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JavaScript Stuck on Finding Form Validation Code Bug

johnwboyd

New Coder
Hello. If someone would be so kind as to help me I have gone through the code up and down many times and used validators but can't seem to find the issue for this form fields validation script or maybe a conflict on the html side. This is the js code:


Code:
//Function to check whether element clicked is form element
function checkel(which){
if (which.style&&intended.test(which.tagName)){
if (ns6&&eventobj.nodeType==3)
eventobj=eventobj.parentNode.parentNode;
return true;
}
else
return false;
}

function echeck(str) {

        var at="@";
        var dot=".";
        var lat=str.indexOf(at);
        var lstr=str.length;
        var ldot=str.indexOf(dot);
        if (str.indexOf(at)==-1){
           return false;
        }

        if (str.indexOf(at)==-1 || str.indexOf(at)==0 || str.indexOf(at)==lstr){
           return false;
        }

        if (str.indexOf(dot)==-1 || str.indexOf(dot)==0 || str.indexOf(dot)==lstr){
            return false;
        }

         if (str.indexOf(at,(lat+1))!=-1){
            return false;
         }

         if (str.substring(lat-1,lat)==dot || str.substring(lat+1,lat+2)==dot){
            return false;
         }

         if (str.indexOf(dot,(lat+2))==-1){
            return false;
         }
        
         if (str.indexOf(" ")!=-1){
            return false;
         }

          return true;               
    }
    function validate_email(maincontactemail,alerttxt)
{
with (field);
  {
  apos=value.indexOf("@");
  dotpos=value.lastIndexOf(".");
  if (apos<1||dotpos-apos<2)
    {alert(alerttxt);return false;}
  else {return true;}
  }
}

function validate_form(thisform)
{
with (thisform)
  {
  if (validate_email(maincontactemail,"Not a valid e-mail address!")==false)
    {maincontactemail.focus();return false;}
  }
}

// JavaScript Document
function CheckTheForm() {
    
     var result = true;
    var msg="";
      
document.getElementById('idmail').style.display="none";
document.getElementById('idmail2').style.display="none";
document.getElementById('fields').style.display="none";
document.getElementById('agree').style.display="none";
document.getElementById('dialer-other').style.display="none";
document.getElementById('maincontact').style.color='#FFFFFF';
document.getElementById('dialerother').style.color='#FFFFFF';
document.getElementById('maincontactemail').style.color='#FFFFFF';
document.getElementById('maincontactemail2').style.color='#FFFFFF';
document.getElementById('chatid').style.color='#FFFFFF';
document.getElementById('chat').style.color='#FFFFFF';
document.getElementById('terms').style.color='#FFFFFF';
document.getElementById('title').style.color='#FFFFFF';
document.getElementById('address').style.color='#FFFFFF';
document.getElementById('city').style.color='#FFFFFF';
document.getElementById('state').style.color='#FFFFFF';
document.getElementById('zip').style.color='#FFFFFF';
document.getElementById('country').style.color='#FFFFFF';
document.getElementById('company').style.color='#FFFFFF';
document.getElementById('website').style.color='#FFFFFF';
document.getElementById('balance').style.color='#FFFFFF';
document.getElementById('configuration').style.color='#FFFFFF';
document.getElementById('dialer').style.color='#FFFFFF';
document.getElementById('dialing_countries').style.color='#FFFFFF';
document.getElementById('purchase').style.color='#FFFFFF';
document.getElementById('refill').style.color='#FFFFFF';
document.getElementById('referral').style.color='#FFFFFF';
document.getElementById('payment').style.color='#FFFFFF';
document.getElementById('Verification').style.color='#FFFFFF';
document.getElementById('Verificationx').style.display="none";
        
        if (document.validate.maincontact.value.length < 2) {
        alert("Please enter main contact name.");
        document.validate.maincontact.focus();
        document.getElementById('maincontact').style.color="#FAEE41";
        result = false;
        }       
        if (document.validate.maincontactemail.value.length < 7) {
        alert("Please enter a valid email.");
        document.validate.maincontactemail.focus();
        document.getElementById('maincontactemail').style.color="#FAEE41";
        result = false;
          }   
        if (document.validate.maincontactemail.value==document.validate.maincontactemail2.value) {
        alert("Please enter a valid 2nd email.");
        document.validate.maincontactemail2.focus();
        document.getElementById('maincontactemail2').style.color="#FAEE41";
        document.getElementById('idmail2').style.display="block";
        result = false;
        }
        var maincontactemail=document.validate.maincontactemail;
        if ((maincontactemail.value==null)||(maincontactemail.value=="")){
        document.validate.maincontactemail.focus();
        document.getElementById('maincontactemail').style.color="#FAEE41";
        result = false;
        }
        if ((echeck(maincontactemail.value)==false) && (maincontactemail.value!='')){
        document.validate.maincontactemail.focus();
        document.getElementById('maincontactemail').style.color="#FAEE41";
        document.getElementById('idmail').style.display="block";
        result = false;
        }   
         if (document.validate.maincontactemail2.value.length < 7) {
        alert("Please enter a 2nd email.");
        document.validate.maincontactemail2.focus();
        document.getElementById('maincontactemail2').style.color="#FAEE41";
        result = false;   
         }           
        var maincontactemail2=document.validate.maincontactemail2;
    
        if ((maincontactemail.value==null)||(maincontactemail.value=="")){
        document.validate.maincontactemail2.focus();
        document.getElementById('maincontactemail2').style.color="#FAEE41";
        result = false;
        }
        if ((echeck(maincontactemail.value)==false) && (maincontactemail.value!='')){
        alert("Please enter a 2nd email.");
        document.validate.maincontactemail2.focus();
        document.getElementById('maincontactemail2').style.color="#FAEE41";
        document.getElementById('idmail').style.display="block";
        result = false;
         }
        if (document.validate.chatid.value.length < 2) {
        alert("Please select your chat client.");
        document.validate.chatid.focus();
        document.getElementById('chatid').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.chat.value.length < 2) {
        alert("Please enter your chat ID.");
        document.validate.chat.focus();
        document.getElementById('chat').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.title.value.length < 2) {
        alert("Please enter your title.");
        document.validate.title.focus();
        document.getElementById('title').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.address.value.length < 2) {
        alert("Please enter your address.");
        document.validate.address.focus();
        document.getElementById('address').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.city.value.length < 2) {
        alert("Please enter your city.");
        document.validate.city.focus();
        document.getElementById('city').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.state.value.length < 2) {
        alert("Please enter your state.");
        document.validate.state.focus();
        document.getElementById('state').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.zip.value.length < 3) {
        alert("Please enter your zip code.");
        document.validate.zip.focus();
        document.getElementById('zip').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.country.value.length < 2) {
        alert("Please select your country.");
        document.validate.country.focus();
        document.getElementById('country').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.company.value.length < 3) {
        alert("Please enter your company name.");
        document.validate.company.focus();
        document.getElementById('company').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.website.value.length < 2) {
        alert("Please enter your website or put none if none.");
        document.validate.website.focus();
        document.getElementById('website').style.color="#FAEE41";
         result = false;   
         }
        if (document.validate.balance.value.length < 1) {
        alert("Please select a minimum balance alert.");
        document.validate.balance.focus();
        document.getElementById('balance').style.color="#FAEE41";
        result = false;   
        }
        if (document.validate.configuration.value.length < 2) {
        alert("Please select a SIP configuration.");
        document.validate.configuration.focus();
        document.getElementById('configuration').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.dialer.value=='') {
        alert("Please select a dialer type.");
        document.validate.dialer.focus();
        document.getElementById('dialer').style.color="#FAEE41";
        result = false;
        }
        if((document.validate.dialer.value=='Other') && (document.validate.dialer_other.value.length < 2)) {
        alert("Please enter your dialer details.");
        document.validate.dialer_other.focus();
        document.getElementById('dialerother').style.color="#FAEE41";
        document.getElementById('dialer-other').style.display="block";
        result = false;
        }
        if (document.validate.dialing_countries.value.length < 2) {
        alert("Please enter your dialing countries.");
        document.validate.dialing_countries.focus();
        document.getElementById('dialing_countries').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.purchase.value.length < 1) {
        alert("Please select an amount.");
        document.validate.purchase.focus();
        document.purchase.style.color="#FAEE41";
         result = false;
        }
          if (document.validate.refill.value.length < 2) {
        alert("Please select a refill option.");
        document.validate.refill.focus();
        document.getElementById('refill').style.color="#FAEE41";
        result = false;
        }
        if (document.validate.referral.value.length < 4) {
        document.validate.referral.focus();
        document.getElementById('referral').style.color="#FAEE41";
        result = false;
        }   
        if (document.validate.payment.value.length < 1) {
        document.validate.payment.focus();
        document.getElementById('payment').style.color="#FAEE41";
        result = false;
        }
        if (!document.validate.terms.checked){
        document.validate.terms.focus();
        document.getElementById('terms').style.color="#FAEE41";
        document.getElementById('agree').style.display="block";
        result = false;           
        }
        if (document.validate.Verification.value!=='bmavoip') {
        document.validate.Verification.focus();
        document.getElementById('Verification').style.color="#FAEE41";
        document.getElementById('Verificationx').style.display="block";
        result = false;
        }
    if(msg==""){
        document.getElementById('fields').style.display="block";
    return result;}
    {
    alert(msg);
    return result;
    }
    if(msg==""){
    return result;}
    {
    alert(msg);
    return result;
    }
}

