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<html>
<head>
    <script>
        function getRefIdFromUrl() {
            const urlParams = new URLSearchParams(window.location.search);
            return urlParams.get('ref_id');
        }

        function fillReferralId() {
            const refId = getRefIdFromUrl();
            if (refId) {
                document.getElementById('Referral_Id__c').value = refId;
            }
        }

        window.onload = fillReferralId;
    </script>
</head>
<body>
    <form action="https://test.salesforce.com/servlet/servlet.WebToLead?encoding=UTF-8&orgId=00D7Z00000056BX" method="POST">
        <input type=hidden name="oid" value="00D0Y000000a7Ox">
        <input type=hidden name="retURL" value="https://www.guidion.com/">
        
        <label for="first_name">First Name</label>
        <input id="first_name" maxlength="40" name="first_name" size="20" type="text" /><br>

        <label for="last_name">Last Name</label>
        <input id="last_name" maxlength="80" name="last_name" size="20" type="text" /><br>

        <label for="email">Email</label>
        <input id="email" maxlength="80" name="email" size="20" type="text" /><br>

        <label for="phone">Phone</label>
        <input id="phone" maxlength="40" name="phone" size="20" type="text" /><br>

        <label for="city">City</label>
        <input id="city" maxlength="40" name="city" size="20" type="text" /><br>

        <label for="company">Company</label>
        <input id="company" maxlength="40" name="company" size="20" type="text" /><br>

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

        <label for="Referral_Id__c" style="display:none;">Referral ID:</label>
        <input id="Referral_Id__c" maxlength="18" name="Referral_Id__c" size="20" type="text" style="display: none;" /><br>

        <input type=hidden name="recordType" id="recordType" value="0121v000000Fs65AAC"><br>
        <input id="lead_source" name="lead_source" type="hidden" value="Website" /><br>

        <input type="submit" name="submit">
    </form>
</body>
</html>
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