{"id":1397,"date":"2022-05-31T18:19:18","date_gmt":"2022-05-31T18:19:18","guid":{"rendered":"https:\/\/britapro.com\/?page_id=1397"},"modified":"2023-09-29T19:12:44","modified_gmt":"2023-09-29T19:12:44","slug":"contact-a-dealer-contact-form","status":"publish","type":"page","link":"https:\/\/britapro.com\/contact\/contact-a-dealer-contact-form\/","title":{"rendered":"Contact a Dealer Contact Form"},"content":{"rendered":"\n<h1>\n\t\tContact a Brita PRO\u00ae partner\n\t<\/h1>\n<h2>\n\t\tContact Dealer Form\n\t<\/h2>\n<h2>\n\t\tClean, pure, great-tasting water is just a few steps away.\n\t<\/h2>\n\t<p>Start with a water quality analysis from an independent EPA-certified laboratory and a free consultation from a Brita PRO\u00ae water filtration expert. You can contact us, or we can contact you.<\/p>\n<form id=\"no-dealer-contact-form\" name=\"nodealercontactform\" novalidate action=\"https:\/\/leadsportal.britapro.com\/form-submit\/\" method=\"POST\">\n\t\t            <label for=\"inputFirstName\">First Name*<\/label>\n\t\t            <input type=\"text\" id=\"inputFirstName\" name=\"FirstName\" required=\"\"\/>\n\t\t                Please provide a first name.\n\t\t            <label for=\"inputLastName\">Last Name*<\/label>\n\t\t            <input type=\"text\" id=\"inputLastName\" name=\"LastName\" required=\"\"\/>\n\t\t                Please provide a last name.\n\t\t    <!-- form-row -->\n\t\t            <label for=\"inputEmail\">Email*<\/label>\n\t\t            <input type=\"email\" id=\"inputEmail\" name=\"Email\" required=\"\"\/>\n\t\t                Please provide a valid email address.\n\t\t            <label for=\"inputPhone\">Phone<\/label>\n\t\t            <input type=\"text\" id=\"inputPhone\" name=\"Phone\"\/>\n\t\t    <!-- form-row -->\n\t\t        <label for=\"inputAddress\">Address<\/label>\n\t\t        <input type=\"text\" id=\"inputAddress\" placeholder=\"1234 Main St\" name=\"Address\"\/>\n\t\t            <label for=\"inputCity\">City<\/label>\n\t\t            <input type=\"text\" id=\"inputCity\" name=\"city\"\/>\n\t\t            <label for=\"inputState\">State*<\/label>\n\t\t            <select id=\"inputState\" name=\"State\" required=\"\">\n\t\t                <option value=\"\">Choose&#8230;<\/option>\n\t\t                <option value=\"AL\">Alabama<\/option>\n\t\t                <option value=\"AK\">Alaska<\/option>\n\t\t                <option value=\"AZ\">Arizona<\/option>\n\t\t                <option value=\"AR\">Arkansas<\/option>\n\t\t                <option value=\"CA\">California<\/option>\n\t\t                <option value=\"CO\">Colorado<\/option>\n\t\t                <option value=\"CT\">Connecticut<\/option>\n\t\t                <option value=\"DE\">Delaware<\/option>\n\t\t                <option value=\"DC\">District Of Columbia<\/option>\n\t\t                <option value=\"FL\">Florida<\/option>\n\t\t                <option value=\"GA\">Georgia<\/option>\n\t\t                <option value=\"HI\">Hawaii<\/option>\n\t\t                <option value=\"ID\">Idaho<\/option>\n\t\t                <option value=\"IL\">Illinois<\/option>\n\t\t                <option value=\"IN\">Indiana<\/option>\n\t\t                <option value=\"IA\">Iowa<\/option>\n\t\t                <option value=\"KS\">Kansas<\/option>\n\t\t                <option value=\"KY\">Kentucky<\/option>\n\t\t                <option value=\"LA\">Louisiana<\/option>\n\t\t                <option value=\"ME\">Maine<\/option>\n\t\t                <option value=\"MD\">Maryland<\/option>\n\t\t                <option value=\"MA\">Massachusetts<\/option>\n\t\t                <option value=\"MI\">Michigan<\/option>\n\t\t                <option value=\"MN\">Minnesota<\/option>\n\t\t                <option value=\"MS\">Mississippi<\/option>\n\t\t                <option value=\"MO\">Missouri<\/option>\n\t\t                <option value=\"MT\">Montana<\/option>\n\t\t                <option value=\"NE\">Nebraska<\/option>\n\t\t                <option value=\"NV\">Nevada<\/option>\n\t\t                <option value=\"NH\">New Hampshire<\/option>\n\t\t                <option value=\"NJ\">New Jersey<\/option>\n\t\t                <option value=\"NM\">New Mexico<\/option>\n\t\t                <option value=\"NY\">New