{"title":"RGA Request for Defective\/Non-Defective Item(s)","description":"\u003cscript src=\"https:\/\/www.google.com\/recaptcha\/api.js\" async defer\u003e\u003c\/script\u003e\n\u003cscript src=\"\/v\/vspfiles\/templates\/EBS\/js\/general.js\" type=\"text\/javascript\"\u003e\u003c\/script\u003e\n\u003cscript type=\"text\/javascript\"\u003e\nfunction validateLargeQuantity() {\n    var fullname = document.getElementById(\"fullname\").value;\n    var phone = document.getElementById(\"phone\").value;\n    var email = document.getElementById(\"email\").value;\n\n    if (fullname === \"\" || phone === \"\" || email === \"\") {\n        alert(\"Please fill in all required fields.\");\n        return false;\n    }\n\n    \/\/ Add more validation checks as needed\n    return true;\n}\n\u003c\/script\u003e\n\u003c!-- form starts --\u003e\n\u003cdiv id=\"general_content\" class=\"quote-pg\"\u003e\n    \u003c!--\u003cform class=\"quote-form\" name=\"eMail\" method=\"post\" action=\"emailform.asp\" onsubmit=\"return validateLargeQuantity();\"\u003e--\u003e\n    \u003cform class=\"quote-form\" name=\"eMail\" method=\"post\" action=\"\/v\/wds-custom\/emailform.asp\" onsubmit=\"return validateLargeQuantity();\"\u003e\n        \u003ctable border=\"0\" cellspacing=\"5\" cellpadding=\"10\" class=\"request-form\"\u003e\n            \u003ctr\u003e\n                \u003ctd colspan=\"2\"\u003e\n                    Fields marked with \u003cb\u003e*\u003c\/b\u003e are required.\n                \u003c\/td\u003e\n            \u003c\/tr\u003e\n            \u003ctr\u003e\n                \u003ctd class=\"small-td-md\"\u003e\u003clabel for=\"ordernumber\"\u003eOrder Number\u003c\/label\u003e\u003c\/td\u003e\n                \u003ctd\u003e\u003cinput type=\"text\" id=\"ordernumber\" name=\"ordernumber\"\u003e\u003c\/td\u003e\n            \u003c\/tr\u003e\n            \u003ctr\u003e\n                \u003ctd\u003e\u003clabel for=\"fullname\"\u003eFull Name \u003cb\u003e*\u003c\/b\u003e\u003c\/label\u003e\u003c\/td\u003e\n                \u003ctd\u003e\u003cinput type=\"text\" id=\"fullname\" name=\"fullname\"\u003e\u003c\/td\u003e\n            \u003c\/tr\u003e\n            \u003ctr\u003e\n                \u003ctd\u003e\u003clabel for=\"phone\"\u003ePhone Number \u003cb\u003e*\u003c\/b\u003e\u003c\/label\u003e\u003c\/td\u003e\n                \u003ctd\u003e\u003cinput type=\"text\" id=\"phone\" name=\"phone\" class=\"phone\"\u003e\u003c\/td\u003e\n            \u003c\/tr\u003e\n            \u003ctr\u003e\n                \u003ctd\u003e\u003clabel for=\"email\"\u003eEmail Address \u003cb\u003e*\u003c\/b\u003e\u003c\/label\u003e\u003c\/td\u003e\n                \u003ctd\u003e\u003cinput type=\"email\" id=\"email\" name=\"email\"\u003e\u003c\/td\u003e\n            \u003c\/tr\u003e\n        \u003c\/table\u003e\n        \u003cdiv class=\"table request-order\"\u003e\n\n            \u003cdiv class=\"tr tr--head\"\u003e\n                \u003cdiv class=\"th\"\u003eQuantity\u003c\/div\u003e\n                \u003cdiv class=\"th\"\u003eManufacturer\u003c\/div\u003e\n                \u003cdiv class=\"th\"\u003eModel #\u003c\/div\u003e\n                \u003cdiv class=\"th\"\u003eNature of Problem\u003c\/div\u003e\n\n            \u003c\/div\u003e\n\n            \u003cdiv class=\"tr\"\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"1-Quantity\" id=\"1-Quantity\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"1-Manufacturer\" id=\"1-Manufacturer\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"1-item-number\" id=\"1-item-number\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"1-Problem\" id=\"1-Problem\"\u003e\u003c\/div\u003e\n            \u003c\/div\u003e\n\n            \u003cdiv class=\"tr\"\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"2-Quantity\" id=\"2-Quantity\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"2-Manufacturer\" id=\"2-Manufacturer\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"2-item-number\" id=\"2-item-number\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"2-Problem\" id=\"2-Problem\"\u003e\u003c\/div\u003e\n            \u003c\/div\u003e\n            \u003cdiv class=\"tr\"\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"3-Quantity\" id=\"3-Quantity\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"3-Manufacturer\" id=\"3-Manufacturer\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"3-item-number\" id=\"3-item-number\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"3-Problem\" id=\"3-Problem\"\u003e\u003c\/div\u003e\n            \u003c\/div\u003e\n\n            \u003cdiv class=\"tr\"\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"4-Quantity\" id=\"4-Quantity\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"4-Manufacturer\" id=\"4-Manufacturer\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"4-item-number\" id=\"4-item-number\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"4-Problem\" id=\"4-Problem\"\u003e\u003c\/div\u003e\n            \u003c\/div\u003e\n\n            \u003cdiv class=\"tr\"\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"5-Quantity\" id=\"5-Quantity\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"5-Manufacturer\" id=\"5-Manufacturer\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"5-item-number\" id=\"5-item-number\"\u003e\u003c\/div\u003e\n                \u003cdiv class=\"td\"\u003e\u003cinput type=\"text\" name=\"5-Problem\" id=\"5-Problem\"\u003e\u003c\/div\u003e\n            \u003c\/div\u003e\n\n            \u003cdiv class=\"text-center\"\u003e\n                If you have more items \/ If you need more line items, please fill out another form\n                \u003cbr\u003e\n            \u003c\/div\u003e\n\u003cbr\u003e\u003cbr\u003e\n            \u003cdiv class=\"text-center\"\u003e\n                \u003cbr\u003e\n                \u003cdiv class=\"g-recaptcha\" data-sitekey=\"6LfQS38UAAAAANwrTVAMX_82sQFwMp__Zah6i432\" style=\"display:inline-block\"\u003e\u003c\/div\u003e\n                \u003cbr\u003e\u003cbr\u003e\t\t\n            \u003c\/div\u003e\n            \u003cdiv class=\"text-center\"\u003e\n                \u003cinput type=\"image\" name=\"submit\" value=\"Submit Quote\" class=\"submit_button\" src=\"https:\/\/cdn.shopify.com\/s\/files\/1\/0681\/6625\/4899\/files\/button_submit.png?v=1731249786\"\u003e\n                \u003cinput type=\"hidden\" name=\"email_From\" value=\"info@electricbargainstores.com\"\u003e\n                \u003cinput type=\"hidden\" name=\"email_To\" value=\"info@electricbargainstores.com\"\u003e\n                \u003cinput type=\"hidden\" name=\"email_Subject\" value=\"RGA Request\"\u003e\n                \u003cinput type=\"hidden\" name=\"email_ThankYou\" value=\"Thank you for submitting your request. Our RGA team will reply within 2-3 business days\"\u003e\n                \u003cinput type=\"hidden\" name=\"email_Redirect\" value=\"\"\u003e\n\n            \u003c\/div\u003e\n        \u003c\/div\u003e\n    \u003c\/form\u003e\n\u003c\/div\u003e\n\u003c!-- form ends --\u003e","products":[],"url":"https:\/\/electricbargainstores.com\/collections\/rga-request-for-defective-non-defective-items.oembed","provider":"Electric Bargain Store","version":"1.0","type":"link"}