Ready-to-use "Contact Us" form
Click here to see how your form will look like
This form is completely customizable!
JavaScript validates required fields; plus there is a verification on the server-side.
Captcha image protects the form against SPAM.
Captcha image can be reloaded.
There are many styles of Captcha image available.
How to use free BasicCaptcha code
1. Copy and paste the code below into your webpage.
2. Change the email address your@email.com to your own email address.
3. Change the return address http://www.YourWebsiteAddress.com/ThankYouPage.htm to your website address.
4. You can also change the email subject - Contact Us Captcha Form.
<h2>Contact Us</h2>
<form action="http://www.SnapHost.com/captcha/send.aspx" id="ContactUsCaptchaWebForm" method="post" onsubmit="return ValidateForm(this);">
<input id="skip_WhereToSend" name="skip_WhereToSend" type="hidden" value="your@email.com" />
<input id="skip_SnapHostID" name="skip_SnapHostID" type="hidden" value="LLCTABGFGEFE" />
<input id="skip_WhereToReturn" name="skip_WhereToReturn" type="hidden" value="http://www.YourWebsiteAddress.com/ThankYouPage.htm" />
<input id="skip_Subject" name="skip_Subject" type="hidden" value="Contact Us Form" />
<input id="skip_ShowUsersIp" name="skip_ShowUsersIp" type="hidden" value="1" />
<input id="skip_SendCopyToUser" name="skip_SendCopyToUser" type="hidden" value="1" />
<script type="text/javascript">
function ValidateForm(frm) {
if (frm.Name.value == "") {alert('Name is required.');frm.Name.focus();return false;}
if (frm.FromEmailAddress.value == "") {alert('Email address is required.');frm.FromEmailAddress.focus();return false;}
if (frm.FromEmailAddress.value.indexOf("@") < 1 || frm.FromEmailAddress.value.indexOf(".") < 1) {alert('Please enter a valid email address.');frm.FromEmailAddress.focus();return false;}
if (frm.Comments.value == "") {alert('Please enter comments or questions.');frm.Comments.focus();return false;}
if (frm.skip_CaptchaCode.value == "") {alert('Enter web form code.');frm.skip_CaptchaCode.focus();return false;}
return true; }
function ReloadCaptchaImage(captchaImageId) {
var obj = document.getElementById(captchaImageId);
var src = obj.src;
var date = new Date();
var pos = src.indexOf('&rad=');
if (pos >= 0) { src = src.substr(0, pos); }
obj.src = src + '&rad=' + date.getTime();
return false; }
</script>
<table border="0" cellpadding="5" cellspacing="0" width="600">
<tr>
<td><b>Name*:</b></td>
<td><input id="Name" name="Name" type="text" maxlength="60" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Phone number:</b></td>
<td><input id="PhoneNumber" name="PhoneNumber" type="text" maxlength="43" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Email address*:</b></td>
<td><input id="FromEmailAddress" name="FromEmailAddress" type="text" maxlength="60" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Comments and questions*:</b></td>
<td><textarea name="Comments" id="Comments" rows="7" cols="40" style="width:350px; border:1px solid #999999;"></textarea></td>
</tr><tr>
<td colspan="2" align="center"> <br />
<table border="0" cellpadding="0" cellspacing="0">
<tr><td colspan="2" style="padding-bottom:18px;">
<!-- Please check our ProCaptcha service which is ad-free:
http://www.SnapHost.com/captcha/ProCaptchaOverview.aspx -->
<a href="http://www.SnapHost.com"
style="text-decoration:none; font-size:11px; font-family:Verdana, Arial, Helvetica; color:#000099;">
This web form is protected from SPAM by
<span style="text-decoration:underline;">SnapHost.com</span></a></td></tr>
<tr valign="top"><td> <i>Enter web form code*:</i>
<input id="skip_CaptchaCode" name="skip_CaptchaCode" type="text" style="width:80px; border:1px solid #999999;" maxlength="6" />
</td><td>
<a href="http://www.SnapHost.com"><img id="CaptchaImage" alt="Web Form Code" title="Anti-spam web forms"
style="margin-left:20px; border:1px solid #999999;"
src="http://www.SnapHost.com/captcha/CaptchaImage.aspx?id=LLCTABGFGEFE&ImgType=2" /></a><br />
<a href="#" onclick="return ReloadCaptchaImage('CaptchaImage');"><span style="font-size:12px;">reload image</span></a>
</td></tr>
</table> <br />
* - required fields.
