1. System Generated Field Panel
2. Author Entered Field Panel
3. Form Title Panel
4. End-user Entered Field Panel
5. Thank You and Error Message Panel
6. Hidden Panel

• System Generated Field Panel
• Author Entered Field Panel
• Form Title Panel
• End-user Entered Field Panel
• Thank You and Error Message Panel
• Hidden Panel

System Generated Field Panel 

MCID

Sort Order

Required Fields

Page From

Site

 Author Entered Field Panel

Author Input Panel - Required fields

Select the form layout

*Type of Form Integration siteComponent slider contactCardForm

Analytics form title

Email address to which form data will be sent

Subject line of the email

Select the market region

*Region ASIA APAC EMEA LATAM USA

Select the country

*Country Bangladesh Australia Hongkong United Kingdom Turkey Kuwait Bahrain Egypt Jordan Greece Oman Lebanon Romania Bulgaria France Poland Portugal Spain UAE Italy Russia Portugal Argentina Columbia Brazil USA

Analytics form type

*Type Of Form Contactform Inquiry Grievance

Backend Integration Type

Select the Backend Integration - Email or KANA (US Only) email kana

Form Title  Panel

End-user Entered Field Panel

First Name

Last Name

Email Id

00962XXXXX

Existing customer?

Yes

No

Location

Location Ajloun Amman Aqaba Irbed Jarash Karak Ma'an Mafraq Ramtha Zarqa Other

I am interested in

I am interested in Product Enquiry Policy / Service Enquiry Claims Feedback / Complaint Other Queries

Does your enquiry relate to…

Does your enquiry relate to… Individual policy Employer or Bank policies

Write your message here

Terms and conditions

SUBMIT

Thank You/Error Panel Configuration

Message Option Same page-fadeout Same page-fixed New page

Settings for same page thank you/error message

Message Delay

An error has occurred.

Please try again. Thanks. 

Thanks for contacting us.

We've received your request and will contact you within the next 48 working hours.

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Page Target Same Tab New Tab

Hidden Panel

Name Of The Template