Pages

Code Context

    <title><?php echo $title_for_layout ?></title>
    <meta name="apple-itunes-app" content="app-id=525816256" /> 
    <meta name="description" content="<?php echo $meta_description; ?>" />

$___viewFn	=	"/home/mycoup7/public_html/app/View/Layouts/page.ctp"
$___dataForView	=	array(
	"pg_header" => array(
	"Headr" => array()
),
	"pg_footer" => array(
	"Footer" => array()
),
	"pack_id" => "1",
	"content_for_layout" => "<style type="text/css">
.sm-header { width:100%;height:108px;background:transparent url(https://d34spuuem3ure1.cloudfront.net/home2013/subpage_header.jpg) repeat-x left center; }
.sub-content {width:950px;margin:20px auto; }
.sub-content h1 {float:left;width:650px;font:normal 32px Helvetica;color:#000;margin:0 0 10px 0;padding:0px; }
.sub-content p.subtext { float:left;width:950px;font:normal 16px Helvetica;color:#000;margin:0 0 0px 0;padding:0px 0 20px 0; }
.sub-content form { width:700px;margin:20px auto;}</style>
<link href="/bootstrap/css/bootstrap.min.css" media="screen" rel="stylesheet" />

<div class="sm-header">
	&nbsp;</div>
<div class="sub-content">
	<h1>
		Request For More Information</h1>
	<p class="subtext">
		Please fill out the form below and a My Coupon Genie Representative will contact you.</p>
	<div style="clear:both;"></div>
	
<div id="msg"></div>
	<form class="form-horizontal" action="/pages/business_contact/1" method="post">
		<fieldset>
			<!-- Text input-->
			<div class="control-group">	
				<label class="control-label">Company Name</label>
				<div class="controls">
					<input class="input-xlarge" value="Company Name (Required)" onfocus="if(this.value == 'Company Name (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Company Name (Required)';}" id="company" name="company" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Street Address</label>
				<div class="controls">
					<input class="input-xlarge" value="Address (Required)" onfocus="if(this.value == 'Address (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Address (Required)';}" id="address" name="address" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">City</label>
				<div class="controls">
					<input class="input-xlarge" value="City (Required)" onfocus="if(this.value == 'City (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='City (Required)';}" id="city" name="city" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">State</label>
				<div class="controls">
					<input class="input-xlarge" value="State (Required)" onfocus="if(this.value == 'State (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='State (Required)';}" id="state" name="state" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Zipcode</label>
				<div class="controls">
					<input class="input-xlarge" value="Zip (Required)" onfocus="if(this.value == 'Zip (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Zip (Required)';}" id="zip" name="zip" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Name Contact</label>
				<div class="controls">
					<input class="input-xlarge"value="Contact (Required)" onfocus="if(this.value == 'Contact (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Contact (Required)';}" id="contact" name="contact" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Email Contact</label>
				<div class="controls">
					<input class="input-xlarge" value="Email (Required)" onfocus="if(this.value == 'Email (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Email (Required)';}" id="email" name="email" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Button Drop Down -->
			<div class="control-group">
				<label class="control-label">Contact Phone</label>
				<div class="controls">
					<div class="input-append">
						<input class="span2" id="phone" name="phone" placeholder="" type="text" />
						<div class="btn-group">
							<button class="btn dropdown-toggle" data-toggle="dropdown">Type</button>
							<ul class="dropdown-menu">
								<li>
									<a href="#">Work</a></li>
								<li>
									<a href="#">Mobile</a></li>
							</ul>
						</div>
					</div>
				</div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Product or Service Promoted</label>
				<div class="controls">
					<input class="input-xlarge" id="promoted" name="promoted" placeholder="" type="text" /></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Advertising</label>
				<div class="controls">
					<label class="checkbox inline"><input name="advertising[]" type="checkbox" value="Local" /> Local </label> <label class="checkbox inline"> <input name="advertising[]" type="checkbox" value="National" /> National </label> <label class="checkbox inline"> <input name="advertising[]" type="checkbox" value="Both" /> Both </label></div>
			</div>
			<!-- Select Basic -->
			<div class="control-group">
				<label class="control-label"># of Locations</label>
				<div class="controls">
					<select class="input-xlarge" id="locs" name="locs"><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option><option>6</option><option>7+</option></select></div>
			</div>
			<!-- Multiple Checkboxes -->
			<div class="control-group">
				<label class="control-label">Channel Distribution</label>
				<div class="controls">
					<label class="checkbox"><input name="channel[]" type="checkbox" value="Website" /> Website </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Facebook App" /> Facebook App </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Mobile App" /> Mobile App </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Mobile Website" /> Mobile Website </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Email Client" /> Email Client </label></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Shopper Intelligence Interest</label>
				<div class="controls">
					<label class="checkbox inline"><input name="intel[]" type="checkbox" value="Yes" /> Yes </label> <label class="checkbox inline"> <input name="intel[]" type="checkbox" value="No" /> No </label></div>
			</div>
			<!-- Multiple Radios -->
			<div class="control-group">
				<label class="control-label">Advertising Budget</label>
				<div class="controls">
					<label class="radio"><input checked="checked" name="budget" type="radio" value="&lt; $1,000" /> &lt; $1,000 </label> <label class="radio"> <input name="budget" type="radio" value="$1,000-$5,000" /> $1,000-$5,000 </label> <label class="radio"> <input name="budget" type="radio" value="$5,000-$10,000" /> $5,000-$10,000 </label> <label class="radio"> <input name="budget" type="radio" value="$10,000-$25,000" /> $10,000-$25,000 </label> <label class="radio"> <input name="budget" type="radio" value="$25,000-$100,000" /> $25,000-$100,000 </label> <label class="radio"> <input name="budget" type="radio" value="$100,000+" /> $100,000+ </label></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Est. Time of Advertising Campaign Launch</label>
				<div class="controls">
					<label class="checkbox inline"><input name="time[]" type="checkbox" value="Immediate" /> Immediate </label> <label class="checkbox inline"> <input name="time[]" type="checkbox" value="1 Month" /> 1 Month </label> <label class="checkbox inline"> <input name="time[]" type="checkbox" value="3 Months" /> 3 Months </label></div>
			</div>
			<!-- Prepended checkbox -->
			<div class="control-group">
				<label class="control-label">Email Me More Info?</label>
				<div class="controls">
					<div class="input-prepend">
						<span class="add-on"><label class="checkbox"><input type="checkbox" /> </label> </span> <input class="span2" id="moreinfo" name="moreinfo" placeholder="Alt Email" type="text" /></div>
				</div>
			</div>