And this is the HTML page code:


Code:
<?php $deny = array("61.21.111.134", "89.149.208.14", "85.17.147.193", "206.214.146.194", "66.249.67.199", "188.227.166.154", "188.163.67.34", "173.245.64.44", "174.96.20.156", "75.94.201.233",  "209.159.147.162");
if (in_array ($_SERVER['REMOTE_ADDR'], $deny)) {
   header("location: http://www.yahoo.com");
   exit();
}session_start(); ?>
<!DOCTYPE HTML>
<html>
<head>
<title>Welcome to BMA Voip  :: Order Low Rate U.S. VoIP, Canada VoIP, UK VoIP, Australia VoIP, &amp; DID From BMA Group.com :: Low Rate VoIP &amp; DID for Call Centers :: Voice Minutes :: Voice Over Internet Protocol :: Voice Termination :: Voice Route :: SIP :: SIP Termination :: SIP route :: White route :: Call Rates :: A-Z VoIP :: VoIP US, VoIP Canada, VoIP UK, VoIP Australia</title>
<meta name="description" content="Low Rate VoIP, DID, & Dialer for: U.S., Canada, UK, Australia" />
<meta name="keywords" content="order low rate U.S. voip, lowest voip rates, candada voip, UK VoIP, australia voip, white route, tier1, voip, direct inward dialing, DID, unlimited DID, wholesale voip, Bulk Voip, low rate voip, low rate voip for call centers, A-Z voip, voice minutes, voice over internet protocol, voice termination, voice route, sip, sip termination, sip route, call rates, low rate predictive dialer, predictive dialer, dialer installation, autodialer, crm, vpn server, dialer" />

<script src="http://ajax.googleapis.com/ajax/libs/jquery/1.3.2/jquery.min.js"></script>
<link href='http://fonts.googleapis.com/css?family=Oswald' rel='stylesheet' type='text/css'>

<link href="bootstrap.css" rel="stylesheet" type="text/css" media="all">
<!-- jQuery (necessary for Bootstrap's JavaScript plugins) -->
<script src="js/jquery-1.11.0.min.js"></script>
<!-- Custom Theme files -->
<link href="style2.css" rel="stylesheet" type="text/css" media="all"/>
<!-- Custom Theme files -->
<meta name="viewport" content="width=device-width, initial-scale=1">
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<script type="application/x-javascript"> addEventListener("load", function() { setTimeout(hideURLbar, 0); }, false); function hideURLbar(){ window.scrollTo(0,1); }>
</script>

<!--Google Fonts-->
<link href='http://fonts.googleapis.com/css?family=Open+Sans:300italic,400italic,600italic,700italic,800italic,400,300,600,700,800' rel='stylesheet' type='text/css'>
<!-- start-smoth-scrolling -->
<script type="text/javascript" src="js/move-top.js"></script>
<script type="text/javascript" src="js/easing.js"></script>
    <script type="text/javascript">
            jQuery(document).ready(function($) {
                $(".scroll").click(function(event){       
                    event.preventDefault();
                    $('html,body').animate({scrollTop:$(this.hash).offset().top},1000);
                });
            });
    </script>


 <link href="images/bma.ico" rel="shortcut Icon">

        <style type="text/css">
<!--
.style112 {font-size: 16px}
.aster {color:#FBC6A2}
-->
        </style>
                <script language="JavaScript" type="text/javascript">
    
function show_hide(hide, show)
{
document.getElementById(hide).style.display="block";
document.getElementById(show).style.display="none";
}
function showHide(id){
   el = document.getElementById(id);
   el.style.display = (el.style.display != 'block')? 'block' : 'none';
}

</script>
<script type="text/javascript" src="voip.js"></script>
</head>
<body>

<div class="header">
  <div class="container">
    <div class="header-main">
      <div class="logo"> <a href="index.html"><img src="images/logo.png" alt="BMA Group" width="134" height="49" border="0"></a>
      </div>
      <table align="center" style="max-width:820px; margin-top: 30px; text-align:center" >
        <tr>
          <td valign="bottom" nowrap="NOWRAP" style="padding: 0px 0px 20px 0px; float: right;"><span class="menu"> <img src="images/icon.png" style="margin-top:-75px; vertical-align:middle; padding-left:20px" alt=""/></span> <span class="navg" >
            <ul class="res">
              <li><a class="scroll" href="index.html # about">About</a> <span class="o">|</span></li>
              <li><a class="scroll" href="index.html#why_us">Why Us? </a> <span class="o">|</span></li>
              <li><a class="scroll" href="index.html#services">Services</a> <span class="o">|</span></li>
              <li><a href="view_campaigns.html">View Campaigns</a> <span class="o">|</span></li>
              <li><a href="faqs.html">FAQs</a> <span class="o">|</span></li>
  <li><a href="order_low_rate_us_canada_uk_australia_worldwide_voip.php">VoIP</a> <span class="o">|</span></li>
              <li><a href="preferred_providers.html">Preferred Service Providers</a> <span class="o">|</span></li>
              <li><a href="contact.php">Contact</a></li>
            </ul>
            <!-- script-for-menu -->
            <script>
                               $( "span.menu" ).click(function() {
                                 $( "ul.res" ).slideToggle( 300, function() {
                                 // Animation complete.
                                  });
                                 });
                            </script>
          </span> </td>
          <td valign="bottom" nowrap="nowrap" style="padding: 23px 0px 30px 20px"><!-- Search box form -->
              <form action="http://www.google.com/cse" id="cse-search-box" target="_blank" style="margin-top: -66px">
                <input name="cx" type="hidden" value="917b16a283c952d0b" />   <input name="ie" type="hidden" value="UTF-8" />
                <input name="q" value="Search"   onFocus="this.value = '';" onBlur="if (this.value == '') {this.value = 'Search';}" style="height: 18px; width:115px; margin-top:5px" />
                <input name="sa" type="submit" class="search" value="" style="width:23px"/>
            </form></td>
        </tr>
      </table>
    </div>
  </div>
</div>

