<div class="two-third">
<h2>Let's get in touch!</h2>
<p>If you have questions or comments, we want to hear from you! Also, distributor opportunities may exist in your area. If you have an interest in selling Y.E.S. products at your location, please use the form below.
<br /><br />
A representative will contact you at our earliest opportunity.<br /><span style="font-size: 10px; color: #D80000">All fields required.</span></p>

<form action="http://campaign.digitalmailmaker.com/index.php" class="contact" method="post" name="campaignform" onsubmit="return validate()" >
<input type="hidden" name="camp" value="websignup">
<input type="hidden" name="perso" value="V1RJNE9VMVhiR3RsYlVadlkwaFZOR0ZuUFQwPStV">

<p><label>First Name:</label>
<br /><input type="text" class="textbox" name="first_name" /></p>

<p><label>Last Name:</label>
<br /><input type="text" class="textbox" name="last_name" /></p>

<p><label>Company:</label>
<br /><input type="text" class="textbox" name="company_name" /></p>

<p><label>Address:</label>
<br /><input type="text" class="textbox" name="address_1" /></p>

<p><label>City:</label>
<br /><input type="text" class="textbox" name="city" /></p>

<p><label>State:</label>
<br /><input type="text" class="textbox" name="state" /></p>

<p><label>Zip:</label>
<br /><input type="text" class="textbox" name="zip" /></p>

<p><label>Email:</label>
<br /><input type="text" class="textbox" name="email" /></p>

<p><label>Phone:</label>
<br /><input type="text" class="textbox" name="contact_phone" /></p>

<p><label>Comments:</label>
<br /><textarea class="textbox" name="comments"  id="message"  rows="" cols="" /></textarea></p>

<input type="submit" name="submit_form" value="Send Message"  id="submit"  />
</form>
</div>

<div class="one-third last">
<h2>Corporate Contact:</h2>
<p><span style="font-size: 14px; line-height: 18px; font-weight: bold">
Lisa Taylor</span><br />
<span style="font-size: 12px; line-height: 18px; font-style: italic">Executive VP</span><br /><br />
<span style="font-size: 13px; line-height: 18px">Phone: 949.496.9400<br />
Email: <a href="mailto:lisa@yesskincare.com">lisa@yesskincare.com</a></span></p>
</div>