			<!-- Verification code -->
			<div class="control-group">
				<label class="control-label">
                   <div id="sec_code" style="float:left"><img src="/pages/captcha"></div>
                </label>
				<div class="controls">
					<div class="input-prepend">
                     <input type="text" name="code" value="Verification Code (Required)" value="Verification Code (Required)" onfocus="if(this.value == 'Verification Code (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Email (Required)';}" id="code" />
				   </div>
				</div>
			</div>
		</fieldset>
		<input class="btn" name="subbut" type="submit" value="Submit Form" />&nbsp;</form>
</div>
<script src="/bootstrap/js/bootstrap.min.js"></script>


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	"title_for_layout" => "Pages"
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	"Headr" => array(
	"content" => "<div id="header">
<div class="main-wrap">
<div class="dropdown">
<ul class="top-nav">
	<li><strong><span style="font-size: 14px;"><strong><a href="https://www.facebook.com/mycoupongenie" target="_blank">Facebook</a></strong></span></strong></li>
	<li><strong><span style="font-size: 14px;"><strong><a href="https://play.google.com/store/apps/details?id=com.coupongenie" target="_blank">Android App</a></strong></span></strong></li>
	<li><strong><span style="font-size: 14px;"><strong><a href="https://itunes.apple.com/us/app/my-coupon-genie-inc/id1414845277?mt=8" target="_blank">Apple App</a></strong></span></strong></li>
	<li><strong><span style="font-size: 14px;"><strong><a href="https://www.mycoupongenie.com/page/business" target="_blank">Ad Packages</a></strong></span></strong></li>
	<li><strong><span style="font-size: 14px;"><strong><a href="/page/about" target="_blank">About Us</a></strong></span></strong></li>
</ul>
<strong><strong><span style="font-size: 14px;"><a class="logo" href="/">My Coupon Genie</a></span></strong> </strong>

