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This field is for validation purposes and should be left unchanged.

Lead Source–Hidden

This is a hidden field has a default value of “100000007” that allows us to flow this into the Lead Source field of Dynamics CRM and set it to “Website”.

Salesforce Lead Source

Salesforce Lead Status

Salesforce Event

Salesforce Owner

Name(Required)

First

Last

Email(Required)

Company(Required)

Direct Phone(Required)

Mobile Phone

Address(Required)

Street Address

Address Line 2

City

ZIP / Postal Code

Address(Required)

CountryState/Province/Region

Original Equipment Mfr. (OEM)

Original Equipment Mfr. (OEM) – – Check box if Stat-X will be integrated into your product.

Land or Marine?(Required)

Industry–Land

Industry–Marine

Industry–Final

This is a hidden field that takes the value of either Industry–Land or Industry–Marine in order to pass it through to Dynamics CRM Industry field.

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