<div align="center" style="background-image:url(images/granite.jpg)"><div class="mediumgray">
          <h3 class="style8">BMA Group VOIP, Dialer, &amp; DID</h3>
    <div id="div2">
            <div class="row">
              <div class="column-half" > </div>
            </div>
      <span class="style18">Order VoIP and/or DID From BMA Group.net White Route VoIP&nbsp;with NO Taxes or Contract</span><br />
            <br />
  </div>
          <div align="center" style="max-width:850px">
            <div class="row wrap_1 wrap_5">
              <div class="grid_3" style="width:100%">
                <div class="box_1">
                  <div class="column-half"><img src="images/hot_rates.png" name="slide" width="139" height="82" id="slide" />&nbsp;<img src="images/delivery.png" width="125" height="112" /><a href="money-back-guarantee.html" target="_blank">&nbsp;</a></div>
                </div>
              </div>
              <div class="grid_3"  style="padding-top: 5px; padding-left:10px; text-align:left;">
                <div class="box_1">
                  <div class="column-half"></div>
                  <div class="column-half" > <img src="images/check.png" width="19" height="16" /> No Contracts or Credit Checks! <br />
                      <span class="style21" style="padding-top:4px"><img src="images/check.png" width="19" height="16" /></span> Predictive Dialer Server <br />
                    &nbsp;&nbsp;&nbsp;          Installation &amp;&nbsp;Activation within 4 Hours! <br />
                    <span class="style21" style="padding-top:4px"><img src="images/check.png" width="19" height="16" /></span> BMA GroupN Server (Virtual Personal Network) <br />
                    &nbsp;&nbsp;&nbsp;&nbsp;Installation &amp; Activation within   Hours!<br />
                    <span class="style21" style="padding-top:4px"><img src="images/check.png" width="19" height="16" /></span><span class="style7">&nbsp;</span>Qualify &amp; Certified Technical Support <br />
                    <span class="style21" style="padding-top:4px"><img src="images/check.png" width="19" height="16" /></span> Online Support </span><br />
                    <span class="style21" style="padding-top:4px"><img src="images/check.png" width="19" height="16" /></span> Tier 1 White Route VoIP</span><br />
                    <br />
                    <br />
                  </div>
                </div>
              </div>
              <div class="grid_3">
                <div class="box_1">
                  <ul>
                    <span class="style13">VoIP Rates &amp; Features</span><br />
                    <li class="style21">Billing cycle is 6/6.</li>
                    <li class="style21">All routes are White. We don’t  deal in gray route.</li>
                    <li class="style21">24x7 email support</li>
                    <li class="style21">Call Transfer &amp; Forwarding is available  upon request.</li>
                    <li class="style21">Additional Channels upon request.</li>
                    <li class="style21">Portal access will be provided to monitor VoIP  minute usages.</li>
                    <li class="style21">Minimum order is <em>ONLY</em> $10 for manual and $20 for predictive dialing. NO free samples/ tests.<br />
                    </li>
                    <li class="style21">Payment can be made either by: </li>
                  </ul>
                </div>
              </div>
            </div>
          </div>
          <div align="center">
            <div class="row wrap_1 wrap_5">
              <div class="grid_2" >
                <div class="box_1"> <span class="style8"><br />
                Low Cost High Quality Voice Over IP</span> <br />
                    <span class="small">All VoIP &amp; DID low rates are in US $.</span><br />
                    <br />
                    <strong class="style21">Predictive Dialer  or Manual Dialer VoIP :: <br />
                      6/6 Billing Cycle </strong><br />
                  <br />
                  <strong>USA VoIP:</strong> <span class="style21">$0.0085</span><br />
                  <br />
                  <strong class="style7">Canada VoIP:</strong> <span class="style21">$0.0075</span><br />
                  <br />
                  <span class="style7"><strong>Australia VoIP</strong>:</span><br />
                  <span class="style21"></strong>Land line: $0.0165<br />
                    Mobile: $0.13</span><br />
                  <br />
                  <strong class="style7">UK VoIP: </strong><br />
                  <span class="style21">Land line: $0.0085<br />
                    Mobile:$0.13</span><br />
                  <span class="style7"><br />
                    <strong>Dominican Republic VoIP:</strong></span><br />
                  <span class="style21">Land Line: $0.035 / minute<br />
                    Mobile: $0.13 / minute</span><br />
                  <br />
                  <span class="style13"><a href="https://www.xe.com/currencyconverter/convert/?Amount=0.85&amp;From=USD&amp;To=INR" target="_blank">View Rates in Local Currency </a></span><br />
                  <br />
                  <br />
                  <span style="margin:10px"><span class="style13 style112">Pay in your Local Currency </span><br />
                    We are also accepting online banking payments in local currencies equivalent in USD $ + bank charges in few countries, such as:<br />
                    - Dominican Republic<br />
                    - India<br />
                    - Pakistan<br />
                    - Philippines<br />
                    - USA<span class="stylesm"><br />
                      Rates are subject to change as per international  tariff.</span></span><br />
                  <br />
                      <a href="#signup_for_voip"><img src="images/signup.png" width="124" height="40" border="0" /></a> </div>
                <div class="grid_3">
                <div class="box_1">
                  <div class="column-half" style="padding-top: 5px; padding-left:10px; text-align:left"> <span style="padding-left:15px"><span style="padding-left:10px"><strong class="style8"><br />
                    <span class="column-half" style="padding-top: 5px; padding-left:10px; text-align:left"><img src="images/happy_voip.jpg" alt="Happy VoIP &amp; DID Agents Using BMA Group's Crystal Clear VoIP" style="width:100%; max-width:210px; height:auto" /></span>                            <br />
                    Important:</strong></span><span style="padding-left:10px"><span class="style21"><br />
                      We are a complete call center solution provider. <br />
                      <br />
                      Is your Predictive Dialer (P.D.) professionally installed? <br />
                      <br />
                      Do you have proper security on your (P.D.)? <br />
                      <br />
                      We are not network security providers. </span></span></span><br />
                  </div>
                </div>
              </div>
              <div class="grid_3">
                <div class="box_1"> <a href="testimonials.html"><img src="images/testimonials.png" style="width:100%; max-width:155px; height:auto" border="0" /></a><br />
                    <br />
                    <span class="style8">Enhance Your VoiP Knowledge<br />
                    </span><br />
                    <a href="voip_notes/VOIP_Glossary.pdf" target="_blank">VoIP Glossary</a><br />
                    <br />
                    <a href="voip_notes/prefixes-GVM.pdf" target="_blank">View International VoIP Prefixes</a><br />
                    <br />
                    <a href="voip_notes/Predictive_Dialer.pdf" target="_blank">Predictive Dialer Defined</a><br />
                    <br />
                    <a href="voip_notes/PD_Presentation.pdf" target="_blank">More Info on Predictive Dialers</a><br />
                    <br />
                    <a href="http://www.facebook.com/GlobalVoip?sk=notes" target="_top">Most Asked VoIP/DID Questions<br />
                    </a><br />
                    <br />
                    <img src="images/pap2_device_02.png" style="width:100%; max-width:224px; height:auto" /><br />
                    <span class="stylesm">Optional phone adaptor sold separately.</span><br />
                    <br />
                </div>
              </div>
            </div>
          </div>
         <br />
          <br />
          <span class="style23">DID’s Basic Plan Includes: </span><span class="style1"><br />
- Unlimited inbound<br />
- 2 channels<br />
» Add ons available upon request. <br />
<br />
<strong>USA  &amp; Canada DID: </strong>Set up Fee (One Time) $10 &amp; Monthly $10<br />
<br />
<strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $15 &amp; Monthly $15<br />
<br />
<strong>USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $45 &amp; Monthly $30</strong></span><br />
<br />
<br />
<p class="style1"><span class="style23"><strong>DID’s Basic    Plan for those using <em>only</em> DID service Includes</strong>:</span><br />
  - Unlimited inbound<br />
  - 2 channels<br />
  » Add-on available upon    request. <br />
  <br />
</p>
<div align="left" style="width:100%;">
<strong>USA &amp; Canada DID:</strong> Set up Fee (One Time) $15 +  Monthly $10 + $10 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
<br />
<strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $20 +  Monthly $15 + $15 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
<strong><br />
USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $55 &amp; Monthly    $40  inclusive Voip Miniutes as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date.
</p>
<ul>
  <li class="style1">Advanced payment is refundable if you do not wish  to continue the service of DID; if we are informed 10 days before the due date. DID will be disabled on due date. <br />
      <br />
  </li>
</ul>
<span class="style23"><br />
DID’s Call Divert to Cell / Mobile Plan Includes</span></strong><span class="style23">:</span><br />
<span class="style1">- Unlimited inbound<br />
- 2 channels<br />
» Add-on available upon    request. </span><br />
<br />
<span class="style1"><strong>USA &amp; Canada DID:</strong> Set up Fee (One Time) $35 +  Monthly $20 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
<br />
<strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $65 +  Monthly $45 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
<strong><br />
USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $65 &amp; Monthly    $65  inclusive Voip Miniutes as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date.
</p>
</span>
<ul>
  <li class="red">Advanced payment is refundable if you do not wish  to continue the service of DID; if we are informed 15 days before the due date. DID will be disabled on due date. </li>
</ul>
<span class="small">Additional channels upon request for low flat rates. <br />
Call Transfer &amp; Forwarding also available  upon  request.<br />
Inbound call setup &amp; handling.</span>
</li>
<br />
<br />
<a href="#signup_for_voip"><span class="red" style="padding-top:4px"><img src="images/signup.png" width="124" height="40" border="0" /></span></a>
</p>
<span style="padding-left:20px"><span style="vertical-align:middle;padding-top:6px"><a name="signup_for_voip" id="signup_for_voip"></a><br />
<br />
<img src="images/check.png" width="19" height="16" /></span> Once you submit the form below you will be emailed the portal log in where you will be able to make payment either by PayPal, Alert Pay, Skrill. Upon receiving the payment the configuration email with details will  follow.</span>
<h2>&nbsp;</h2>
    </div></div>
        


