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frm

frm

// Add Shortcode
function custom_form() {

	// Code
    <script type="text/javascript">
$( document ).ready(function() {
	$("#submitfrm").click(function(e) {


		  var fullName = $("#first_name").val().split(" "),
		      firstName = fullName[0],
		      lastName = fullName[fullName.length - 1];
		  $("#first_name").val(firstName);
		  $("#last_name").val(lastName);
		  $("#phone_number").val(phone);
		  $("#email").val(email);
		  $("#PickUpCity").val(pickup_city);
		  $("#PickUpState").val(pickup_state_code);
		  $("#DeliveryCity").val(dropoff_city);
		  $("#DeliveryState").val(dropoff_state_code);
		  $("#VehicleYear").val(year1);
		  $("#VehicleMake").val(make1);
		  $("#VehicleModel").val(mode11);

		  //Stop form from submitting
		  e.preventDefault();

		  //Dont alery any parent handlers of the event
		  e.stopPropagation();

		  //Get the form contents
		  var formContents = $("#myform").serialize();
		  
		  //Make an ajax call to the api.
		  $.ajax({
			  url: "submit.php",
			  method: "POST",
			  data: formContents
		  }).done(function(result) {

			  //Check for successfull response.
			 if (result.indexOf("SUCCESS") != -1)
			 {
				 //Redirect to the thank you page.
			 window.location = "http://www.americancartransporters.com/thank-you";
			 	alert(result);
			 }

			 else
			 {
				 //HANDLE ERRORS HERE
				 if (result.indexOf("DUPLICATE PHONE") != -1)
				 {
					   //display error here.
					   alert("Phone number has already been submitted. Please contact us at 877-238-4718 if you need to change your quote information");
				 }

				 else
				 {
					   alert("Please check the form to make sure all fields are correctly filled out.");
				 }
			 }
		  });
	   
	});
});
</script>
<form id="myform" action="" method="post" class="wpcf7-form" >

<div style="display: none;">

<input type="hidden" name="utm_source" value="<?php echo $utm_source ?>" />
<input type="hidden" name="utm_medium" value="<?php echo $utm_medium ?>" />
<input type="hidden" name="utm_term" value="<?php echo $utm_term ?>" />
<input type="hidden" name="utm_content" value="<?php echo $utm_content ?>" />
<input type="hidden" name="utm_campaign" value="<?php echo $utm_campaign ?>" />
<input type="hidden" name="type" value="<?php echo $type ?>" />

</div>

<p><span class="wpcf7-form-control-wrap Name">

<input type="text" id="first_name" name="first_name" value="" size="40" placeholder="Full Name" required/></span></p>

<span class="wpcf7-form-control-wrap Name"><input type="text" name="last_name" id="last_name" value="" size="40" placeholder="Last Name" required/></span></p>

<p><span class="wpcf7-form-control-wrap Email"><input type="email" name="email" value="" size="40"  placeholder="Email" required/></span></p>
<p>
<span class="wpcf7-form-control-wrap Phone"><input type="tel" name="phone_number" value="" size="7" maxlength="15"  placeholder="Phone" required/></span>
</p>
<p>
<span class="wpcf7-form-control-wrap VehicleMake"><input type="text" name="VehicleMake" value="" size="40" placeholder="Vehicle Make" required/></span>
</p>
<p>
<span class="wpcf7-form-control-wrap VehicleModel"><input type="text" name="VehicleModel" value="" size="40"  placeholder="Vehicle Model" required/></span>
</p>
<p>
<span class="wpcf7-form-control-wrap VehicleYear"><input type="text" name="VehicleYear" value="" size="40"  placeholder="Vehicle Year" required/></span>
</p>
<p>
    <span class="wpcf7-form-control-wrap ShipOnDate"><input type="date" name="ShipOnDate" value="" size="40" title="mm/dd/yyyy" pattern="d{1,2}/d{1,2}/d{4}" placeholder="Ship on Date" required/> </span>
</p>
<p>
<span class="wpcf7-form-control-wrap PickUpCity"><input type="text" name="PickUpCity" value="" size="40" placeholder="Pick Up City" required/></span>
</p>
<p>
<span class="wpcf7-form-control-wrap PickUpState"><select name="PickUpState" required>

<option value="Select Pick Up State">Select Pick Up State</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Pennsylvania">Pennsylvania</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="Washington D.C.">Washington D.C.</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></span>
</p>
<p>
     <span class="wpcf7-form-control-wrap DeliveryCity">
     <input type="text" name="DeliveryCity" value="" size="40" placeholder="Delivery City" required/></span>
</p>
<p>
<span class="wpcf7-form-control-wrap DeliveryState"><select name="DeliveryState" ><option value="Select Delivery State" required>Select Delivery State</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Pennsylvania">Pennsylvania</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="Washington D.C.">Washington D.C.</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select></span></p>
<p>
    <span class="wpcf7-form-control-wrap your-message"><textarea name="comments" cols="40" rows="10" class="wpcf7-form-control wpcf7-textarea"  placeholder="Additional Information"></textarea></span> </p>
<p><input type="submit" value="Get My Quote!" class="wpcf7-form-control wpcf7-submit" id="submitfrm"/></p>

<div class="icons">
<a href="" onclick="window.open('http://transportreviews.com/company/american-car-transporters-inc.asp','mywin','width=600,height=800,toolbar=0,menubar=0,location=0,status=1,scrollbars=1,resizable=1,left=0,top=0');return false;"><img class="transport" src="http://www.americancartransporters.com/wp-content/themes/html5blank-master/img/transport.png" border="0" /><img class="fivestar" src="http://www.americancartransporters.com/wp-content/themes/html5blank-master/img/fivestar.png" border="0" /></a><a href="" onclick="window.open('http://www.bbb.org/south-east-florida/business-reviews/vehicle-transport-services/american-car-transporters-in-pompano-beach-fl-90070171','mywin','width=600,height=800,toolbar=0,menubar=0,location=0,status=1,scrollbars=1,resizable=1,left=0,top=0');return false;"><img class="betterbb" src="http://www.americancartransporters.com/wp-content/themes/html5blank-master/img/bbb.png" border="0" /></a></p></div>
</form>
}
add_shortcode( 'form', 'custom_form' );