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

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

Form submission source

*PublishedDate

*Domain

Language Value

LanguageValue

Form Fields

Author Input Panel

Author Input Panel - Required fields

Select the form Layout

*Type of Form Integration siteComponent slider contactCardForm

Analytics form type

*Type Of Form Contactform Inquiry Grievance

Analytics form title

*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

Campaign Nam

Campaign Term / Key phrase

Campaign Content

Analytics Source

Analytics Medium

Email

WebSite

Quote Result / information

Form Title Panel

Start by filling out the form.

User Input Panel

All fields are required

First Name

Last Name

What is your query regarding?

What is your query regarding? Life Insurance Medical Insurance Pet Insurance Something Else

Phone (968xxxxxxxxx)

Email

*By checking this box, you agree for a MetLife advisor to contact you by phone or email to discuss your life insurance needs.

SUBMIT

_{By clicking submit you confirm your acceptance to our Terms of Use and Privacy Policy.}

Thank You/Error Panel Configuration

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

Settings for same page thank you/error message

Message Delay

Error.

Please fill out all the required form fields in order to proceed.

Thank you.

A MetLife Advisor will contact you soon.

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Page Target Same Tab New Tab

Hidden Panel

Name Of The Template