Inquiry test

System Generated Field Panel
Author Entered Field Panel
Form Title Panel
End-user Entered Field Panel
Thank You and Error Message Panel
Hidden Panel

System Generated Field Panel
Author Entered Field Panel
Form Title Panel
End-user Entered Field Panel
Thank You and Error Message Panel
Hidden Panel

System Generated Panel

Market Region

This is a Required field for GLU to process this request:

Form submission source

*PublishedDate

*Domain

Language Value

Form Fields

Author Input Panel

Author Input Panel - Required fields

Select the form Layout

Analytics form type

Analytics form title

*Request Type

Lead

Case

Xmlformname

Date field format

Author Input Panel - Optional fields

Campaign Nam

Campaign Term / Key phrase

Campaign Content

Analytics Source

Analytics Medium

WebSite

Quote Result / information

Form Title Panel

User Input Panel

Best time to Contact

*Individual or Group policy?

*I am interested in

If salary below 4000 is selected or insured is on student visa or if documents for new born are not yet issued, you will be routed to another portal to complete the formalities.

Who is the Insurance for?

*Visa Sponsor

Please select your visa type

Please select your age group of the insured

Please select the salary of the insured

Above 4,000 AED

4,000 AED and below or Unemployed

Are the documents of the new born such as visa/passport/emirates ID issued?

Yes

*Salutation

*First Name

*Last Name

*Phone (971xxxxxxxxx)

*Email

*Date of Birth (dd/mm/yyyy)

Company Name

Number of employees (Minimum 4)

Industry

Please do not share credit card details or any financial information in this form

Message (Max. 1000 characters)

Thank You/Error Panel Configuration

Settings for same page thank you/error message

Message Delay

Error

An error has occurred. Please try again later.

Thank you

Your request has been submitted successfully.

You can also contact MetLife at the numbers below.

UAE: 800 6385433
Qatar: 800 9711
Bahrain: 800 08033
Kuwait: +965 2 2089333
Oman: 800 70708
Any other country: +971 4 415 4555

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Hidden Panel

Name Of The Template