</div>




<div class="gray">
<form method="post" name="validate" action="#" enctype="multipart/form-data">
        <tr>
         <table border="0" align="center">
            <tr>
              <td><img src="images/arrow2.gif" width="26" height="27" /></td>
              <td>To order your high quality, great low rate VoIP / DID simply complete the form below.
              </td>
           </tr>
          </table></td>
    </tr>
    
          <tr>
            <td valign="top" align="center"><table border="0" align="center" cellpadding="3" cellspacing="0" bgcolor="#090909" style="border:solid 1px #0099CC; width:100%; max-width:1000px">
              <tr>
                <td bgcolor="#000040" class="style1"><div align="right"><strong>Call Center  Information</strong></div></td>
                <td bgcolor="#000040" class="stylesm"><div align="left">Be sure to accurately fill the details of the person responsible for payments in order to refill in time to avoid disruption of service. </div></td>
              </tr>
              <tr>
                <td bgcolor="#090909" class="style1"><div align="left" class="style1" style="padding-left:20px"><a href="#" onMouseOver="Tip('Your information will be kept confidential and secure. We respect your privacy.', CLOSEBTN, false, SHADOW, true, TITLE, 'Data Security', STICKY, false, PADDING, 9, OFFSETY, 20, OPACITY, 90)" onMouseOut="UnTip()"><img src="images/lock.png" width="15" height="19" border="0" /></a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span class="aster">*</span> = Required</div></td>
                <td bgcolor="#090909" class="style1">&nbsp;</td>
              </tr>
              <tr>
                <td bgcolor="#1D1D1D" class="style1"><div align="right" id="maincontact" >
                  
                <span class="aster">*</span>First &amp; Last Name</div></td>
                <td bgcolor="#1D1D1D" class="style1">
                  
                  <div align="left">
                    <input name="maincontact" type="text"value="<? echo $maincontact?>" size="25" />
                </div></td>
              </tr>
              <tr>
  <td valign="top" class="style1"><div align="right" id="maincontactemail"><span class="aster">*</span>Email</div></td>
  <td valign="top" class="style1"><div align="left">
  <input name="maincontactemail" type="text" value="<? echo $maincontactemail?>" size="20" />
  </div><div id="idmail" style="font-size:14px; color:#F7F2AB; display:none; text-align:left; margin-top:3px">
    <div align="left">Please enter in a valid email. We respect your privacy.<br />
      See <span class="linksm"><a href="privacy.html" target="_blank">Privacy Page</a></span> for more details.</div>
                  </div></td>
              </tr>
              <tr>
                <td valign="top" bgcolor="#1D1D1D" class="style1"><div style="padding-top:2px"></div><div align="right" id="maincontactemail2"><span class="aster">*</span>2nd Email<br />
                <span class="small">To ensure you receive important details.</span> </div></td>
                <td valign="top" bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="maincontactemail2" type="text" value="<? echo $maincontactemail2?>" size="20" />
                  </div>
                    <div id="idmail2" style="font-size:14px;color:#F7F2AB; display:none; text-align:left; margin-top:3px">
                      <div align="left">Please enter in a second valid email to ensure you receive the important details. We respect your privacy.<br />
                        See <span class="linksm"><a href="javascript:openWin('privacy.html')">Privacy Page</a></span> for more detai</div>
                </div></td>
              </tr>
              <tr class="style1">
                <td height="24" class="style17"><div align="right" id="chat" style="padding-top:3px"><span style="padding-top:3px"><span class="aster">*</span>Skype, Telegram, or Gtalk? </span>
                    <div align="right" class="small">Recommended method of <br />
                    communication. Skype preferred.</div>
                  <span style="padding-top:3px"><br />
                  </span></div></td>
                <td valign="top"><div align="left">
                  <select name="chat">
                    <option value="" selected>Select</option>
                    <option value="Skype">Skype</option>
                     <option value="Telegram">Telegram</option>
                    <option value="Whatsap">Gtalk</option>
                  </select>
                  </div>                  </td>
              </tr>
              <tr>
                <td bgcolor="#1D1D1D" class="style1"><div align="right" id="chatid"><span class="aster">*</span>Chat ID</div></td>
                <td bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="chatid" type="text" value="<? echo $chatid?>" size="30" />
                </div></td>
              </tr>
              <tr>
                <td class="style1"><div align="right" id="title"><span class="aster">*</span>Title/ Position</div>                  </td>
                <td valign="top" class="style1">
                  <div align="left">
                    <input name="title" type="text" value="<? echo $title?>" size="20" />
                  </div></td>
              </tr>
              <tr>
                <td  bgcolor="#1D1D1D" class="style1"><div align="right" id="address"><span class="aster">*</span>Address</div></td>
                <td bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="address" type="text" value="<? echo $address?>" size="20" />
                </div></td>
              </tr>
              <tr>
                <td  class="style1"><div align="right" id="city"><span class="aster">*</span>City</div></td>
                <td class="style1"><div align="left">
                  <input name="city" type="text" value="<? echo $city?>" size="20" />
                </div></td>
              </tr>
              <tr>
                <td  bgcolor="#1D1D1D" class="style1"><div align="right" id="state"><span class="aster">*</span>State</div></td>
                <td bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="state" type="text" value="<? echo $state?>" size="20" />
                </div></td>
              </tr>
              <tr>
                <td class="style1"><div align="right" id="zip"><span class="aster">*</span>Zip/ Postal Code </div></td>
                <td class="style1"><div align="left">
                    <input name="zip" type="text" value="<? echo $zip?>" size="10" />
                </div></td>
              </tr>
              <tr>
                <td bgcolor="#1D1D1D" class="style1"><div align="right" id="country"><span class="aster">*</span>Country</div></td>
                <td bgcolor="#1D1D1D" class="style1">
                  <div align="left">
                    <select name="country" style="width:250px">
                      <option  value='' selected="selected"
    >Select</option>
                      <option  value='AFG'
    > Afghanistan</option>
                      <option  value='ALB'
    > Albania</option>
                      <option  value='DZA'
    > Algeria</option>
                      <option  value='ASM'
    > American Samoa</option>
                      <option  value='AND'
    > Andorra</option>
                      <option  value='AGO'
    > Angola</option>
                      <option  value='AIA'
    > Anguilla</option>
                      <option  value='ATA'
    > Antarctica</option>
                      <option  value='ATG'
    > Antigua And Barbuda</option>
                      <option  value='ARG'
    > Argentina</option>
                      <option  value='ARM'
    > Armenia</option>
                      <option  value='ABW'
    > Aruba</option>
                      <option  value='AUS'
    > Australia</option>
                      <option  value='AUT'
    > Austria</option>
                      <option  value='AZE'
    > Azerbaijan</option>
                      <option  value='BHS'
    > Bahamas</option>
                      <option  value='BHR'
    > Bahrain</option>
                      <option  value='BGD'
    > Bangladesh</option>
                      <option  value='BRB'
    > Barbados</option>
                      <option  value='BLR'
    > Belarus</option>
                      
