<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> <% ' Website Contact Form Generator ' http://www.tele-pro.co.uk/scripts/contact_form/ ' This script is free to use as long as you ' retain the credit link ' declare variables Dim EmailFrom Dim EmailTo Dim Subject Dim FirstName Dim LastName Dim Age Dim emailAddress Dim zip Dim HomeTel Dim altTel Dim Comments Dim stopWork Dim stillWorking Dim PendingClaim Dim doctor ' get posted data into variables EmailFrom = "Inquiries@dwfox.com" EmailTo = "kcimat007@gmail.com,jradmdwf@sbcglobal.net" Subject = "Questions from Website" FirstName = Trim(Request.Form("FirstName")) LastName = Trim(Request.Form("LastName")) Age = Trim(Request.Form("Age")) emailAddress = Trim(Request.Form("emailAddress")) zip = Trim(Request.Form("zip")) HomeTel = Trim(Request.Form("HomeTel")) altTel = Trim(Request.Form("altTel")) Comments = Trim(Request.Form("Comments")) stopWork = Trim(Request.Form("stopWork")) stillWorking = Trim(Request.Form("stillWorking")) PendingClaim = Trim(Request.Form("PendingClaim")) doctor = Trim(Request.Form("doctor")) ' validation Dim validationOK validationOK=true If (validationOK=false) Then Response.Redirect("error.html?" & EmailFrom) ' prepare email body text Dim Body Body = Body & "First Name: " & FirstName & VbCrLf Body = Body & "Last Name: " & LastName & VbCrLf Body = Body & "Age: " & Age & VbCrLf Body = Body & "emailAddress: " & emailAddress & VbCrLf Body = Body & "Zip Code: " & zip & VbCrLf Body = Body & "Primary Telephone: " & HomeTel & VbCrLf Body = Body & "Alt Telephone: " & altTel & VbCrLf Body = Body & "Comments: " & Comments & VbCrLf Body = Body & "When did they stop working?: " & stopWork & VbCrLf Body = Body & "Still Working: " & stillWorking & VbCrLf Body = Body & "Do they have a pending claim: " & PendingClaim & VbCrLf Body = Body & "Are they being treated by a doctor: " & doctor & VbCrLf ' send email Dim mail Set mail = Server.CreateObject("CDONTS.NewMail") mail.To = EmailTo mail.From = EmailFrom mail.Subject = Subject mail.Body = Body mail.Send ' redirect to success page Response.Redirect("thankyou.html?" & EmailFrom) %>