<div class="modal-wrapper">
<div class="error_container" style="display: none">
<ul></ul>
</div>
<form action="/" method="post" id="cf_form" style="display: block;">
<div id="cf-1">
<div class="cf-header" style="display: block;">
<div class="row" style="display: block;">
<h4>Tell us about yourself. Fill out this form and we will get in touch shortly.</h4>
</div>
<div id="cf_errors" class="error alert fields alert-danger" style="display:block;text-align: left;">
Error. Please review the fields. You have to fill all of them.
</div>
</div>
<div class="cf-body" style="display: block;">
<div class="row" style="display: block;">
<div class="form-group col-xs-12 col-md-6" style="z-index:150001">
<input type="text" name="cf_first_name" id="cf_first_name" placeholder="First Name"/>
</div>
<div class="form-group col-xs-12 col-md-6" style="z-index:150001">
<input type="text" name="cf_last_name" id="cf_last_name" placeholder="Last Name"/>
</div>
<div class="form-group phone-form-group col-xs-12 col-md-6" style="z-index:150001">
<input required type="text" name="cf_phone" id="cf_phone"/>
<span id="valid-msg" class="phone-msg phone-validation hide">✓ Valid</span>
<span id="error-msg" class="phone-msg phone-validation hide"></span>
</div>
<div class="form-group col-xs-12 col-md-6" style="z-index:150001">
<input type="email" name="email" id="cf_email" placeholder="EMail"/>
</div>
<div class="form-group col-xs-12 col-md-12">
<textarea class="form-control" id="cf_message" placeholder="Message"></textarea>
</div>
</div>
<div class="form-group">
<label class="checkbox-label" for="privacy_policy">To respond to your requests, we need to store and process the information provided, including personal data. Please check the box to give your consent. CELO uses the information you have sent us to contact you and offer you the best experience through content, product information and services. You can unsubscribe from these communications at any time. For more information, please check our <a href='https://www.celofixings.com/content/6-privacy-policy' target='_blank'>Privacy Policy</a></label>
</div>
<div class="form-group">
<input type="checkbox" class="form-control" name="terms" id="cf_terms" value="1"/>
<label class="checkbox-label" for="privacy_policy">I agree to receive communications from CELO.</label>
</div>
</div>
<div class="cf-footer" style="display: block;">
<div class="row">
<div class="col-xs-12 form-submit-btn-wrapper" style="text-align: center">
<span class="btn btn-primary form-submit-btn" onclick="ajax_contact_form_validation();">Submit</span>
</div>
</div>
</div>
</div>
<div id="cf-3" style="display:none">
<div class="cf-header" style="display: block;">
<div id="cf3_success" class="success alert alert-success" style="display:block">
Thank you very much. Your request has been sent successfully. Our team will contact you as soon as possible.
</div>
</div>
</div>
</form>
</div>
<script>
var form_controller = 'https://www.celofixings.cl/customised-experiences-for-distributors';
var cf_contact_form_title = 'Contact Us';
</script>
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