New Client Information
Do not leave any fields blank.  If a contact does not appliy please select Not Applicable or Same as.
(Form will only work correctly in Internet Explorer 6.0 or later)
 

This is the first interactive form I ever created, I was working for Captive Indoor Media (now Codigo), back in 2006. There are three form that were use to collect data from new customers about their contacts, locations (digital signage) and network requirements. This is the client contact information page. This is the first web page I created using an external css style sheet

The form has been tested in Internet Explorer(IE) 6, 7, 8 and 9 and it works correctly for the most part. There are a few function issue in newer browsers. I have also tested in Google Chrome, and the "Same as" dropdown menu does not become available for some reason. This web page was never formated for mobile web back in 2006.

Company Name:

Contacts:

 

1. IT Contact:
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

 

2. A/V Contact:
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

 

3. Facilites Contact:
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

 

4. Billing Contact:
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

 

5. Scheduler Contact:
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

 

6. Content Creation Contact:
Not Applicable
 
Name:
Email:
Phone:
Cell:
Street Address:
City:

   
Location Details:
 
 
How many locations?
 
 
 
 
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