1. System Generated Field Panel
2. Author Entered Field Panel
3. Form Title Panel
4. End-user Entered Field Panel
5. Thank You and Error Message Panel
6. Hidden Panel

• System Generated Field Panel
• Author Entered Field Panel
• Form Title Panel
• End-user Entered Field Panel
• Thank You and Error Message Panel
• Hidden Panel

System Generated Panel 

Market Region ASIA APAC EMEA LATAM

This is a Required field for GLU to process this request:

*Nation / Country Bangladesh Australia Hongkong United Kingdom Turkey Kuwait Bahrain Egypt Jordan Greece Oman Lebanon Romania Bulgaria France Poland Portugal Spain UAE Italy Russia Portugal Argentina Columbia Brazil

LanguageValue

 Author Input Panel

Author Input Panel - Required fields

*Type of Form Integration siteComponent slider contactCardForm

*Type Of Form Contactform Inquiry Grievance

*Request Type

Lead

Case

*Xmlformname

Date field format

Select the date format used in the form (if date field is used) yyyy/mm/dd mm/dd/yyyy dd/mm/yyyy yyyy-mm-dd mm-dd-yyyy dd-mm-yyyy

Author Input Panel - Optional fields

Analytics Medium

Email

WebSite

Form Title  Panel

Request a call from a specialist

User Input Panel

Please fill in all fields

Name

Last Name

Email Address

Mobile number

Product Interests

Product Interests Individual Product Group Product

Preferred Bank (Optional)

Company Name

Industry

Number of employees

Preferred contact method

Email

Telephone

I am interested in

I am interested in Group Medical Solutions Group Life & Disability Group savings & Pensions SME Pre-packaged Solutions Other Pre-packaged Solutions Wellness Initiatives Other

Additional Information

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SUBMIT

Thank You/Error Panel Configuration

Message Option Same page-fadeout Same page-fixed New page

Option One/Two Configuration

Message Delay

Error

Please review your information

Thank you for contacting us.

A MetLife representative will contact you within 2 business days

Option Three Configuration

Error Page

Thank You Page

Page Target Same Tab New Tab

Hidden Panel