document.getElementById('element_64_0').focus();
				alert("Company: is a required field.");
				return false;
			}
	document.getElementById('submitbutton').disabled = true;
	document.getElementById('submitbutton').value = 'Submitting Form Data...';
	return true;
}


document.write("<form action='http://leadmanager.lpimultimedia.com/form/submit' method='post' onsubmit='return lpilm_validate()'><ul class='formlist'>");
document.write("<input type='hidden' name='id' value='64' />");
document.write("<input type='hidden' name='source' value='' />");

document.write("<li class='formitem required' style=''><span class='formlabel'>First Name</span> <span class='formvalue'><input type='text' name='fname' id='fname' value='' size='25' /></span></li>");







document.write("<li class='formitem required' style=''><span class='formlabel'>Last Name</span> <span class='formvalue'><input type='text' name='lname' id='lname' value='' size='25' /></span></li>");







document.write("<li class='formitem required' style=''><span class='formlabel'>Phone</span> <span class='formvalue'><input type='text' name='phone' id='phone' value='' size='25' /></span></li>");







document.write("<li class='formitem required' style=''><span class='formlabel'>Email</span> <span class='formvalue'><input type='text' name='email' id='email' value='' size='25' /></span></li>");







document.write("<li class='formitem required' style=''><span class='formlabel'>Company:</span> <span class='formvalue'><input type='text' name='element_64_0' id='element_64_0' value='' size='25' /></span></li>");









document.write("<li class='submit' style=''><input type='submit' id='submitbutton' value='Submit Form' /></li>");
document.write("</ul><br clear='all' /></form>");