<ul class="nav">
	<li><strong><strong><span style="font-size: 16px;"><span style="font-size:16px;"><em><strong><em><strong><a class="login" href="https://www.mycoupongenie.com/users/login">Log in</a></strong></em></strong></em></span></span></strong></strong></li>
	<li><strong><strong><span style="font-size: 16px;"><span style="font-size:16px;"><em><strong><span style="font-size:16px;"><a href="https://www.mycoupongenie.com/redeem" target="_blank"><em><strong>Redeem</strong></em></a></span></strong></em></span></span></strong></strong></li>
	<li><strong><strong><span style="font-size: 16px;"><span style="font-size:16px;"><em><strong><span style="font-size:16px;"><em><strong><a href="/users/register">Sign up</a></strong></em></span></strong></em></span></span></strong></strong></li>
	<li><strong><strong><span style="font-size: 16px;"><em><strong><em><strong><a href="https://www.mycoupongenie.com/pages/contact_us">Contact Us</a></strong></em></strong></em></span></strong></strong></li>
</ul>
</div>
</div>
</div>
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$pg_footer	=	array(
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	"content" => "<div class="clear"></div>

<div class="main-wrap footer">
<ul>
	<li class="top">Helpful Links</li>
	<li><a href="https://www.mycoupongenie.com/users/register">Sign Up</a></li>
	<li><a href="https://www.mycoupongenie.com/users/login">Log In</a></li>
	<li><a href="https://www.mycoupongenie.com/redeems" target="_blank">Redeem</a></li>
	<li><a href="/page/how_it_works">How it Works</a></li>
	<li><a href="/page/about">About Us</a></li>
	<li><a href="/page/rewards">Rewards</a></li>
	<li><a href="https://www.mycoupongenie.com/page/business"><em style="color: rgb(7, 130, 193);"><strong>Ad Packages</strong></em></a></li>
	<li><a href="/pages/contact_us" style="color: rgb(7, 130, 193);">Contact &amp; Support</a></li>
</ul>

<h4 style="line-height: 1.2em; color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; background-color: rgb(255, 255, 255); text-align: center;"><em style="font-weight: normal;"><strong>Download My Coupon Genie:</strong></em>&nbsp;<strong><a href="https://itunes.apple.com/us/app/my-coupon-genie-inc/id1414845277?mt=8" target="_blank">Apple App</a>&nbsp;or <a href="https://play.google.com/store/apps/details?id=com.coupongenie" target="_blank">Android App</a></strong><br />
&nbsp;<br />
<strong>We Build your Facebook, Google Search, Mobile Following, Email Following</strong><br />
&nbsp;&nbsp;<br />
<a href="https://www.mycoupongenie.com/page/business" style="font-style: italic; font-weight: bold;">REACH&nbsp;NEW CUSTOMERS &amp;&nbsp;BUILD your loyal customer base TODAY&nbsp;with My Coupon Genie</a><b style="font-style: italic; font-weight: normal;">&nbsp;</b></h4>

<p style="text-align: center;"><strong>*&nbsp;Promote Deals - Offers - Specials&nbsp;&nbsp;*&nbsp;Message Nearby Shoppers&nbsp;* Convert Sales</strong></p>

<h4 style="font-weight: normal; line-height: 1.2em; color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255);"></h4>

<p style="text-align: center;"><a href="http://www.facebook.com/mycoupongenie" style="color: rgb(7, 130, 193); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center;" target="_blank" title="My Coupon Genie Facebook">Facebook</a><span style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center; background-color: rgb(255, 255, 255);">&nbsp;|&nbsp;</span><a href="http://twitter.com/MCG_Offers" style="color: rgb(7, 130, 193); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center;" target="_blank" title="My Coupon Genie Twitter">Twitter</a><span style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center; background-color: rgb(255, 255, 255);">&nbsp;|&nbsp;</span><a href="/page/privacy_policy" style="color: rgb(7, 130, 193); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center;" title="Privacy Policy">Privacy Policy</a><span style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center; background-color: rgb(255, 255, 255);">&nbsp;|&nbsp;</span><a href="/page/terms_of_use" style="color: rgb(7, 130, 193); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; text-align: center;" title="Terms of Use">Terms of Use</a></p>

