Lead Capture Form

Form Fields

Preview

<!-- Nelkins Properties Lead Capture Form -->
<form id="eb-lead-form" style="max-width:400px;font-family:system-ui">
  <input name="name" placeholder="Full Name" required style="width:100%;padding:10px;margin:6px 0;border:1px solid #333;border-radius:6px;background:#1a1a1a;color:#fff" />
  <input name="phone" placeholder="Phone (+971...)" required style="width:100%;padding:10px;margin:6px 0;border:1px solid #333;border-radius:6px;background:#1a1a1a;color:#fff" />
  <input name="email" type="email" placeholder="Email" style="width:100%;padding:10px;margin:6px 0;border:1px solid #333;border-radius:6px;background:#1a1a1a;color:#fff" />
  <input name="community" placeholder="Community of Interest" style="width:100%;padding:10px;margin:6px 0;border:1px solid #333;border-radius:6px;background:#1a1a1a;color:#fff" />
  
  
  <button type="submit" style="width:100%;padding:12px;margin:8px 0;background:#c8a55a;color:#000;font-weight:600;border:none;border-radius:6px;cursor:pointer">
    Get in Touch
  </button>
  <p id="eb-msg" style="text-align:center;font-size:13px;color:#888"></p>
</form>
<script>
document.getElementById("eb-lead-form").addEventListener("submit",async function(e){
  e.preventDefault();
  const f=new FormData(e.target);
  const d=Object.fromEntries(f);
  d.userId="usr_elite_broker_001";
  d.source="Web Form";
  document.getElementById("eb-msg").textContent="Sending...";
  try{
    const r=await fetch("https://your-site.com/api/lead-capture",{
      method:"POST",headers:{"Content-Type":"application/json"},body:JSON.stringify(d)
    });
    const j=await r.json();
    document.getElementById("eb-msg").textContent=j.success?"Thank you! We'll be in touch.":"Something went wrong.";
    if(j.success)e.target.reset();
  }catch{document.getElementById("eb-msg").textContent="Network error.";}
});
</script>