Sample request form

<script text="text/javascript"><!-- [et_pb_line_break_holder] -->var getUrlParameter = function getUrlParameter(sParam) {<!-- [et_pb_line_break_holder] --> var sPageURL = decodeURIComponent(window.location.search.substring(1)),<!-- [et_pb_line_break_holder] --> sURLVariables = sPageURL.split('&'),<!-- [et_pb_line_break_holder] --> sParameterName,<!-- [et_pb_line_break_holder] --> i;<!-- [et_pb_line_break_holder] --> for (i = 0; i < sURLVariables.length; i++) {<!-- [et_pb_line_break_holder] --> sParameterName = sURLVariables[i].split('=');<!-- [et_pb_line_break_holder] --> if (sParameterName[0] === sParam) {<!-- [et_pb_line_break_holder] --> return sParameterName[1] === undefined ? true : sParameterName[1];<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] -->};<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->var samplerequest = getUrlParameter('ref);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->if (samplerequest != null) {<!-- [et_pb_line_break_holder] --> document.getElementById('yoursamplerequested').value = samplerequest;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></script>