Web Form

I need a form that I want to use on a number of different html pages.

The form will have three mandatory text fields and one (optional) numeric field:

The text fields will be:
email1 (the form has to verify that the email entered is a valid email)
email2 (let’s them type the email again, to verify that they entered the correct email)
Message (limit of say 250 Characters)

The numeric field will be for a dollar amount, but it is optional for the user.

Once the user submit the form, …

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