Why are there required fields? There is no CC so you basically should just be looking for a means to contact them. I always take any form submission provided there is one of either email or phone. Especially with PPC because ya pays whether you get the lead or not so... Anything else is gravy and makes closing the sale that much easier. The verfication field is IMO, just an impediment to conversion and AFAICS, has no function other than to stop bots. IMO, just one more thing that gets in the way.

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SEO Myths? or Misunderstood Techniques?