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Example of a "Sign Up" form

This is a Sign Up form which can be used on any website. It collects data and sends it to a specified email address. The Captcha image will keep Spam Bots from submitting junk to your email box. The form has a JavaScript validation. Fields marked with * are required. You can add more fields if needed.
Feel free to copy the code. However you will need a unique "SnapHostID". You can get it after the registration.


First name *
 Last name *
Organization *
Email address *
Work Phone
 Home Phone
Cell Phone
 Fax
Address 1 *
Address 2
City *
 State/Province
Country *
 Zip/Postal Code


Enter security code * 		FORM SECURITY CODE

* - required fields.