<META HTTP-EQUIV="Content-type" CONTENT="text/html; charset=UTF-8">
<script src="https://www.google.com/recaptcha/api.js"></script>
<script>
 function timestamp() { var response = document.getElementById("g-recaptcha-response"); if (response == null || response.value.trim() == "") {var elems = JSON.parse(document.getElementsByName("captcha_settings")[0].value);elems["ts"] = JSON.stringify(new Date().getTime());document.getElementsByName("captcha_settings")[0].value = JSON.stringify(elems); } } setInterval(timestamp, 500); 
</script>

<!--  ----------------------------------------------------------------------  -->
<!--  NOTE: Please add the following <FORM> element to your page.             -->
<!--  ----------------------------------------------------------------------  -->

<form action="https://webto.salesforce.com/servlet/servlet.WebToCase?encoding=UTF-8" method="POST">

<input type=hidden name='captcha_settings' value='{"keyname":"Alex_Support","fallback":"true","orgId":"00D300000000Swd","ts":""}'>
<input type="hidden" name="orgid" value="00D300000000Swd"/>
  <input type="hidden" name="retURL" value="http://support.companioncorp.com"/>

  ">

<!--  ----------------------------------------------------------------------  -->
<!--  NOTE: These fields are optional debugging elements. Please uncomment    -->
<!--  these lines if you wish to test in debug mode.                          -->
<!--  <input type="hidden" name="debug" value=1>                              -->
<!--  <input type="hidden" name="debugEmail"                                  -->
<!--  value="marketing@companioncorp.com">                                    -->
<!--  ----------------------------------------------------------------------  -->

<label for="name"><b>Name</b></label> <br /><input>Contact Name</label><input  id="name" maxlength="80" name="name" size="3020" type="text" /><br /><br />><br>

  <label for="email"><b>Email<>Email</b></label>label><input <br /><input  id="email" maxlength="80" name="email" size="3020" type="text" /><br /><br />><br>

  <label for="phone"><b>Phone</b></label> <br /><input>Phone</label><input  id="phone" maxlength="40" name="phone" size="3020" type="text" /><br /><br />><br>

  <label for="subject"><b>Subject</b></label> <br /><input>Subject</label><input  id="subject" maxlength="80" name="subject" size="3020" type="text" /><br /><br />><br>

  <label for="description"><b>Description</b></label> <br /><textarea name="description" rows="10" cols="70"></textarea><br /><br />

  >Description</label><textarea name="description"></textarea><br>

<input type="hidden"  id="external" name="external" value="1" /><br>

<div class="g-recaptcha" data-sitekey="6LdFm8MUAAAAAB-e7abdRcMuSSA-yvRCC1ARd0MH"></div><br>
<input type="submit" name="submit"/>

</form>