Email address required for guest access

We have a guest network with a customized web page right now. When the user connects, it asks for their name and logs it to a RADIUS server. However, the user can leave this field blank and press enter to gain access. Is there some way to force a user to enter their name into this page before access can be granted? We don't want to enter a username for each user because there are too many. I found this page and this is what we want to happen (I can't figure out how to do it).
http://www.cisco.com/en/US/docs/solutions/Enterprise/Mobility/emob41dg/ch10GuAc.html#wp999843
(figure 10-7)
We would like a page like this, but the user MUST enter a name or email before proceeding. No password is required. Down the road, we will attempt to verify the email that they enter, however we are not worried about that now.
Thanks

This is how we have it setup. However, they don't have to enter anything, the entry field can be blank and they can still be granted access. All we want is for them to enter something in this field before they are allowed on.

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