                      <option  value='BEL'
    > Belgium</option>
                      <option  value='BLZ'
    > Belize</option>
                      <option  value='BEN'
    > Benin</option>
                      <option  value='BMU'
    > Bermuda</option>
                      <option  value='BTN'
    > Bhutan</option>
                      <option  value='BOL'
    > Bolivia</option>
                      <option  value='BIH'
    > Bosnia And Herzegovina</option>
                      <option  value='BWA'
    > Botswana</option>
                      <option  value='BVT'
    > Bouvet Island</option>
                      <option  value='BRA'
    > Brazil</option>
                      <option  value='IOT'
    > British Indian Ocean Territory</option>
                      <option  value='BRN'
    > Brunei Darussalam</option>
                      <option  value='BGR'
    > Bulgaria</option>
                      <option  value='BFA'
    > Burkina Faso</option>
                      <option  value='BDI'
    > Burundi</option>
                      <option  value='KHM'
    > Cambodia</option>
                      <option  value='CMR'
    > Cameroon</option>
                      <option  value='CAN'
    > Canada</option>
                      <option  value='CPV'
    > Cape Verde</option>
                      <option  value='CYM'
    > Cayman Islands</option>
                      <option  value='CAF'
    > Central African Republic</option>
                      <option  value='TCD'
    > Chad</option>
                      <option  value='CHL'
    > Chile</option>
                      <option  value='CHN'
    > China</option>
                      <option  value='CXR'
    > Christmas Island</option>
                      <option  value='CCK'
    > Cocos (Keeling); Islands</option>
                      <option  value='COL'
    > Colombia</option>
                      <option  value='COM'
    > Comoros</option>
                      <option  value='COG'
    > Congo</option>
                      <option  value='COD'
    > Congo, The Democratic Republic Of The</option>
                      <option  value='COK'
    > Cook Islands</option>
                      <option  value='CRI'
    > Costa Rica</option>
                      <option  value='HRV'
    > Croatia</option>
                      <option  value='CUB'
    > Cuba</option>
                      <option  value='CYP'
    > Cyprus</option>
                      <option  value='CZE'
    > Czech Republic</option>
                      <option  value='DNK'
    > Denmark</option>
                      <option  value='DJI'
    > Djibouti</option>
                      <option  value='DMA'
    > Dominica</option>
                      <option  value='DOM'
    > Dominican Republic</option>
                      <option  value='ECU'
    > Ecuador</option>
                      <option  value='EGY'
    > Egypt</option>
                      <option  value='SLV'
    > El Salvador</option>
                      <option  value='GNQ'
    > Equatorial Guinea</option>
                      <option  value='ERI'
    > Eritrea</option>
                      <option  value='EST'
    > Estonia</option>
                      <option  value='ETH'
    > Ethiopia</option>
                      <option  value='FLK'
    > Falkland Islands (Malvinas);</option>
                      <option  value='FRO'
    > Faroe Islands</option>
                      <option  value='FJI'
    > Fiji</option>
                      <option  value='FIN'
    > Finland</option>
                      <option  value='FRA'
    > France</option>
                      <option  value='GUF'
    > French Guiana</option>
                      <option  value='PYF'
    > French Polynesia</option>
                      <option  value='ATF'
    > French Southern Territories</option>
                      <option  value='GAB'
    > Gabon</option>
                      <option  value='GMB'
    > Gambia</option>
                      <option  value='GEO'
    > Georgia</option>
                      <option  value='DEU'
    > Germany</option>
                      <option  value='GHA'
    > Ghana</option>
                      <option  value='GIB'
    > Gibraltar</option>
                      <option  value='GRC'
    > Greece</option>
                      <option  value='GRL'
    > Greenland</option>
                      <option  value='GRD'
    > Grenada</option>
                      <option  value='GLP'
    > Guadeloupe</option>
                      <option  value='GUM'
    > Guam</option>
                      <option  value='GTM'
    > Guatemala</option>
                      <option  value='GIN'
    > Guinea</option>
                      <option  value='GNB'
    > Guinea-Bissau</option>
                      <option  value='GUY'
    > Guyana</option>
                      <option  value='HTI'
    > Haiti</option>
                      <option  value='HMD'
    > Heard Island And McDonald Islands</option>
                      <option  value='VAT'
    > Holy See (Vatican City State);</option>
                      <option  value='HND'
    > Honduras</option>
                      <option  value='HKG'
    > Hong Kong</option>
                      <option  value='HUN'
    > Hungary</option>
                      <option  value='ISL'
    > Iceland</option>
                      <option  value='IND'
    > India</option>
                      <option  value='IDN'
    > Indonesia</option>
                      <option  value='IRN'
    > Iran, Islamic Republic Of</option>
                      <option  value='IRQ'
    > Iraq</option>
                      <option  value='IRL'
    > Ireland</option>
                      <option  value='ISR'
    > Israel</option>
                      <option  value='ITA'
    > Italy</option>
                      <option  value='JAM'
    > Jamaica</option>
                      <option  value='JPN'
    > Japan</option>
                      <option  value='JOR'
    > Jordan</option>
                      <option  value='KAZ'
    > Kazakhstan</option>
                      <option  value='KEN'
    > Kenya</option>
                      <option  value='KIR'
    > Kiribati</option>
                      <option  value='PRK'
    > Korea, Democratic People's Republic Of</option>
                      <option  value='KOR'
    > Korea, Republic of</option>
                      <option  value='KWT'
    > Kuwait</option>
                      <option  value='KGZ'
    > Kyrgyzstan</option>
                      <option  value='LAO'
    > Lao People's Democratic Republic</option>
                      <option  value='LVA'
    > Latvia</option>
                      <option  value='LBN'
    > Lebanon</option>
                      <option  value='LSO'
    > Lesotho</option>
                      <option  value='LBR'
    > Liberia</option>
                      <option  value='LBY'
    > Libyan Arab Jamahiriya</option>
                      <option  value='LIE'
    > Liechtenstein</option>
                      <option  value='LTU'
    > Lithuania</option>
                      <option  value='LUX'
    > Luxembourg</option>
                      <option  value='MAC'
    > Macao</option>
                      <option  value='MKD'
    > Macedonia, The Former Yugoslav Republic Of</option>
                      <option  value='MDG'
    > Madagascar</option>
                      <option  value='MWI'
    > Malawi</option>
                      <option  value='MYS'
    > Malaysia</option>
                      <option  value='MDV'
    > Maldives</option>
                      <option  value='MLI'
    > Mali</option>
                      <option  value='MLT'
    > Malta</option>
                      <option  value='MHL'
    > Marshall islands</option>
                      <option  value='MTQ'
    > Martinique</option>
                      <option  value='MRT'
    > Mauritania</option>
                      <option  value='MUS'
    > Mauritius</option>
                      <option  value='MYT'
    > Mayotte</option>
                      <option  value='MEX'
    > Mexico</option>
                      <option  value='FSM'
    > Micronesia, Federated States Of</option>
                      <option  value='MDA'
    > Moldova, Republic Of</option>
                      <option  value='MCO'
    > Monaco</option>
                      <option  value='MNG'
    > Mongolia</option>
                      <option  value='MSR'
    > Montserrat</option>
                      <option  value='MAR'
    > Morocco</option>
                      <option  value='MOZ'
    > Mozambique</option>
                      <option  value='MMR'
    > Myanmar</option>
                      <option  value='NAM'
    > Namibia</option>
                      <option  value='NRU'
    > Nauru</option>
                      <option  value='NPL'
    > Nepal</option>
                      <option  value='NLD'
    > Netherlands</option>
                      <option  value='ANT'
    > Netherlands Antilles</option>
                      <option  value='NCL'
    > New Caledonia</option>
                      <option  value='NZL'
    > New Zealand</option>
                      <option  value='NIC'
    > Nicaragua</option>
                      <option  value='NER'
    > Niger</option>
                      <option  value='NGA'
    > Nigeria</option>
                      <option  value='NIU'
    > Niue</option>
                      <option  value='NFK'
    > Norfolk Island</option>
                      <option  value='MNP'
    > Northern Mariana Islands</option>
                      <option  value='NOR'
    > Norway</option>
                      <option  value='OMN'
    > Oman</option>
                      <option  value='PAK'
    > Pakistan</option>
                      <option  value='PLW'
    > Palau</option>
                      <option  value='PSE'
    > Palestinian Territory, Occupied</option>
                      <option  value='PAN'
    > Panama</option>
                      <option  value='PNG'
    > Papua New Guinea</option>
                      <option  value='PRY'
