var captchaWidgetmpFrm134f5bfe66864d47b34c490c86c3c765; var mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container = document.currentScript.parentNode; (function () { var containerDiv = document.createElement('div'); containerDiv.id = "mpFrm134f5bfe66864d47b34c490c86c3c765"; containerDiv.classList.add("mpForm"); containerDiv.setAttribute("data-mpid", "51017"); if(document.currentScript && document.currentScript.parentNode && document.currentScript.parentNode.nodeName && document.currentScript.parentNode.nodeName.toLowerCase() === "head") { document.addEventListener("DOMContentLoaded", (event) => { var bodyHolder = document.getElementsByTagName("body"); if (bodyHolder && bodyHolder[0]) { bodyHolder[0].appendChild(containerDiv); } }) } else { document.currentScript.parentNode.insertBefore(containerDiv, document.currentScript); mpFormmpFrm134f5bfe66864d47b34c490c86c3c765Find(); } })(); function mpFormmpFrm134f5bfe66864d47b34c490c86c3c765Find() { if(!mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container) return; if (mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container && mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container.nodeName && mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container.nodeName.toLowerCase() === "head") { var mpFind = document.querySelectorAll("[data-mpid='51017']"); if (mpFind.length && !mpFind[0].innerHTML) { mpFind[0].id = "mpFrm134f5bfe66864d47b34c490c86c3c765" } } else { var mpFound = false; Array.from(mpCurrentScriptmpFrm134f5bfe66864d47b34c490c86c3c765Container.children).forEach(c => { if (c.id === "mpFrm134f5bfe66864d47b34c490c86c3c765") mpFound = true; }) if (!mpFound) { var mpOthers = Array.from(mpCurrentScript07e24aa369784d2cbd152d7404f04983Container.children).filter(e => e.dataset && e.dataset.mpid === "51017"); if (mpOthers.length === 1) { mpOthers[0].id = "mpFrm134f5bfe66864d47b34c490c86c3c765"; } } } } function mpForm07e24aa369784d2cbd152d7404f04983Check() { let checkBoxes = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[type="checkbox"]'); if(checkBoxes) { for(var i = 0; i < checkBoxes.length; i++) { let checkBox = checkBoxes[i]; var attr = checkBox.getAttribute('data-prevval'); if (typeof attr !== typeof undefined && attr !== false) { checkBox.value = checkBox.getAttribute("data-prevval"); checkBox.removeAttribute("data-prevval"); checkBox.removeAttribute("checked"); } } } } function mpForm07e24aa369784d2cbd152d7404f04983Submit(event) { event.preventDefault(); let msgHlder = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelector('[id=mpmessageholder]'); let mpMsg = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelector('[id=mpmessage]'); let checkBoxes = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[type="checkbox"]'); if(checkBoxes) { for(var i = 0; i < checkBoxes.length; i++) { let checkBox = checkBoxes[i]; if( checkBox.checked == true ) { if(checkBox.getAttribute('data-prevval')) { checkBox.value = checkBox.getAttribute('data-prevval'); } else { checkBox.value = 1; } } else { checkBox.setAttribute('data-prevval',checkBox.value); checkBox.value = 0; } } } let form_data = Array.from( new FormData(document.getElementById('mpform-07e24aa369784d2cbd152d7404f04983')), function(e) { return { name: e[0], value: e[1] } } ) try { for(var i = 0; i < checkBoxes.length; i++) { let checkBox = checkBoxes[i]; let found = form_data.find(f=>f.name == checkBox.name) if(!found) { form_data.push({name: checkBox.name, value: checkBox.checked ? checkBox.value : "0"}) } } } catch(err){} try { form_data.push({ name: "mpTrkH", value: document.location.host }) form_data.push({ name: "mpTrkO", value: document.location.origin }) form_data.push({ name: "mpTrkP", value: document.location.pathname }) form_data.push({ name: "mpTrkQ", value: document.location.search }) form_data.push({ name: "mpTrkUUID", value: getTrackingId07e24aa369784d2cbd152d7404f04983() }) } catch(err){} //check valid telnos var failed = ""; if(msgHlder) { msgHlder.style.display = "none"; } let telInputs = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[type=TELNO]'); if(telInputs) { for(var i = 0; i < telInputs.length; i++) { let telInput = telInputs[i]; var iti = window.intlTelInputGlobals.getInstance(telInput); telInput.classList.remove("mpm-field-error"); if(iti.isValidNumber() == false && telInput.value && telInput.value.length) { telInput.classList.add("mpm-field-error"); failed = "Please enter a valid telephone number"; } else { let found = form_data.find(f=> f.name == telInput.name); if (found) { found.value = iti.getNumber(); // intenationally formatted version of the number } } } } if(failed != "") { mpMsg.innerHTML = failed; msgHlder.style.display = "block"; return; } let button = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelector('button'); if(button) { button.disabled = true; button.opacity = "0.5"; } mpMsg.innerHTML = 'Sending your details...'; var xhr = new XMLHttpRequest(); xhr.open("POST", "https://api.transpond.io/form?am=38385&fid=51017", true); xhr.onreadystatechange = function () { if (xhr.readyState === 4 && xhr.status === 200) { mpForm07e24aa369784d2cbd152d7404f04983Check(); button.disabled = false; button.style.opacity = "1"; mpMsg.innerHTML = ""; msgHlder.style.display = "block"; let response = JSON.parse(xhr.responseText); if (!response || (!response.download && !response.downloads)) { try { document.getElementById('mpform-07e24aa369784d2cbd152d7404f04983').reset(); } catch(e) {} } if(response) { if (response.redirect) { window.location.href = response.redirect; } else if (response.message) { if (response.download) window.open(response.download, '_blank'); if (response.downloads && response.downloads.length) { const parent = button.parentElement; response.downloads.forEach(link => { const hiddenButton = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelector("a[href='" + link.replace + "']"); if (hiddenButton) { hiddenButton.href = link.link; hiddenButton.closest('[data-type="FORMFILE"]').style.display = 'block'; } }); parent.style.display = "none"; } mpMsg.innerHTML = response.message; } else if (response.replace) { document.getElementById('mpform-07e24aa369784d2cbd152d7404f04983').innerHTML = response.form } } grecaptcha.reset(captchaWidgetmpFrm134f5bfe66864d47b34c490c86c3c765); } else { mpForm07e24aa369784d2cbd152d7404f04983Check(); button.disabled = false; button.style.opacity = "1"; mpMsg.innerHTML = ""; msgHlder.style.display = "block"; var error = "Error submitting form"; if (xhr.responseText) { const errorJson = JSON.parse(xhr.responseText); if(errorJson.error && typeof errorJson.error === 'string') { error = errorJson.error; } } mpMsg.innerHTML = error; grecaptcha.reset(); } }; let urlEncodedDataPairs = []; form_data.forEach((m, i) => { let name = m.name; if (name === 'capsule_note') { name += '_' + i; } urlEncodedDataPairs.push(encodeURIComponent(name)+ "=" + encodeURIComponent(m.value)); }); const urlEncodedData = urlEncodedDataPairs.join('&').replace(/%20/g, '+'); xhr.setRequestHeader('Content-type', 'application/x-www-form-urlencoded'); xhr.send(urlEncodedData); return; } function mpmRecaptchaLoaded07e24aa369784d2cbd152d7404f04983() { captchaWidgetmpFrm134f5bfe66864d47b34c490c86c3c765 = grecaptcha.render('mpmRecaptchampFrm134f5bfe66864d47b34c490c86c3c765', { 'sitekey' : '6LdEC_YZAAAAAGTcHXOaYInDU-pdY1cbJBEbmin2' }); } function getTrackingId07e24aa369784d2cbd152d7404f04983() { try { let uuid = document.cookie.match('(^|;)\s*mpz\s*=\s*([^;]+)')?.pop() || ''; if(!uuid) { let found = document.cookie.split(';').find(c => c.indexOf('mpz=') > -1); if (found) uuid = found.split('=')[1]; } return uuid; } catch(e) { } }; function mpmFormInit07e24aa369784d2cbd152d7404f04983 () { var subscriberData = undefined; var form = '
Please complete all required fields marked with *.
You\'ll then receive an email asking you to confirm your email address - please do this, otherwise we won\'t receive your form! 
We will apply credit to your account according to the total currency order for order requests received up to 24 November 2025, as follows:

1 x demo kit = 10%
2 x demo kits = xx%
3 x demo kits = xx%
4 x demo kits = xx%
5 or more demo kits = xx%

When we receive your demo kit order request, we will contact you to request your purchase order.
