***** Diagnostics *****
Data posted to fake fields!
***** Origin Data *****
Timestamp: 10/18/2024 9:02 pm EDT
IP Address: 23.105.150.104
Form Title: Contact Us
File Name: ContactUs.php
Session ID: 69e8b5ee62ab6a8f4ad0f7612c51e09d
Form ID: 
Key: 
User Agent: Mozilla/5.0 (Windows NT 10.0; WOW64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/114.0.0.0 YaBrowser/22.7.0 Yowser/2.5 Safari/537.36
PHP_SELF: /forms/Views/ContactUs.php
argv: Array
argc: 1
GATEWAY_INTERFACE: CGI/1.1
SERVER_ADDR: 67.227.187.99
SERVER_NAME: www2.achievetestprep.com
SERVER_SOFTWARE: Apache
SERVER_PROTOCOL: HTTP/1.1
REQUEST_METHOD: POST
REQUEST_TIME: 1729299730
REQUEST_TIME_FLOAT: 1729299730.9432
QUERY_STRING: action=submit
DOCUMENT_ROOT: /home/achievetestprep/public_html/www2.achievetestprep.com
HTTP_ACCEPT: text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7
HTTP_ACCEPT_ENCODING: gzip, deflate, br
HTTP_ACCEPT_LANGUAGE: en-US,en;q=0.5
HTTP_CONNECTION: keep-alive
HTTP_HOST: www2.achievetestprep.com
HTTP_REFERER: https://www2.achievetestprep.com/forms/Views/ContactUs.php
HTTP_USER_AGENT: Mozilla/5.0 (Windows NT 10.0; WOW64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/114.0.0.0 YaBrowser/22.7.0 Yowser/2.5 Safari/537.36
HTTPS: on
REMOTE_ADDR: 23.105.150.104
REMOTE_PORT: 1743
SCRIPT_FILENAME: /home/achievetestprep/public_html/www2.achievetestprep.com/forms/Views/ContactUs.php
SERVER_ADMIN: webmaster@www2.achievetestprep.com
SERVER_PORT: 443
SCRIPT_NAME: /forms/Views/ContactUs.php
REQUEST_URI: /forms/Views/ContactUs.php?action=submit
***** Field Array *****
Array
(
    [fname] => Array
        (
            [label] => First Name
            [placeholder] => Your first name
            [column] => 1
            [required] => 1
            [req_dependant] => None
            [type] => text
            [size] => 25
            [sf_lead_field] => First_Name__c
            [hs_field] => firstname
            [value] => 
        )

    [lname] => Array
        (
            [label] => Last Name
            [placeholder] => Your last name
            [column] => 1
            [required] => 1
            [req_dependant] => None
            [type] => text
            [size] => 25
            [sf_lead_field] => Name
            [hs_field] => lastname
            [value] => 
        )

    [email] => Array
        (
            [label] => Email Address
            [placeholder] => your@emailaddress.com
            [column] => 1
            [required] => 1
            [req_dependant] => None
            [type] => email
            [size] => 25
            [sf_lead_field] => Email__c
            [hs_field] => email
            [value] => 
        )

    [phone] => Array
        (
            [label] => Mobile Phone
            [placeholder] => 123 345 6789
            [column] => 1
            [required] => 1
            [req_dependant] => none
            [type] => phone
            [size] => 25
            [sf_lead_field] => Mobile_Primary__c
            [hs_field] => phone
            [note] => 
            [value] => 
        )

    [request] => Array
        (
            [label] => Type of request
            [placeholder] => Please select
            [column] => 
            [required] => 1
            [req_dependant] => None
            [type] => select
            [options] => Array
                (
                    [See if I qualify for Achieve's programs] => See if I qualify for Achieve's programs
                    [Request a personalized college plan with pricing] => Request a personalized college plan with pricing
                    [Ready to start and select a plan] => Ready to start and select a plan
                    [Tech issues / unable to connect with advisor] => Tech issues / unable to connect with advisor
                    [Customer support request] => Customer support request
                    [Enterprise Partnership request] => Enterprise Partnership request
                    [Feedback on how we can improve] => Feedback on how we can improve
                )

            [value] => 
        )

    [comment] => Array
        (
            [label] => Describe How We Can Help
            [placeholder] => Your description on how we can help
            [column] => 
            [required] => 1
            [req_dependant] => none
            [type] => textarea
            [rows] => 6
            [value] => 
        )

    [term] => Array
        (
            [label] => <i style="text-transform:none;font-size:12px;font-weight:400;letter-spacing:0;">I agree to Achieve's <a href="https://www.achievetestprep.com/terms-and-conditions" target="_blank">terms</a> and to being contacted via email, phone, or sms at the email and phone provided.</i>
            [column] => 
            [required] => 1
            [req_dependant] => None
            [type] => checkbox
            [value] => 
        )

)