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	var fieldDescription = Array("Name", "Email Address", "City", "Location", "Category", "Message");
	// dialog message
	var alertMsg = "To best respond to you, we require all questions to be answered. Please complete the following:\n";
	
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<!-- tr, td { 	font-family: Georgia, Georgia-Bold, sans-serif; 	font-size: 11px; 	color:#93908b; } body { 	background: #000; 	font-family: Georgia, Georgia-Bold, sans-serif; 	color:#93908b; 	font-size: 11px; 	 } --> 
<table border="0" cellspacing="0" cellpadding="2" width="100%">
<tbody>
<tr>
<td><strong><span style="color: #93908b; font-size: small;">Speak Up!</span></strong> * It is important for you to complete all fields so that we may best respond to your message.<br /><br />&nbsp;</td>
</tr>
</tbody>
</table>
<form onsubmit="return formCheck(this);" action="http://www.grimaldispizzeria.com/contact.php" method="POST"> 
<table border="0" cellspacing="0" cellpadding="5" width="550">
<tbody>
<tr>
<td>
<div><strong>Name</strong>:</div>
<br /></td>
<td><input id="name" name="name" size="40" type="text" /><br /></td>
</tr>
<tr>
<td>
<div><strong>Email Address</strong>:</div>
<br /></td>
<td><input name="emailAddress" size="40" type="text" /><br /></td>
</tr>
<tr>
<td>
<div><strong>City</strong>:</div>
<br /></td>
<td>
<div><select name="location" size="3"> 
<option value="Chandler - The Falls at Ocotillo">The Falls at Ocotillo - Chandler, AZ</option>
<option value="Chandler - Casa Paloma">Casa Paloma -Chandler, AZ</option> 
<option value="Gilbert - San Tan Village">Gilbert, AZ</option> 
<option value="North Scottsdale - Market Street at DC Ranch">North Scottsdale, AZ</option> 
<option value="Peoria - Park West">Peoria, AZ</option> 
<option value="Scottsdale - Old Town"> Scottsdale, AZ</option> 
<option value="Tucson - Sam Hughes Place"> Tucson, AZ</option> 
<option value="Clematis-West Palm Beach Florida"> Clematis - West Palm Beach, FL</option>
<option value="Palm Beach Gardens, Florida">Palm Beach Gardens, FL</option>
<option value="Fort Meyers - Bell Tower"> Fort Myers, FL</option> 
<option value="Las Vegas - Boca Park"> Boca Park-Las Vegas, NV</option>
<option value="Las Vegas - Rainbow"> Rainbow-Las Vegas, NV</option> 
<option value="Las Vegas - Richmar Plaza"> Richmar-Las Vegas, NV</option> 
<option value="Sparks - Legends at Sparks Marina"> Sparks, NV</option> 
<option value="Summerlin - Boca Park"> Summerlin, NV</option> 
<option value="Allen - Watters Creek"> Allen, TX</option> 
<option value="Corpus Christi - La Palmera"> Corpus Christi, TX</option> 
<option value="Dallas - West Village">West Village - Dallas, TX</option>
<option value="Dallas - Park Lane"> Park Lane - Dallas, TX</option> 
<option value="Houston - The Woodlands"> Houston, TX</option> 
<option value="San Antonio - La Cantera"> La Cantera - San Antonio, TX</option>
<option value="San Antonio - The Quarry">The Quarry - San Antonio, TX</option> 
<option value="Sugar Land - First Colony"> Sugar Land, TX</option> 
</select></div>
<br /></td>
</tr>
<tr>
<td>
<div><strong>Location</strong>:</div>
<br /></td>
<td>
<div><select name="SemailTo" size="3"> 
<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, fruiz@grimaldispizzeria.com, jstogsdill@grimaldispizzeria.com"> Allen - Watters Creek</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mkamsiuk@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Chandler - The Falls at Ocotillo</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, tfieramosca@grimaldispizzeria.com, lwhitney@grimaldispizzeria.com"> Chandler - Casa Paloma</option>

<option value="vdilorio@grimaldispizzeria.com , ttierney@grimaldispizzeria.com ,egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, acaruth@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzellar@grimaldispizzeria.com"> Clematis- West Palm Beach</option>

<option value="mmilligan@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com"> Corpus Christi - La Palmera</option>

<option value="mallen@grimaldispizzeria.com, fruiz@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, acaruth@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzellar@grimaldispizzeria.com"> Dallas - Park Lane</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, fruiz@grimaldispizzeria.com, rleggett@grimaldispizzeria.com"> Dallas - West Village</option>

<option value="ttierney@grimaldispizzeria.com ,egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, acaruth@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzellar@grimaldispizzeria.com,  jboinis@grimaldispizzeria.com"> Downtown at The Gardens- Palm Beach Gardens</option>

<option value="egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, ttierney@grimaldispizzeria.com,plawson@grimaldispizzeria.com"> Fort Myers - Bell Tower</option>

<option value="jborzone@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Gilbert - San Tan Village</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com, gmurillo@grimaldispizzeria.com"> Houston - The Woodlands</option>

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, jstubbs@grimaldispizzeria.com, clattuca@grimaldispizzeria.com, cgarcia@grimaldispizzeria.com"> Las Vegas - Rainbow</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, jstubbs@grimaldispizzeria.com, gbongiorno@grimaldispizzeria.com"> Las Vegas - Richmar Plaza</option>
 
<option value="edavis@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mkamsiuk@grimaldispizzeria.com, mprice@grimaldispizzeria.com, ddrago@grimaldispizzeria.com"> North Scottsdale - Market Street at DC Ranch</option> 

<option value="rseidner@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Peoria - Park West</option>    

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com, amota@grimaldispizzeria.com"> San Antonio - La Cantera</option>

<option value=" akibodeaux@grimaldispizzeria.com, bfisher@grimaldispizzeria.com, , egreenwald@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, acaruth@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzellar@grimaldispizzeria.com"> San Antonio - The Quarry</option> 

<option value="ddrago@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Scottsdale - Old Town</option> 

<option value="bwhitehead@grimaldispizzeria.com, clattuca@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Scottsdale Quarter - Scottsdale</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com,  vdenigris@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Sparks - Legends at Sparks Marina</option> 

<option value="pgibson@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, bfisher@grimaldispizzeria.com"> Sugar Land - First Colony</option> 

<option value="dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, rmessley@grimaldispizzeria.com"> Summerlin - Boca Park</option> 

<option value="jspear@grimaldispizzeria.com, dfieramosca@grimaldispizzeria.com, egreenwald@grimaldispizzeria.com, cwhite@grimaldispizzeria.com, mprice@grimaldispizzeria.com"> Tucson - Sam Hughes Place</option> 

</select></div>
<br /></td>
</tr>
<tr>
<td>
<div><strong>Category</strong>:</div>
<br /></td>
<td>
<div><select name="SemailCc" size="3"> <option value="CC: clattuca@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Food and Beverage Experience</option> <option value="CC: clattuca@grimaldispizzeria.com, bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Dining Experience</option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com, bolgheri@gmail.com"> Web Site Suggestion </option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Marketing Promotion </option> <option value="CC: bmaroney@grimaldispizzeria.com, lzeller@grimaldispizzeria.com"> Other </option> </select></div>
<br /></td>
</tr>
<tr>
<td>
<div><strong>Message</strong>:</div>
<br /></td>
<td><textarea id="message" cols="50" rows="4" name="message"></textarea></td>
</tr>
<tr>
<td style="text-align: center;" colspan="2"><br /><input name="Submit" type="submit" value="Submit" /></td>
</tr>
</tbody>
</table>
</form>