<div class="clear"></div>
</div>
<!-- Start of Async HubSpot Analytics Code --><script type="text/javascript">
    (function(d,s,i,r) {
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      var n=d.createElement(s),e=d.getElementsByTagName(s)[0];
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	"logged_in_content" => "<div class="clear"></div>

<div class="main-wrap footer">
<ul>
	<li class="top">Helpful Links</li>
	<li><a href="https://www.mycoupongenie.com/users/register" style="color: rgb(7, 130, 193);">Sign Up</a></li>
	<li><a href="https://www.mycoupongenie.com/users/login" style="color: rgb(7, 130, 193);">Log In</a></li>
	<li><a href="https://www.mycoupongenie.com/redeems" style="color: rgb(7, 130, 193);" target="_blank">Redeem</a></li>
	<li><a href="https://www.mycoupongenie.com/page/business"><em style="color: rgb(7, 130, 193);"><strong><em style="color: rgb(7, 130, 193);">Ad Packages</em></strong></em></a></li>
	<li><a href="/page/how_it_works" style="color: rgb(7, 130, 193);">How it Works</a></li>
	<li><a href="/page/about" style="color: rgb(7, 130, 193);">About Us</a></li>
	<li><a href="/page/rewards" style="color: rgb(7, 130, 193);">Rewards</a></li>
	<li><em style="color: rgb(7, 130, 193);"><strong><a href="/pages/contact_us" style="color: rgb(7, 130, 193);">Contact &amp; Support</a></strong></em></li>
</ul>

<h4 style="font-weight: normal; line-height: 1.2em; color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255); text-align: center;"><em><strong>Download My Coupon Genie:</strong></em>&nbsp;<strong><a href="https://itunes.apple.com/us/app/my-coupon-genie-inc/id1414845277?mt=8" style="color: rgb(7, 130, 193);" target="_blank">Apple App</a>&nbsp;or&nbsp;<a href="https://play.google.com/store/apps/details?id=com.coupongenie" style="color: rgb(7, 130, 193);" target="_blank">Android App</a></strong><br />
&nbsp;<br />
<strong>We Build your Facebook, Google Search, Mobile Following, Email Following</strong></h4>

<h4 style="font-weight: normal; line-height: 1.2em; color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255); text-align: center;"><a href="https://www.mycoupongenie.com/page/business" style="color: rgb(7, 130, 193); font-style: italic; font-weight: bold;">REACH&nbsp;NEW CUSTOMERS &amp;&nbsp;BUILD your loyal&nbsp;customer base TODAY&nbsp;with My Coupon Genie</a><span style="font-style: italic;">&nbsp;</span></h4>

<p style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255); text-align: center;"><strong>*&nbsp;Promote Deals - Offers - Specials&nbsp;&nbsp;*&nbsp;Message Nearby Shoppers&nbsp;* Convert Sales</strong></p>

<h4 style="font-weight: normal; line-height: 1.2em; color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255);"></h4>

<p style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255); text-align: center;"><a href="http://www.facebook.com/mycoupongenie" style="color: rgb(7, 130, 193);" target="_blank" title="My Coupon Genie Facebook">Facebook</a>&nbsp;|&nbsp;<a href="http://twitter.com/MCG_Offers" style="color: rgb(7, 130, 193);" target="_blank" title="My Coupon Genie Twitter">Twitter</a>&nbsp;|&nbsp;<a href="/page/privacy_policy" style="color: rgb(7, 130, 193);" title="Privacy Policy">Privacy Policy</a>&nbsp;|&nbsp;<a href="/page/terms_of_use" style="color: rgb(7, 130, 193);" title="Terms of Use">Terms of Use</a></p>

