<form action='https://crm.zoho.com/crm/WebForm'  name="WebForm1223601000000740036" method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatery()' accept-charset='UTF-8' class="avia_ajax_form av-form-labels-visible   avia-builder-el-2  avia-builder-el-no-sibling  ">
<!-- <form action="./Alex _ Contact_files/Alex _ Contact.html" method="post" class="avia_ajax_form av-form-labels-visible   avia-builder-el-2  avia-builder-el-no-sibling  " data-avia-form-id="1" data-avia-redirect=""> -->
<input type='text' style='display:none;' name='xnQsjsdp' value='42e7740b3ac56185f2c3f8974b2bad89d7c6432161c46ce6da07567dd4931f07'/>
    <input type='hidden' name='zc_gad' id='zc_gad' value=''/>
    <input type='text' style='display:none;' name='xmIwtLD' value='e7a178c67e3770aaedd3541ad5ec146595a30f344c503aa616d0e8722f95b384'/>
    <input type='text'  style='display:none;' name='actionType' value='Q3VzdG9tTW9kdWxlMQ=='/>
    <input type='text' style='display:none;' name='returnURL' value='https&#x3a;&#x2f;&#x2f;mindreframing.org' />
    <select style='display:none;' name='COBJ1CF12'>
            <option value='-None-'>-None-</option>
            <option selected value='mindreframing'>mindreframing</option>
            <option value='ITreframing'>ITreframing</option>
            <option value='accountingreframing'>accountingreframing</option>
            <option value='Belize Business Formations'>Belize Business Formations</option>
          </select>
  <fieldset>
    <h3>Send us mail</h3>
    <p class=" first_form  form_element form_element_fourth" id="element_avia_title_1">
      <label for="avia_title_1">Title <abbr class="required" title="required">*</abbr></label>

      <select name="COBJ1CF11" class="select is_empty" id="avia_title_1">
        <option value="Mr.">Mr.</option>
        <option value="Mrs.">Mrs.</option>
      </select>
    </p>
    <p class=" form_element form_element_third" id="element_avia_first_name_1">
      <label for="avia_first_name_1">First Name <abbr class="required" title="required">*</abbr></label>

      <input name="COBJ1CF1" class="text_input is_empty" type="text" id="avia_first_name_1" value="">
    </p>
    <p class=" form_element form_element_third" id="element_avia_last_name_1">
      <label for="avia_last_name_1">Last Name <abbr class="required" title="required">*</abbr></label>

      <input name="NAME" class="text_input is_empty" type="text" id="avia_last_name_1" value="">
    </p>
    <p class=" first_form  form_element form_fullwidth" id="element_avia_e-mail_1">
      <label for="avia_e-mail_1">E-Mail <abbr class="required" title="required">*</abbr></label>
      <input name="Email" class="text_input is_email" type="text" id="avia_e-mail_1" value="">
    </p>
    <p class=" first_form  form_element form_fullwidth" id="element_avia_phone_1">
      <label for="avia_phone_1">Phone <abbr class="required" title="required">*</abbr></label>
      <input name="COBJ1CF7" class="text_input is_phone" type="text" id="avia_phone_1" value="">
    </p>
    <p class=" first_form  form_element form_element_fourth" id="element_avia_house_no_1">
      <label for="avia_house_no_1">House No</label>
      <input name="COBJ1CF4" class="text_input " type="text" id="avia_house_no_1" value="">
    </p>
    <p class=" form_element form_element_three_fourth" id="element_avia_street_1">
      <label for="avia_street_1">Street</label>
      <input name="COBJ1CF3" class="text_input " type="text" id="avia_street_1" value="">
    </p>
    <p class=" first_form  form_element form_element_fourth" id="element_avia_zip_code_1">
      <label for="avia_zip_code_1">ZIP Code</label>
      <input name="COBJ1CF6" class="text_input " type="text" id="avia_zip_code_1" value="">
    </p>
    <p class=" form_element form_element_three_fourth" id="element_avia_city_1">
      <label for="avia_city_1">City</label>
      <input name="COBJ1CF5" class="text_input " type="text" id="avia_city_1" value="">
    </p>
    <p class=" first_form  form_element form_fullwidth" id="element_avia_country_1">
      <label for="avia_country_1">Country</label>
      <input name="COBJ1CF10" class="text_input " type="text" id="avia_country_1" value="">
    </p>
    <p class=" first_form  form_element form_fullwidth" id="element_avia_subject_1">
      <label for="avia_subject_1">Subject <abbr class="required" title="required">*</abbr></label>
      <input name="COBJ1CF9" class="text_input is_empty" type="text" id="avia_subject_1" value="">
    </p>
    <p class=" first_form  form_element form_fullwidth" id="element_avia_message_1">
      <label for="avia_message_1" class="textare_label hidden textare_label_avia_message_1">Message <abbr class="required" title="required">*</abbr></label>
      <textarea name="COBJ1CF8" class="text_area is_empty" cols="40" rows="7" id="avia_message_1"></textarea>
    </p>
    <!-- <p class="hidden">
      <input type="text" name="avia_avia_username_1" class="hidden " id="avia_avia_username_1" value="">
    </p> -->
    <p class="form_element ">
      <!-- <input type="hidden" value="1" name="avia_generated_form1"> -->
      <input type="submit" value="Submit" class="button" data-sending-label="Sending">
    </p>
  </fieldset>
  <script> var mndFileds=new Array('NAME');var fldLangVal=new Array('Last Name');function reloadImg(){if(document.getElementById('imgid').src.indexOf('&d') !== -1 ){document.getElementById('imgid').src=document.getElementById('imgid').src.substring(0,document.getElementById('imgid').src.indexOf('&d'))+'&d'+new Date().getTime();}else{document.getElementById('imgid').src = document.getElementById('imgid').src+'&d'+new Date().getTime();}}function checkMandatery(){var name='';var email='';for(i=0;i<mndFileds.length;i++){ var fieldObj=document.forms['WebForm1223601000000740036'][mndFileds[i]];if(fieldObj) {if(((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0){alert(fldLangVal[i] +' cannot be empty'); fieldObj.focus(); return false;}else if(fieldObj.nodeName=='SELECT'){if(fieldObj.options[fieldObj.selectedIndex].value=='-None-'){alert(fldLangVal[i] +' cannot be none'); fieldObj.focus(); return false;}} else if(fieldObj.type =='checkbox'){ if (fieldObj.checked == false){     alert('Please accept  '+fldLangVal[i]); fieldObj.focus();return false;}}try{if(fieldObj.name == 'Last Name'){name = fieldObj.value;}}catch(e){}}}try{if($zoho){var LDTuvidObj = document.forms['WebForm1223601000000740036']['LDTuvid'];if(LDTuvidObj){LDTuvidObj.value = $zoho.salesiq.visitor.uniqueid();}var firstnameObj = document.forms['WebForm1223601000000740036']['First Name'];if(firstnameObj){name = firstnameObj.value +' '+name;}$zoho.salesiq.visitor.name(name);var emailObj = document.forms['WebForm1223601000000740036']['Email'];if(emailObj){email = emailObj.value;$zoho.salesiq.visitor.email(email);}}}catch(e){}}</script>
</form>