York<\/option>\n\t\t                <option value=\"NC\">North Carolina<\/option>\n\t\t                <option value=\"ND\">North Dakota<\/option>\n\t\t                <option value=\"OH\">Ohio<\/option>\n\t\t                <option value=\"OK\">Oklahoma<\/option>\n\t\t                <option value=\"OR\">Oregon<\/option>\n\t\t                <option value=\"PA\">Pennsylvania<\/option>\n\t\t                <option value=\"RI\">Rhode Island<\/option>\n\t\t                <option value=\"SC\">South Carolina<\/option>\n\t\t                <option value=\"SD\">South Dakota<\/option>\n\t\t                <option value=\"TN\">Tennessee<\/option>\n\t\t                <option value=\"TX\">Texas<\/option>\n\t\t                <option value=\"UT\">Utah<\/option>\n\t\t                <option value=\"VT\">Vermont<\/option>\n\t\t                <option value=\"VA\">Virginia<\/option>\n\t\t                <option value=\"WA\">Washington<\/option>\n\t\t                <option value=\"WV\">West Virginia<\/option>\n\t\t                <option value=\"WI\">Wisconsin<\/option>\n\t\t                <option value=\"WY\">Wyoming<\/option>\n\t\t            <\/select>\n\t\t                Please select a state.\n\t\t            <label for=\"inputZip\">Zip*<\/label>\n\t\t            <input type=\"text\" id=\"inputZip\" name=\"PostalCode\" required=\"\" maxlength=\"5\" pattern=\"[0-9]{5}\"\/>\n\t\t                Please provide a valid zip code.\n\t\t    <!-- form-row -->\n\t\t        <label for=\"inputProductCategory\">What product category are you interested in?<\/label>\n\t\t        <select id=\"inputProductCategory\" name=\"ImInterestedIn\">\n\t\t            <option selected=\"\"><\/option>\n\t\t            <option value=\"Softeners\">Softeners<\/option>\n\t\t            <option value=\"Whole Home Filters\">Whole Home Filters<\/option>\n\t\t            <option value=\"Drinking Water Systems\">Drinking Water Systems<\/option>\n\t\t        <\/select>\n\t\t        <label for=\"inputInstallLocation\">Where will your Brita PRO<sup>&reg;<\/sup> be installed?<\/label>\n\t\t        <select id=\"inputInstallLocation\" name=\"WhereInstalled\">\n\t\t            <option selected=\"\"><\/option>\n\t\t            <option value=\"Home\">Home<\/option>\n\t\t            <option value=\"Office\">Office<\/option>\n\t\t            <option value=\"Commercial\">Commercial<\/option>\n\t\t            <option value=\"Industrial\">Industrial<\/option>\n\t\t        <\/select>\n\t\t        <label for=\"inputWaterSource\">Water source<\/label>\n\t\t        <select id=\"inputWaterSource\" name=\"WaterSource\">\n\t\t            <option selected=\"\"><\/option>\n\t\t            <option value=\"Municipal\/City\">Municipal\/City<\/option>\n\t\t            <option value=\"Well\">Well<\/option>\n\t\t        <\/select>\n\t\t    <input type=\"hidden\" name=\"formid\" value=\"FFADFF22-4F21-4874-9D0DA47E6861108C\"\/>\n\t\t    <input type=\"hidden\" name=\"thankyouPage\" value=\"https:\/\/britapro.com\/contact\/contact-a-dealer-contact-form\/thank-you\/\"\/>\n\t\t    <input type=\"hidden\" name=\"Country\" value=\"US\"\/>\n\t\t    <button type=\"submit\">Send<\/button>\n\t\t<\/form>\n\n","protected":false},"excerpt":{"rendered":"<p>Contact a Brita PRO\u00ae partner Contact Dealer Form Clean, pure, great-tasting water is just a few steps away. Start with a water quality analysis from an independent EPA-certified laboratory and a free consultation from a Brita PRO\u00ae water filtration expert. You can contact us, or we can contact you. First Name* Please provide a first&hellip;<\/p>\n","protected":false},"author":2,"featured_media":141,"parent":110,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"acf":[],"_links":{"self":[{"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/pages\/1397"}],"collection":[{"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/comments?post=1397"}],"version-history":[{"count":0,"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/pages\/1397\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/pages\/110"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/media\/141"}],"wp:attachment":[{"href":"https:\/\/britapro.com\/wp-json\/wp\/v2\/media?parent=1397"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}