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<script type="text/javascript" src="https://marketing.omnifymarketing.com/acton/form/25431/0021/form.js"></script>
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<form id="form_0021" method="post" enctype="multipart/form-data" action="https://marketing.omnifymarketing.com/acton/forms/userSubmit.jsp" accept-charset="UTF-8" target="targetsubmitframe">
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                        <div class="formField">  <div class="formFieldLabel" style="display: none;">  <label for="form_0021_fld_4"> Location</label>  </div>  <select size="1" id="form_0021_fld_4" name="preferred_location" class="formFieldSmall" style="display: none;">  <option value="" selected="true">* What is your preferred location?</option>  <option value="-1:::gbush411@hotmail.com, thebushflooringcenter@gmail.com:::Cincinatti, OH" selected="selected">Cincinatti, OH</option></select>  </div>
                        
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            <tr>  <td class="ao_tbl_cell" style="padding-left: 10px; padding-right: 10px" align="center">  <div align="left">    <input type="hidden" id="form_0021_fld_10" name="dealername" value="Bush's Flooring Center">  <input type="hidden" id="form_0021_fld_11" name="dealermhwkacct" value="">  <input type="hidden" id="form_0021_fld_12" name="dealerurl" value="">  <input type="hidden" id="form_0021_fld_13" name="dealerfrom" value="gbush411@hotmail.com">  <input type="hidden" id="form_0021_fld_14" name="dealerlogo" value="https://clientassets.web.broadlume.com/1246/images/image.png#size=380,63">  <input type="hidden" id="form_0021_fld_15" name="dealeraddr" value="1940 Dana Avenue Cincinnati, OH 45207">  <input type="hidden" id="form_0021_fld_16" name="dealeraddrline" value="">  <input type="hidden" id="form_0021_fld_17" name="dealerphone" value="(513) 351-4300">  <input type="hidden" id="form_0021_fld_18" name="dealerfacebook" value="">  <input type="hidden" id="form_0021_fld_19" name="dealertwitter" value="">  <input type="hidden" id="form_0021_fld_20" name="dealeryoutube" value="">  <input type="hidden" id="form_0021_fld_21" name="dealergooglep" value="">  <input type="hidden" id="form_0021_fld_22" name="dealerlinkedin" value="">  <input type="hidden" id="form_0021_fld_23" name="dealerinstagram" value="">  <input type="hidden" id="form_0021_fld_24" name="dealerpinterest" value="">  <input type="hidden" id="form_0021_fld_25" name="omnifycampaign" value="INSERTCAMPAIGNHERE">  <input type="hidden" id="form_0021_fld_26" name="tags" value="">  <input type="hidden" id="form_0021_fld_27" name="formname" value="INSERTFORMNAME">  <input type="hidden" id="form_0021_fld_28" name="promotion" value="promotion">  <input type="hidden" id="form_0021_fld_29" name="source" value="source">  <input type="hidden" id="form_0021_fld_30" name="foreignid" value="fe83f9de-2988-42a3-97f1-d0ffada0906c">  <input type="hidden" id="form_0021_fld_31" name="dealerzip" value="45207">  <input type="hidden" id="form_0021_fld_32" name="storelocation" value="">  <input type="hidden" id="form_0021_fld_33" name="sourcedetail" value="SOURCEDETAIL">  <input type="hidden" id="form_0021_fld_34" name="sourceurl" value="">  <input type="hidden" id="form_0021_fld_35" name="formcategory" value="FORMCATEGORY">  <input type="hidden" id="form_0021_fld_36" name="dealercity" value="Cincinnati">  <input type="hidden" id="form_0021_fld_37" name="dealerstate" value="OH">  <input type="hidden" id="form_0021_fld_40" name="traffic-type" value="">  <input type="hidden" id="form_0021_fld_41" name="traffic-medium" value="">  <input type="hidden" id="form_0021_fld_42" name="traffic-source" value="">  <input type="hidden" id="form_0021_fld_43" name="traffic-term" value="">  <input type="hidden" id="form_0021_fld_44" name="traffic-content" value="">  <input type="hidden" id="form_0021_fld_45" name="traffic-campaign" value="">    <input type="hidden" id="form_0021_fld_48" name="floorlytics-blob" value="">  </div>  </td>  </tr>
            <tr>  <td class="ao_tbl_cell" style="padding-left: 10px; padding-right: 10px;" align="center">  <div align="left">  <div class="formField">  <div class="formFieldLabel" style="display: none">  <label for="form_0021_fld_8">Comments  </label>  </div>  <textarea class="formTextArea formTextAreaLarge formTextAreaWidthLarge" id="form_0021_fld_8" name="comments" placeholder="Comments"></textarea>  </div>  </div>  </td>  </tr>
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                                                <tbody><tr>
                                                    <td width="5" align="left">
                                                        <input type="checkbox" name="optin" id="form_0021_fld_5-0" value="Keep me up to date with exclusive offers." checked="checked">
                                                    </td>
                                                    <td align="left" style="padding-top: 3px; padding-right: 10px">
                                                        <label for="form_0021_fld_5-0" class="prodClass formFieldLabel checkboxFieldLabel" style="max-width:220px">
                                                            Keep me up to date with exclusive offers.