<input id="skip_Submit" name="skip_Submit" type="submit" value="Submit" />
</td></tr>
</table><br />
</form>
How to use ProCaptcha code
1. Create an account if you have not done it yet.
2. Copy and paste the code below into your webpage.
3. Specify a form in your profile with SnapHostID LLCTABGFGEFE.
<h2>Contact Us</h2>
<form action="http://www.SnapHost.com/captcha/WebFormSubmit.aspx" id="ContactUsCaptchaWebForm" method="post" onsubmit="return ValidateForm(this);">
<input id="SnapHostID" name="SnapHostID" type="hidden" value="LLCTABGFGEFE" />
<script type="text/javascript">
function ValidateForm(frm) {
if (frm.Name.value == "") {alert('Name is required.');frm.Name.focus();return false;}
if (frm.FromEmailAddress.value == "") {alert('Email address is required.');frm.FromEmailAddress.focus();return false;}
if (frm.FromEmailAddress.value.indexOf("@") < 1 || frm.FromEmailAddress.value.indexOf(".") < 1) {alert('Please enter a valid email address.');frm.FromEmailAddress.focus();return false;}
if (frm.Comments.value == "") {alert('Please enter comments or questions.');frm.Comments.focus();return false;}
if (frm.CaptchaCode.value == "") {alert('Enter web form code.');frm.CaptchaCode.focus();return false;}
return true; }
function ReloadCaptchaImage(captchaImageId) {
var obj = document.getElementById(captchaImageId);
var src = obj.src;
var date = new Date();
var pos = src.indexOf('&rad=');
if (pos >= 0) { src = src.substr(0, pos); }
obj.src = src + '&rad=' + date.getTime();
return false; }
</script>
<table border="0" cellpadding="5" cellspacing="0" width="600">
<tr>
<td><b>Name*:</b></td>
<td><input id="Name" name="Name" type="text" maxlength="60" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Phone number:</b></td>
<td><input id="PhoneNumber" name="PhoneNumber" type="text" maxlength="43" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Email address*:</b></td>
<td><input id="FromEmailAddress" name="FromEmailAddress" type="text" maxlength="60" style="width:350px; border:1px solid #999999;" /></td>
</tr><tr>
<td><b>Comments and questions*:</b></td>
<td><textarea name="Comments" id="Comments" rows="7" cols="40" style="width:350px; border:1px solid #999999;"></textarea></td>
</tr><tr>
<td colspan="2" align="center"> <br />
<table border="0" cellpadding="0" cellspacing="0">
<tr valign="top">
<td> <i>Enter web form code*:</i>
<input id="CaptchaCode" name="CaptchaCode" type="text" style="width:80px; border:1px solid #999999;" maxlength="6" />
</td><td>
<a href="http://www.SnapHost.com"><img id="CaptchaImage" alt="Web Form Code" title="Anti-spam web forms"
style="margin-left:20px; border:1px solid #999999;"
src="http://www.SnapHost.com/captcha/WebForm.aspx?id=LLCTABGFGEFE&ImgType=2" /></a><br />
<a href="#" onclick="return ReloadCaptchaImage('CaptchaImage');"><span style="font-size:12px;">reload image</span></a>
</td></tr>
</table> <br />
* - required fields.
<input id="skip_Submit" name="skip_Submit" type="submit" value="Submit" />
</td></tr>
</table><br />
</form>