CHP BU > CloudPages > API Internal Testing Forms > CHP eNews 2022-23 - TEST FORM


      <h2>CHP eNews 2022-23 - Test Form</h2>
      <form action="https://pages.upmc.com/chp-enews-2022-api-internal-testing-form" method="post">
         <label>Email</label>
         <input type="text" name="email_address"><br>
         <label>First Name</label>
         <input type="text" name="first_name"><br>
         <label>Last Name</label>
         <input type="text" name="last_name"><br>
         <label>Zip Code</label>
         <input type="text" name="zip_code"><br>
         <!---
         <label>Region</label>
         <input type="text" name="region"><br>
         -->
         <label>Category</label>
         <input type="text" name="category"><br>
         <label>Subcategory</label>
         <input type="text" name="subcategory"><br>
         <input name="submitted" type="hidden" value="true" />
         <input type="submit" value="Submit">
      </form>