Contact Form with States

Note: This form can be downloaded and imported into your Integrify instance. The downloadable .json file is at the bottom of this page. Directions for importing forms.

This contact form can be used to collect sales leads or any other purpose for collecting contact information. The State dropdown includes all US states and has values assigned by region (1=East Coast, 2=Midwest, 3=West Coast). We also included a basic list of industries for the Industry field.

Note: You may need to right-click the button and save the .JSON file to avoid opening the file in your browser.