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                                    </td>
                                </tr>
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            <tr>  <td style="padding-bottom: 10px" align="center" id="form_0021_ao_submit_button">  <input class="btn btn-danger btn-block" id="form_0021_ao_submit_input" type="button" name="Submit" value="SEND" onclick="doSubmit(document.getElementById('form_0021'));">  </td>  </tr>
            <tr class="formNegCap">  <td>      <label for="ao_form_neg_cap" style="display: none;">ao_form_neg_cap</label>  <input type="text" id="ao_form_neg_cap" name="ao_form_neg_cap" value="">  </td>  </tr>
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<script>document.addEventListener("DOMContentLoaded", function () { var logoFile = cmsLogoSrc; var logoURL = "http://" + window.location.host + "/image.ashx?i=" + logoFile.slice(5); $('input[name="dealerlogo"]').attr("value", logoURL); $("#form_0021").attr("target", "targetsubmitframe"); $("#form_0021").css("width", "93%"); $('input[name="dealername"]').attr("value", cmsAccountName); $('input[name="dealermhwkacct"]').attr("value", cmsMohawkAccountNumber); $('input[name="dealerurl"]').attr("value", cmsWebsiteDomain); $('input[name="dealerfrom"]').attr("value", cmsEmailAttr); $('input[name="dealeraddr"]').attr("value", cmsAddress); $('input[name="dealeraddrline"]').attr("value", cmsAddressLine); $('input[name="dealerphone"]').attr("value", cmsPhone); $('input[name="dealerfacebook"]').attr("value", cmsFacebook); $('input[name="dealertwitter"]').attr("value", cmsTwitter); $('input[name="dealeryoutube"]').attr("value", cmsYoutubeChannel); $('input[name="dealergooglep"]').attr("value", cmsGooglePlus); $('input[name="dealerlinkedin"]').attr("value", cmsLinkedin); $('input[name="dealerinstagram"]').attr("value", cmsInstagram); $('input[name="dealerpinterest"]').attr("value", cmsPinterest); $('input[name="tags"]').attr("value", cmsUrl); $('input[name="sourceurl"]').attr("value", cmsFullUrl); $('input[name="foreignid"]').attr("value", cmsAccountId); $('input[name="dealerzip"]').attr("value", cmsStructuredAddressZip); $('input[name="storelocation"]').attr("value", cmsStoreLocationId); $('input[name="dealercity"]').attr("value", cmsStructuredAddressCity); $('input[name="dealerstate"]').attr("value", cmsStructuredAddressState); $('input[name="formcategory"]').attr("value", eventLabelType); $('input[name="formname"]').attr("value", eventActionType); });</script>
<iframe name="targetsubmitframe" id="targetsubmitframe">    <p>Your browser does not support iframes.</p>  </iframe></body></html></div><div id="page131_htmltext3" class=" htmltext3_wp_outer" style="" replacecontent="childrenonly" loadcapacity="1" orientation="" data-macro="cms:companyname--partly">*Valid for only 30 days from form fill out. This coupon cannot be combined with any other offer or discount. One coupon limit per person, per order, at Bush's Flooring Center.<br><div class="clear_div" style="clear:both;height:0px;"> </div></div><div class="clear_div" style="clear:both;height:0px;"> </div></div><div id="page131_container7" class="wp_col_content columns2_col_box_1" replacecontent="childrenonly"><div style="height:0px;width:0px">&#160;</div><div class="clear_div" style="clear:both;height:0px;"> </div></div></div></div></div><div class="clear_div" style="clear:both;height:0px;"> </div><div class="clear_div" style="clear:both;height:0px;"> </div></div><div class="clear_div" style="clear:both;height:0px;"> </div></div>

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