    > Paraguay</option>
                      <option  value='PER'
    > Peru</option>
                      <option  value='PHL'
    > Philippines</option>
                      <option  value='PCN'
    > Pitcairn</option>
                      <option  value='POL'
    > Poland</option>
                      <option  value='PRT'
    > Portugal</option>
                      <option  value='PRI'
    > Puerto Rico</option>
                      <option  value='QAT'
    > Qatar</option>
                      <option  value='REU'
    > Reunion</option>
                      <option  value='ROU'
    > Romania</option>
                      <option  value='RUS'
    > Russian Federation</option>
                      <option  value='RWA'
    > Rwanda</option>
                      <option  value='SHN'
    > SaINT Helena</option>
                      <option  value='KNA'
    > SaINT Kitts And Nevis</option>
                      <option  value='LCA'
    > SaINT Lucia</option>
                      <option  value='SPM'
    > SaINT Pierre And Miquelon</option>
                      <option  value='VCT'
    > SaINT Vincent And The Grenadines</option>
                      <option  value='WSM'
    > Samoa</option>
                      <option  value='SMR'
    > San Marino</option>
                      <option  value='STP'
    > S&Atilde;&fnof;&AElig;&rsquo;&Atilde;&sbquo;&Acirc;&pound;o Tom&Atilde;&fnof;&AElig;&rsquo;&Atilde;&sbquo;&Acirc;&copy; And Principe</option>
                      <option  value='SAU'
    > Saudi Arabia</option>
                      <option  value='SEN'
    > Senegal</option>
                      <option  value='SYC'
    > Seychelles</option>
                      <option  value='SLE'
    > Sierra Leone</option>
                      <option  value='SGP'
    > Singapore</option>
                      <option  value='SVK'
    > Slovakia</option>
                      <option  value='SVN'
    > Slovenia</option>
                      <option  value='SLB'
    > Solomon Islands</option>
                      <option  value='SOM'
    > Somalia</option>
                      <option  value='ZAF'
    > South Africa</option>
                      <option  value='SGS'
    > South Georgia And The South Sandwich Islands</option>
                      <option  value='ESP'
    > Spain</option>
                      <option  value='LKA'
    > Sri Lanka</option>
                      <option  value='SDN'
    > Sudan</option>
                      <option  value='SUR'
    > Suriname</option>
                      <option  value='SJM'
    > Svalbard and Jan Mayen</option>
                      <option  value='SWZ'
    > Swaziland</option>
                      <option  value='SWE'
    > Sweden</option>
                      <option  value='CHE'
    > Switzerland</option>
                      <option  value='SYR'
    > Syrian Arab Republic</option>
                      <option  value='TWN'
    > Taiwan, Province Of China</option>
                      <option  value='TJK'
    > Tajikistan</option>
                      <option  value='TZA'
    > Tanzania, United Republic Of</option>
                      <option  value='THA'
    > Thailand</option>
                      <option  value='TLS'
    > Timor-Leste</option>
                      <option  value='TGO'
    > Togo</option>
                      <option  value='TKL'
    > Tokelau</option>
                      <option  value='TON'
    > Tonga</option>
                      <option  value='TTO'
    > Trinidad And Tobago</option>
                      <option  value='TUN'
    > Tunisia</option>
                      <option  value='TUR'
    > Turkey</option>
                      <option  value='TKM'
    > Turkmenistan</option>
                      <option  value='TCA'
    > Turks And Caicos Islands</option>
                      <option  value='TUV'
    > Tuvalu</option>
                      <option  value='UGA'
    > Uganda</option>
                      <option  value='UKR'
    > Ukraine</option>
                      <option  value='ARE'
    > United Arab Emirates</option>
                      <option  value='GBR'
    > United Kingdom</option>
                      <option  value='USA'
    > United States</option>
                      <option  value='UMI'
    > United States Minor Outlying Islands</option>
                      <option  value='URY'
    > Uruguay</option>
                      <option  value='UZB'
    > Uzbekistan</option>
                      <option  value='VUT'
    > Vanuatu</option>
                      <option  value='VEN'
    > Venezuela</option>
                      <option  value='VNM'
    > Vietnam</option>
                      <option  value='VGB'
    > Virgin Islands, British</option>
                      <option  value='VIR'
    > Virgin Islands, U.S.</option>
                      <option  value='WLF'
    > Wallis And Futuna</option>
                      <option  value='ESH'
    > Western Sahara</option>
                      <option  value='YEM'
    > Yemen</option>
                      <option  value='YUG'
    > Yugoslavia</option>
                      <option  value='ZMB'
    > Zambia</option>
                      <option  value='ZWE'
    > Zimbabwe</option>
                      <option  value='ASC'
    > Ascension Island</option>
                      <option  value='DGA'
    > Diego Garcia</option>
                      <option  value='XNM'
    > Inmarsat</option>
                      <option  value='TMP'
    > East timor</option>
                      <option  value='AK'
    > Alaska</option>
                      <option  value='HI'
    > Hawaii</option>
                      <option  value='CIV'
    > C&Atilde;&fnof;&AElig;&rsquo;&Atilde;&sbquo;&Acirc;&acute;te d'Ivoire</option>
                      <option  value='ALA'
    > Aland Islands</option>
                      <option  value='BLM'
    > Saint Barthelemy</option>
                      <option  value='GGY'
    > Guernsey</option>
                      <option  value='IMN'
    > Isle of Man</option>
                      <option  value='JEY'
    > Jersey</option>
                      <option  value='MAF'
    > Saint Martin</option>
                      <option  value='MNE'
    > Montenegro, Republic of</option>
                      <option  value='SRB'
    > Serbia, Republic of</option>
                      <option  value='CPT'
    > Clipperton Island</option>
                      <option  value='TAA'
    > Tristan da Cunha</option>
                    </select>
                  </div></td>
              </tr>
              <tr>
                <td class="style1"><div align="right" id="company"><span class="aster">*</span>Company/ Organization Name </div></td>
                <td class="style1">
                  <div align="left">
                    <input name="company" type="text"  value="<? echo $company?>" size="30" />
                  </div></td>
              </tr>
              <tr>
                <td bgcolor="#1D1D1D" class="style1"><div align="right" id="website"><span class="aster">*</span>Website</div></td>
                <td bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="website" type="text" value="<? echo $website?>" size="30" />
                </div></td>
              </tr>
              <tr>
                <td  class="style1">&nbsp;</td>
                <td class="style1"></td>
              </tr>
              <tr>
                <td  bgcolor="#000040" class="style1"><div align="right"><strong>VoIP Account Information</strong></div></td>
                <td bgcolor="#000040" class="style1"><div align="left"></div></td>
              </tr>
              <tr>
                <td valign="top"  class="style1">
                  <div style="height:7px"></div><div align="right" id="balance" style="padding-top:5px">
                  <span class="aster">*</span>Minimum Balance Alert </div></td>
                <td class="style1"><div style="></div>
                <div align="left">
                  <div style="height:7px"></div>
                    <div align="left">
                      <select name="balance" class="form_input_select">
                        <option  value="" selected="selected">Select</option>
                        <option value="$5">$5 </option>
                        <option value="$10">$10 </option>
                        <option value="$20">$20 </option>
                        <option value="$50">$50 </option>
                        <option value="$100">$100 </option>
                        <option value="$500">$500 </option>
                        <option value="$1000">$1000 </option>
                      </select>
                    </div>
                  <div style="height:7px"></div>
                </div>
                  <div style="></div>
                <div align="left" class="stylesm">An email will be sent when your balance reaches the level you select. </div></td>
              </tr>
              <tr>
                <td  bgcolor="#1D1D1D" class="style1"><div align="right" id="configuration"><span class="aster">*</span>Configuration Type</div></td>
                <td bgcolor="#1D1D1D" class="style1">
                  <div align="left">
                    <select name="configuration">
                      <option value="" selected="selected">Select</option>
                      <option value="SIP">SIP</option>
                      <option value="IAX">IAX (predictive dialer)</option>
                    </select>
                  </div>          </td>
              </tr>
              <tr>
                <td valign="top"  class="style1"><div style="height:3px"></div>
                  <div align="right" id="dialer"><span class="aster">*</span>Dialer</div></td>
                <td>
 <script type="text/javascript">
    function ShowHideDiv() {
        var ddlPassport = document.getElementById("ddlPassport");
        var dvPassport = document.getElementById("dvPassport");
        dvPassport.style.display = ddlPassport.value == "Other" ? "block" : "none";
    }
</script>