<p style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255);"></p>

<p style="color: rgb(51, 51, 51); font-family: sans-serif, Arial, Verdana, &quot;Trebuchet MS&quot;; font-size: 13px; background-color: rgb(255, 255, 255); text-align: justify;"></p>

<p></p>

<div class="clear"></div>
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$pack_id	=	"1"
$content_for_layout	=	"<style type="text/css">
.sm-header { width:100%;height:108px;background:transparent url(https://d34spuuem3ure1.cloudfront.net/home2013/subpage_header.jpg) repeat-x left center; }
.sub-content {width:950px;margin:20px auto; }
.sub-content h1 {float:left;width:650px;font:normal 32px Helvetica;color:#000;margin:0 0 10px 0;padding:0px; }
.sub-content p.subtext { float:left;width:950px;font:normal 16px Helvetica;color:#000;margin:0 0 0px 0;padding:0px 0 20px 0; }
.sub-content form { width:700px;margin:20px auto;}</style>
<link href="/bootstrap/css/bootstrap.min.css" media="screen" rel="stylesheet" />

<div class="sm-header">
	&nbsp;</div>
<div class="sub-content">
	<h1>
		Request For More Information</h1>
	<p class="subtext">
		Please fill out the form below and a My Coupon Genie Representative will contact you.</p>
	<div style="clear:both;"></div>
	