'; let failedCount = 0 function finishedLoading07e24aa369784d2cbd152d7404f04983() { window.mpFormLoading = false; let container = document.getElementById('mpFrm134f5bfe66864d47b34c490c86c3c765'); if (!container) { mpFormmpFrm134f5bfe66864d47b34c490c86c3c765Find(); failedCount++; if(failedCount > 10) return console.log('Form failed too many times mpFrm134f5bfe66864d47b34c490c86c3c765'); return setTimeout(finishedLoading07e24aa369784d2cbd152d7404f04983, 300) } container.innerHTML = form; let containerChildren = container.childNodes; let msgHlder = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelector('[id=mpmessageholder]'); if(msgHlder) { msgHlder.style.display = "hide" } let telInputs = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[type=TELNO]'); if(telInputs) { for(var i = 0; i < telInputs.length; i++) { let telInp = telInputs[i]; telInp.style.width = "100%"; telInp.style.paddingLeft = "50px"; window.intlTelInput(telInp, { initialCountry: "us", utilsScript: "https://api.transpond.io/plugins/telNoVerificationUtils.js" } ); } } if(subscriberData) { let customFields = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[name*="customField-"]') if(customFields) { for(var i = 0; i < customFields.length; i++) { let customField = customFields[i]; var cfID = customField.name; if(cfID) { cfID = cfID.split("-")[1]; let newValue = ""; if(subscriberData.customFields[cfID]) newValue = subscriberData.customFields[cfID]; customField.value = newValue } } } let customFieldsTextArea = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('textarea[name*="customField-"]') if(customFieldsTextArea) { for(var i = 0; i < customFieldsTextArea.length; i++) { let customField = customFieldsTextArea[i]; var cfID = customField.name; if(cfID) { cfID = cfID.split("-")[1]; let newValue = ""; if(subscriberData.customFields[cfID]) newValue = subscriberData.customFields[cfID]; customField.value = newValue; } } } let emailAddressFields = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").querySelectorAll('input[name$="emailAddress"]') if(emailAddressFields) { for(var i = 0; i < emailAddressFields.length; i++) { let emailAddressField = emailAddressFields[i]; emailAddressField.value = subscriberData.emailAddress; } } } var mpmRecaptchaScript = document.createElement("SCRIPT"); mpmRecaptchaScript.src = 'https://www.google.com/recaptcha/api.js?onload=mpmRecaptchaLoaded07e24aa369784d2cbd152d7404f04983&render=explicit'; mpmRecaptchaScript.type = 'text/javascript'; mpmRecaptchaScript.async = "async"; mpmRecaptchaScript.defer = "defer"; document.getElementsByTagName("head")[0].appendChild(mpmRecaptchaScript); } function mpmPopup07e24aa369784d2cbd152d7404f04983() { let popups = document.getElementById("mpform-07e24aa369784d2cbd152d7404f04983").getElementsByClassName("mpm-popup"); if(popups) { for(var i = 0; i < popups.length; i++) { let popup = popups[i]; popup.classList.toggle("show"); } } } function mploadTelInput07e24aa369784d2cbd152d7404f04983() { if(!window.intlTelInput) { var script = document.createElement("SCRIPT"); script.src = 'https://api.transpond.io/plugins/telNoVerification.js'; script.type = 'text/javascript'; script.onload = function () { finishedLoading07e24aa369784d2cbd152d7404f04983(); }; document.getElementsByTagName("head")[0].appendChild(script); } else { finishedLoading07e24aa369784d2cbd152d7404f04983(); } } var link = document.createElement("link"); link.href = "https://api.transpond.io/public/css/form.css"; link.type = "text/css"; link.rel = "stylesheet"; document.getElementsByTagName("head")[0].appendChild(link); var mTelI = document.createElement("link"); mTelI.href = "https://api.transpond.io/plugins/telNoVerification.css"; mTelI.type = "text/css"; mTelI.rel = "stylesheet"; document.getElementsByTagName("head")[0].appendChild(mTelI); mploadTelInput07e24aa369784d2cbd152d7404f04983(); } if(!window.mpFormLoading){ window.mpFormLoading = true; mpmFormInit07e24aa369784d2cbd152d7404f04983(); } else { function waitForOtherFormsmpFrm134f5bfe66864d47b34c490c86c3c765() { if(window.mpFormLoading == false) { console.log("Form Loaded"); mpmFormInit07e24aa369784d2cbd152d7404f04983(); } else { setTimeout(waitForOtherFormsmpFrm134f5bfe66864d47b34c490c86c3c765,300); } } waitForOtherFormsmpFrm134f5bfe66864d47b34c490c86c3c765(); }