{if segment_2=='au_sable_professional_network' AND segment_3!=''}
<div id="contact-form">
{exp:freeform:form
   collection="Mentor Template"
   required="firstname|lastname|email"
   return="/alumni_and_grad_fellows/au_sable_professional_network/thanks/"
   notify="info@ausable.org"
   recipients="yes"
   recipient_email="{recipient_email}"
   template="mentor_template"
}
<fieldset>
	<label>First Name *</label><input type="text" name="firstname" class="field" />
	<label>Last Name *</label><input type="text" name="lastname" class="field" />
	<label>Email *</label><input type="text" name="email" class="field" />
	<label>Phone</label><input type="text" name="phone1" class="field" />	
	<label>Select Mentor</label>
		<br /><select name="recipient_email">
			{exp:channel:entries channel="mentors" dynamic="off"}
				<option value="{mentor_email}">{title}</option>
			{/exp:channel:entries}
		</select>
			<p class="form"><label>Request</label><textarea rows="3" name="comments" cols="1"></textarea></p>

	<p class="form"></p>
	{if captcha}
	<p class="form">
		<label>Please enter the word<br />you see below:</label><input type="text" name="captcha" class="field" />
	</p>
	<p class="form">
		<label>&nbsp;</label>{captcha}
	</p>
	{/if}
	<p><label></label><em>* denotes required field</em></p>
	
	<input type="submit" name="submit" class="submit-btn-forms" value="Submit" />
</fieldset>
{/exp:freeform:form}
</div>
{/if}