<div id="msg"></div>
	<form class="form-horizontal" action="/pages/business_contact/1" method="post">
		<fieldset>
			<!-- Text input-->
			<div class="control-group">	
				<label class="control-label">Company Name</label>
				<div class="controls">
					<input class="input-xlarge" value="Company Name (Required)" onfocus="if(this.value == 'Company Name (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Company Name (Required)';}" id="company" name="company" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Street Address</label>
				<div class="controls">
					<input class="input-xlarge" value="Address (Required)" onfocus="if(this.value == 'Address (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Address (Required)';}" id="address" name="address" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">City</label>
				<div class="controls">
					<input class="input-xlarge" value="City (Required)" onfocus="if(this.value == 'City (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='City (Required)';}" id="city" name="city" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">State</label>
				<div class="controls">
					<input class="input-xlarge" value="State (Required)" onfocus="if(this.value == 'State (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='State (Required)';}" id="state" name="state" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Zipcode</label>
				<div class="controls">
					<input class="input-xlarge" value="Zip (Required)" onfocus="if(this.value == 'Zip (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Zip (Required)';}" id="zip" name="zip" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Name Contact</label>
				<div class="controls">
					<input class="input-xlarge"value="Contact (Required)" onfocus="if(this.value == 'Contact (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Contact (Required)';}" id="contact" name="contact" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Email Contact</label>
				<div class="controls">
					<input class="input-xlarge" value="Email (Required)" onfocus="if(this.value == 'Email (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Email (Required)';}" id="email" name="email" placeholder="" required="" type="text" /></div>
			</div>
			<!-- Button Drop Down -->
			<div class="control-group">
				<label class="control-label">Contact Phone</label>
				<div class="controls">
					<div class="input-append">
						<input class="span2" id="phone" name="phone" placeholder="" type="text" />
						<div class="btn-group">
							<button class="btn dropdown-toggle" data-toggle="dropdown">Type</button>
							<ul class="dropdown-menu">
								<li>
									<a href="#">Work</a></li>
								<li>
									<a href="#">Mobile</a></li>
							</ul>
						</div>
					</div>
				</div>
			</div>
			<!-- Text input-->
			<div class="control-group">
				<label class="control-label">Product or Service Promoted</label>
				<div class="controls">
					<input class="input-xlarge" id="promoted" name="promoted" placeholder="" type="text" /></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Advertising</label>
				<div class="controls">
					<label class="checkbox inline"><input name="advertising[]" type="checkbox" value="Local" /> Local </label> <label class="checkbox inline"> <input name="advertising[]" type="checkbox" value="National" /> National </label> <label class="checkbox inline"> <input name="advertising[]" type="checkbox" value="Both" /> Both </label></div>
			</div>
			<!-- Select Basic -->
			<div class="control-group">
				<label class="control-label"># of Locations</label>
				<div class="controls">
					<select class="input-xlarge" id="locs" name="locs"><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option><option>6</option><option>7+</option></select></div>
			</div>
			<!-- Multiple Checkboxes -->
			<div class="control-group">
				<label class="control-label">Channel Distribution</label>
				<div class="controls">
					<label class="checkbox"><input name="channel[]" type="checkbox" value="Website" /> Website </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Facebook App" /> Facebook App </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Mobile App" /> Mobile App </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Mobile Website" /> Mobile Website </label> <label class="checkbox"> <input name="channel[]" type="checkbox" value="Email Client" /> Email Client </label></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Shopper Intelligence Interest</label>
				<div class="controls">
					<label class="checkbox inline"><input name="intel[]" type="checkbox" value="Yes" /> Yes </label> <label class="checkbox inline"> <input name="intel[]" type="checkbox" value="No" /> No </label></div>
			</div>
			<!-- Multiple Radios -->
			<div class="control-group">
				<label class="control-label">Advertising Budget</label>
				<div class="controls">
					<label class="radio"><input checked="checked" name="budget" type="radio" value="&lt; $1,000" /> &lt; $1,000 </label> <label class="radio"> <input name="budget" type="radio" value="$1,000-$5,000" /> $1,000-$5,000 </label> <label class="radio"> <input name="budget" type="radio" value="$5,000-$10,000" /> $5,000-$10,000 </label> <label class="radio"> <input name="budget" type="radio" value="$10,000-$25,000" /> $10,000-$25,000 </label> <label class="radio"> <input name="budget" type="radio" value="$25,000-$100,000" /> $25,000-$100,000 </label> <label class="radio"> <input name="budget" type="radio" value="$100,000+" /> $100,000+ </label></div>
			</div>
			<!-- Multiple Checkboxes (inline) -->
			<div class="control-group">
				<label class="control-label">Est. Time of Advertising Campaign Launch</label>
				<div class="controls">
					<label class="checkbox inline"><input name="time[]" type="checkbox" value="Immediate" /> Immediate </label> <label class="checkbox inline"> <input name="time[]" type="checkbox" value="1 Month" /> 1 Month </label> <label class="checkbox inline"> <input name="time[]" type="checkbox" value="3 Months" /> 3 Months </label></div>
			</div>
			<!-- Prepended checkbox -->
			<div class="control-group">
				<label class="control-label">Email Me More Info?</label>
				<div class="controls">
					<div class="input-prepend">
						<span class="add-on"><label class="checkbox"><input type="checkbox" /> </label> </span> <input class="span2" id="moreinfo" name="moreinfo" placeholder="Alt Email" type="text" /></div>
				</div>
			</div>

			<!-- Verification code -->
			<div class="control-group">
				<label class="control-label">
                   <div id="sec_code" style="float:left"><img src="/pages/captcha"></div>
                </label>
				<div class="controls">
					<div class="input-prepend">
                     <input type="text" name="code" value="Verification Code (Required)" value="Verification Code (Required)" onfocus="if(this.value == 'Verification Code (Required)'){this.value='';}" onblur="if(this.value == ''){this.value='Email (Required)';}" id="code" />
				   </div>
				</div>
			</div>
		</fieldset>
		<input class="btn" name="subbut" type="submit" value="Submit Form" />&nbsp;</form>
</div>
<script src="/bootstrap/js/bootstrap.min.js"></script>


"
$scripts_for_layout	=	""
$title_for_layout	=	"Pages"

include - APP/View/Layouts/page.ctp, line 13
View::_render() - CORE/Cake/View/View.php, line 598
View::renderLayout() - CORE/Cake/View/View.php, line 414
View::render() - CORE/Cake/View/View.php, line 376
Controller::render() - CORE/Cake/Controller/Controller.php, line 900
Dispatcher::_invoke() - CORE/Cake/Routing/Dispatcher.php, line 114
Dispatcher::dispatch() - CORE/Cake/Routing/Dispatcher.php, line 89
[main] - ROOT/index.php, line 93

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