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${ parent.decodeEntities(`First Name`) } * parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) } /> `} />

${ parent.decodeEntities(`Last Name`) } * parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) } /> `} />

${ parent.decodeEntities(`Email Address`) } * parent.activateValidation({"message":"This field is required.","emailMessage":"Please enter a valid Email address","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> `} />

${ parent.decodeEntities(`Contact Number`) } * parent.activateValidation({"message":"A phone numbrer is required.","minLength":11,"maxLength":"","type":"by_character_length","required":true,"expression":"null"}, el)} /> `} />

{ parent.handleRadioDefault(el); parent.activateValidation({"message":"This field is required.","required":true}, el) }} checked=${'Home/Office Number' === parent.getValue('Number Type')} /> ${ parent.decodeEntities(`Home/Office`) }

{ parent.handleRadioDefault(el); parent.activateValidation({"message":"This field is required.","required":true}, el) }} checked=${'Mobile Number' === parent.getValue('Number Type')} /> ${ parent.decodeEntities(`Mobile`) }

`} />

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`} />

Please review our privacy policy and terms and conditions. Lenzlink Services believes that online privacy is a fundamental human right. We respect your privacy and we will never sell your information. Period.

parent.activateValidation({"message":"Captcha didn't matched.","required":true}, el) } />

`} />

parent.activateValidation({"message":"You must agree to the terms.","required":true}, el)} /> I have read the privacy policy and agree to the terms and conditions.

`} />

${is_dummy_markup ? message_position === 'bottom' ? props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''} ${is_dummy_markup ? ' ' : message_position === 'bottom' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''} `

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