    <select id="ddlPassport" name="dialer" onchange="ShowHideDiv()">
        <option value="" selected="selected">Select</option>
                    <option value="Vicidialer" >Vicidialer</option>
                    <option value="GoAuto Dialer" >GoAuto Dialer</option>
                    <option value="Other">Other: </option>         
    </select>

<div id="dvPassport" style="display: none">
<span id="dialerother">*Other Dialer</span> &nbsp;<input name="dialer_other" type="text" size="15" >
</div>
<div id="dialer-other" style="font-size:14px;color:#F7F2AB; display:none; text-align:left; margin-top:3px">
                  Please enter or select the type of dialer used.</div>                  </td>
              </tr>
              <tr>
                <td  bgcolor="#1D1D1D" class="style1"><div align="right" id="dialing_countries"><span class="aster">*</span>Countries to Dial (Termination) </div></td>
                <td bgcolor="#1D1D1D" class="style1">
                  <div align="left">
                    <input name="dialing_countries" type="text" value="<? echo $dialing_countries?>" size="30" />
                  </div></td>
              </tr>
              <tr>
                <td valign="top" class="style1"><div align="right" id="purchase">
                  <div style="height:4px"></div>
                  <span class="aster">*</span>Amount to Purchase $<br />
                </div></td>
                <td>
                  <div align="left" style="padding-right:5px">
                    <select name="purchase">
                      <option value="" selected="selected">Select</option>
                      <option value="$10">$10 (Manual Dialing)</option>
                      <option value="$20">$20 (Predictive Dialer)</option>
                    </select><div style="height:10px"></div>
                    <span class="stylesm"> To open an account clients are required to purchase a maximum &amp; minimum of $10 for manual and $20 for predictive dialing in order to test quality. Thereafter they can buy as      much as needed using the same payment method. ($50 is the minimum on refill.) <br />
                      <br />
                      All transfer fees will be added to the cost. E.g. PayPal: ($25 + $1.16 = $26.16) and ($50 + $2.32 = $52.32).</span><br />
                    <br />
                    <span class="style8">Please Note:</span><span class="style1"> We are not network security providers.</span><div style="height:5px"></div>
                  </div></td>
              </tr>
              <tr>
                <td valign="top" bgcolor="#1D1D1D" class="style1"><div style="height:1px"></div>
                <div align="right" id="refill"><span class="aster">*</span>Auto Refill</div></td>
                <td valign="top" bgcolor="#1D1D1D" class="style1">
                  <div align="left">
                    <select name="refill">
                      <option value="">Select</option>
                      <option value="Yes">Yes</option>
                      <option value="No">No</option>
                    </select>
                  </div>
 
                    <div align="left" style="padding-right:5px; margin-top:10px"><span class="stylesm">If you select 'Yes' then when you reach $X (select <span style="padding-top:5px">'Minimum Balance Alert' above</span>) it will automatically charge your account &amp; will be notified. If you select 'No' then you will receive an email stating that you have reached your Minimum balance and need to refill.</span>                    </div>
                   </td>
            </tr>

          
              <tr>
                <td class="style1" style="padding:10px"><div align="right"><strong>Check to order DIDs</strong></div></td>
                <td class="style1" style="padding: 10px 10px 10px 0px"><table border="0" align="left" cellpadding="0">
                  <tr>
                    <td><input type="checkbox" name="did" id="did" value="didval" onClick="showHide('dids')"/></td>
                    <td><strong><span class="style8"><img src="images/unlimited_inbound_did.png" alt="Unlimited Inbound DID One Great Flat Rate" style="max-width:239px; height:auto; width:100%" height="27" border="0"/></span></strong></td>
                  </tr>
                </table></td>
              </tr>
              <tr>
                <td colspan="2" class="style1" style="padding:10px">   <div id="dids" style="background-color:#0A0A07; display:none"><div style="padding:20px; border: 1px dotted #FF8000; align="left"><span class="style8">DID’s Basic Plan Includes: </span><br />
                  - Unlimited inbound<br />
                  - 2 channels<br />
                  » Add ons available upon request. <br />
  <br />
  <strong>USA  &amp; Canada DID: </strong>Set up Fee (One Time) $10 &amp; Monthly $10<br />
  <br />
  <strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $15 &amp; Monthly $15<br />
  <br />
  <strong>USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $45 &amp; Monthly $30</strong><br />
  <br />
<br />
  <br />
  <p class="style1"><span class="style8"><strong>DID’s Basic    Plan for those using <em>only</em> DID service Includes</strong>:</span><br />
    - Unlimited inbound<br />
    - 2 channels<br />
    » Add-on available upon    request. <br />
    <br />
    <strong>USA &amp; Canada DID:</strong> Set up Fee (One Time) $15 +  Monthly $10 + $10 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
    <br />
    <strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $20 +  Monthly $15 + $15 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
    <strong><br />
      USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $55 &amp; Monthly    $40  inclusive Voip Miniutes as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. </p>
 <div align="left"> <ul>
    <li class="style1">Advanced payment is refundable if you do not wish  to continue the service of DID; if we are informed 10 days before the due date. DID will be disabled on due date. <br />
      </li>
  </ul>
<br />
  <span class="style8"><br />
    DID’s Call Divert to Cell / Mobile Plan Includes</span></strong><span class="style8">:</span><br />
                  - Unlimited inbound<br />
                  - 2 channels<br />
                  » Add-on available upon    request. <br />
  <br />
  <strong>USA &amp; Canada DID:</strong> Set up Fee (One Time) $35 +  Monthly $20 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
  <br />
  <strong>UK &amp; Australia DID:</strong> Set up Fee (One Time) $65 +  Monthly $45 as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date. <br />
  <strong><br />
    USA &amp; Canada Toll Free DID:</strong> Set up Fee (One Time) $65 &amp; Monthly    $65  inclusive Voip Miniutes as advanced monthly payment which is<strong> package convertable to VoIP Mintes </strong>if notify 10 days  prior due to date.
  </p>
  <ul>
    <li class="red">Advanced payment is refundable if you do not wish  to continue the service of DID; if we are informed 15 days before the due date. DID will be disabled on due date. </li>
  </ul>
  <span class="red" style="padding-top:4px">Additional channels upon request for low flat rates. <br />
    Call Transfer &amp; Forwarding also available  upon  request.
  </li>
    </span></div>
                <div id="didsel" class="style8" align="center" style="display:none"><br />
                  
                  Please enter in the details for your DID(s) you wish to order.<br /><br />
  <img src="images/arrow2.gif" /></div>
                 <div align="left" id="did1">
                  
                   <span class="aster"><br />
                   *</span>Country of DID
                   <select name="did1" class="marg">
                     <option value="" selected="selected">Select</option>
                     <option value="USA">USA</option>
                     <option value="Australia">Australia</option>
                     <option value="UK">UK</option>
                     <option value="Canada">Canada</option>
                     </select>
                   </div>
                          <div align="left" id="did1state"><span class="aster">*</span>State
                            <input name="did1state" type="text" class="marg" id="did1state" value="<? echo $did1state?>" size="20" />
                        <span class="small">Please spell out entire state.**</span> </div>
                          <div align="left" id="did1city"><span class="aster">*</span>City
                            <input name="did1city" type="text" class="marg" value="<? echo $did1city?>" size="20" />
                  </div>
                  
                  <div align="left" id="did1channels" ><span class="aster">*</span>Number of Channels
                    <input name="did1channels" type="text" class="marg" value="<? echo $did1channels?>" size="3" />
                    In addition to 2 included.</div>
                   <br />
                  <br /> <div align="left" class="didheader">
                    <strong>2nd DID(s)                    </strong>(optional)</div>
                        <div align="left" id="did2">Country of DID
                          <select name="did2" class="marg">
                            <option value="" selected="selected">Select</option>
                            <option value="USA">USA</option>
                            <option value="Australia">Australia</option>
                            <option value="UK">UK</option>
                            <option value="Canada">Canada</option>
                          </select>
                        </div>
                          <div align="left" id="did2state" >State
                            <input name="did2state" type="text" class="marg" value="<? echo $did2state?>" size="20" />
                        <span class="small">                    **</span></div><div align="left" id="FieldData24">City
                          <input name="did2city" type="text" class="marg" value="<? echo $did2city?>" size="20" />
                          </div>
                  
                  <div align="left" id="did2channels">Number of Channels
                    <input name="did2channels" type="text" class="marg" value="<? echo $did2channels?>" size="3" />
                    In addition to 2 included.<br />
                    <br />
                    <br />
                    </div>
                    <div align="left" class="didheader"><strong>3rd DID(s)                    </strong>(optional)</div>
                        <div align="left" id="did3" >Country of DID
                          <select name="did3" class="marg">
                            <option value="" selected="selected">Select</option>
                            <option value="USA">USA</option>
                            <option value="Australia">Australia</option>
                            <option value="UK">UK</option>
                            <option value="Canada">Canada</option>
                          </select>
                        </div>
                          <div align="left" id="did3state">State
                            <span class="small">
                            <input name="did3state" type="text" class="marg" value="<? echo $did3state?>" size="20" />
                            **</span></div>
                          <div align="left" id="did3city">City
                            <input name="did3city" type="text" class="marg" value="<? echo $did3city?>" size="20" />
                  </div>
                  
