HVI BU > CloudPages > API Internal Testing Forms > HVI Somerset - TEST FORM


      <h2>HVI Somerset - Test Form</h2>
      <form action="https://pages.upmc.com/hvi-somerset-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>Phone Number</label>
         <input type="text" name="phone_number"><br>
         <label>Zip Code</label>
         <input type="text" name="zip_code"><br><br>

   <label>Would you like to opt in to marketing communications? (marketing_opt_in checkbox)</label><br>
                <select name="marketing_opt_in" id="marketing_opt_in" multiple>
                    <option value="true">Yes</option>
                </select><br><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>