RF Industries Feedback Form

<%@ Language=VBScript %> <%option Explicit%> RF Industries Feedback Form

Enter the following information to receive our latest catalogs and to be added to our Internet mailing list.

Required Fields:*

Name: *

Title:

Company: *

Address1:

Address2:

City:    State: Zip:

Country:

Phone:

Fax:

E-Mail: *

Please check areas of interest

Connectors

Cable Assemblies

Kits

Tools

How did you hear about RF Industries?

Any other comments or questions regarding our products or our web site?

Add me to your e-mail list.

<% dim TheMail, TheMessage, msgTo, msgFrom, msgSubject, msgBody dim chkConnectors, chkCables, chkKits, chkTools, chkAddEmail set TheMail = server.CreateObject("cdonts.newmail") msgFrom = trim(Request.Form("email")) msgTo = trim(Request.Form("mailto")) msgSubject = trim(Request.Form("subject")) msgBody = "Name: " + Request.Form("name") & vbcrlf msgBody = msgBody & "Title: " + Request.Form("title") & vbcrlf msgbody = msgbody & "Company: " + Request.Form("company") & vbcrlf msgbody = msgbody & "Address1: " + Request.Form("add1") & vbcrlf msgbody = msgbody & "Address2: " + Request.Form("add2") & vbcrlf msgbody = msgbody & "City: " + Request.Form("city") &vbcrlf msgbody = msgbody & "State: " + Request.Form("st") &vbcrlf msgbody = msgbody & "Zip: " + Request.Form("zip") &vbcrlf msgbody = msgbody & "Country: " + Request.Form("country") &vbcrlf msgbody = msgbody & "Phone: " + Request.Form("phone") &vbcrlf msgbody = msgbody & "Fax: " + Request.Form("fax") &vbcrlf msgbody = msgbody & "Email: " + Request.Form("email") &vbcrlf &vbcrlf msgbody = msgbody & "Message: " + Request.Form("message") &vbcrlf &vbcrlf msgbody = msgbody & "Comments: " + Request.Form("message2") &vbcrlf &vbcrlf chkConnectors = Request.Form("connectors") chkCables = Request.Form("cableassemblies") chkKits = Request.Form("kits") chkTools = Request.Form("tools") chkAddEmail = Request.Form("addtoemail") if chkConnectors = 0 and chkCables = 0 and chkKits = 0 and chkTools = 0 then msgbody = msgbody & "No Information Requested" &vbcrlf else msgbody = msgbody & "Please Send me Information on:" &vbcrlf if chkconnectors = 1 then msgbody = msgbody & " Connectors" &vbcrlf end if if chkcables = 1 then msgbody = msgbody & " Cable Assemblies" &vbcrlf end if if chkkits = 1 then msgbody = msgbody & " Kits" &vbcrlf end if if chktools = 1 then msgbody = msgbody & " Tools" &vbcrlf &vbcrlf end if end if if chkAddEmail = 1 then msgbody = msgbody & "Please add me to your Email Database" &vbcrlf else msgbody = msgbody & "Please DO Not add me to your Email Database" &vbcrlf end if 'end if if msgFrom ="" then Response.Write("Please complete the form and then click the submit button") else TheMail.From = msgFrom TheMail.To = MsgTo TheMail.Subject = msgSubject TheMail.Body = msgBody Response.Write(Request.Form("MailTo"))%>
<% Response.Write(Request.Form("email"))%>
<% Response.Write(Request.Form("subject"))%>
<% Response.Write(Request.Form("body"))%>
<% TheMail.Send set themail = nothing end if %>