                  <div align="left" id="did3channels" >Number of Channels
                    <input name="did3channels" type="text" class="marg" value="<? echo $did3channels?>" size="3" />
                    In addition to 2 included.<br />
                    <br />
                    </div>
                    <div align="left" class="didheader"><strong>4th DID(s)                    </strong>(optional)</div>
                        <div align="left" id="did4">Country of DID
                          <select name="did4" class="marg">
                            <option value="" selected="selected">Select</option>
                            <option value="USA">USA</option>
                            <option value="Australia">Australia</option>
                            <option value="UK">UK</option>
                            <option value="Canada">Canada</option>
                          </select>
                        </div>
                          <div align="left" id="did3state">State
                            <span class="small">
                            <input name="did4state" type="text" class="marg" value="<? echo $did4state?>" size="20" />
                      **</span></div><div align="left">City
                        <input name="did4city" type="text" class="marg" value="<? echo $did4city?>" size="20" />
                        </div>
                  
                  <div align="left" id="did4channels">Number of Channels
                    <input name="did4channels" type="text" class="marg" value="<? echo $did4channels?>" size="3" />
                    In addition to 2 included</div>
                </div><br /></div>
                  <table border="0" align="center" cellpadding="5" cellspacing="0" style="border: 1px #30302B solid; width:100%; max-width:1000px">
                    <tr>
                      <td colspan="2" valign="top"><span class="style8"><strong>&nbsp;Usage &amp; Refund Policy </strong></span></td>
                    </tr>
                    <tr>
                      <td width="29" valign="top" bgcolor="#1D1D1D"><div align="right">01.</div></td>
                      <td bgcolor="#1D1D1D"><div align="left">Client/ User will be given a substitute account if the service is down for more than 48 hours.<br />
                      </div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">02.</div></td>
                      <td><div align="left">Client/ User will not be able to operate your account if there is not sufficient funds. (depending on the channel)</div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">03.</div></td>
                      <td bgcolor="#1D1D1D"> <div align="left">Client/ User will not misuse the services to threaten, abuse, or engage in illegal activities. Doing so will terminate your account and no refund will be given. (See <a href="money-back-guarantee.html" target="_blank">refund policy</a>.) </div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">04.</div></td>
                      <td><div align="left">Client/ User will not use it for any political purpose.</div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">05.</div></td>
                      <td bgcolor="#1D1D1D"><div align="left">In-case of fraud BMA Group is not responsible.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">06.</div></td>
                      <td><div align="left">BMA Group is not responsible if your account is miss-used or has unauthorized use.</div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">07. </div></td>
                      <td bgcolor="#1D1D1D"><div align="left">All money transfer fees during refill or opening the account are on the client/ user.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">08.</div></td>
                      <td><div align="left">Rates are subject to change as per international tariff.</div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">09.</div></td>
                      <td bgcolor="#1D1D1D"><div align="left">We have no refund policy. Refund will only be made in case the service is not operational due to block Port or a very     valid issue. It will be made upon request of suspension of account and with request of refund in writing by email.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">10.</div></td>
                      <td><div align="left">The Internet is the most unreliable method of communication. Our VoIP quality is Tier-1 connecting direct to your server.     VoIP/DID connectivity issues resulting from Internet Service Provider are not the responsibility of BMAV. There will be no refund. In case of fault from our server we will provide you alternative connection / link. </div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">11.</div></td>
                      <td bgcolor="#1D1D1D"><div align="left">These rates are for end users only.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">12.</div></td>
                      <td><div align="left">All email correspondence must be kept in continuity from the email used for this form.</div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">13.</div></td>
                      <td bgcolor="#1D1D1D"> <div align="left">Account # has to be mentioned in all comunication when alloted.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">14.</div></td>
                      <td><div align="left"><strong>Warning:</strong> Any fraudulent chargeback will be prosecuted and the customer blacklisted. </div></td>
                    </tr>
                    <tr>
                      <td valign="top" bgcolor="#1D1D1D"><div align="right">15.</div></td>
                      <td bgcolor="#1D1D1D"><div align="left">To open an account clients are required to purchase a maximum &amp; minimum of $10 for manual and $20 for predictive dialing in order to test quality. Thereafter they can buy as      much as needed using the same payment method.</div></td>
                    </tr>
                    <tr>
                      <td valign="top"><div align="right">16.</div></td>
                      <td>VoIP minutes must be purchase from BMA Group as long the prices are competitive. If for some reason the client wishes to discontinue our services the client should inform us in advance so that accomodations to keep you as a client can be made as necessary.<br />
                        <br />
                        Installation time for dialer requires 72 WORKING HOURS Min.<br />
  <br />
  <span class="style7">Support:</span><br />
                        Tech support:  Mon - Sat 9am Eastern to 9pm Pacific USA Time<br />
                        General Support: Mon - Sat 9am Eastern to 9pm Pacific USA Time<br />
                      Email and Ticket Support: 24x7</td>
                    </tr>
                    </table>
                    <br /></td>
              </tr>
              <tr>
                <td valign="top" class="style1"><div align="right" id="FieldData34">Message (optional) </div></td>
                <td valign="top" class="style1"><div align="left">
                  <textarea name="message" cols="27" id="message"><? echo $message ?></textarea>
                  </div>
                  </label></td>
              </tr>
              <tr>
                <td align="left" bgcolor="#1D1D1D" class="style1"><div align="right" class="style17" id="referral"><span class="aster">*</span>Referral Source</div></td>
                <td bgcolor="#1D1D1D" class="style1"><div align="left">
                  <input name="referral" type="text" value="<? echo $referral?>" size="20" />
                  </div>
                    <div></div></td>
              </tr>
              <tr>
                <td bgcolor="#1D1D1D" class="style1">&nbsp;</td>
                <td  bgcolor="#1D1D1D" class="style1"><div align="left">Please include the full name if any.</div></td>
              </tr>
              <tr>
                <td class="style1"><div align="right" class="style17" id="payment"><span class="aster">*</span>Payment Method<br />
                </div></td>
                <td valign="top" class="style1"><div align="left">
                  <select name="payment">
                    <option value="" selected="selected">Select</option>
                    <option value="PayPal">PayPal</option>
                    <option value="MoneyBookers">MoneyBookers</option>
                    <option value="AlertPay">AlertPay</option>
                    </select>
                </div></td>
              </tr>
              
              <tr>
                <td  bgcolor="#1D1D1D" class="style1"><div align="right" id="terms">
                  <div align="right"><span class="aster">*</span>I agree to the rates and terms of this page.</div>
                </div></td>
                <td bgcolor="#1D1D1D" class="style1">
                  <div align="left">
                    <input name="terms" type="checkbox" value="Agree"/>
                    <span id="agree" style="color:#F8FFB8; display:none">You must agree to the terms.</span>
                    IP: <?php $IP = $_SERVER['REMOTE_ADDR']; echo $IP; ?>
                  </div> <span id="IPAddressx" style="font-size:11px;color:#F7F2AB; display:none">Hiding your IP?</span></td>
              </tr>
              <tr>
                <td valign="top"><div align="right"  id="Verification" ><span class="aster">*</span>Human Verification </div></td>
                <td valign="top" class="style1"><div align="left">
                  <input name="Verification" type="text" size="10" />
                  
                 Enter the text: <strong>bmavoip</strong> </div>
                 <div id="Verificationx" style="color:#F8FFB8; display:none">Please type or paste the verification text in bold above</div></td>
              </tr>
              <tr>
                <td valign="top" class="style1"><div align="left" style="padding:10px 10px 10px 20px"><strong>Important:</strong><br />
                  Be sure to add: support a t bmagroup.net to your safe list and check your bulk folder and mark not spam if the reply message goes there.
                  <div id="fields" style="font-size:14px; display:none">
                    <br />
                    
                    <table border="0" cellpadding="3" >
                      <tr>
                        <td valign="top"><img src="images/x.png" /></td>
                        <td>There are some fields which need to be properly completed to submit the form. Please scroll up and fix all the fields in yellow text. <br />
                          Thank you!</td>
                      </tr>
                  </table>      </div>
                    </div>              </td>
                <td valign="top" class="style1">
                  
                  <div align="left">
                    <input name="Input" type="image" class="send" onClick="return CheckTheForm();" value="submit" src="images/submit0.png" alt="submit">
                    </div></td>
              </tr>
              </table>
            </form>
          </div>
<div class="navy" align="center">

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