<% if(Request.Form("btnsubmit")="submit")then firstname=escape_single_quote(Request.Form("FName")) lastname=escape_single_quote(Request.Form("LName")) companyname=escape_single_quote(Request.Form("CName")) email=escape_single_quote(Request.Form("Email")) Address1=escape_single_quote(Request.Form("Address1")) Address2=escape_single_quote(Request.Form("Address2")) City=escape_single_quote(Request.Form("City")) country=escape_single_quote(Request.Form("country")) Zip=escape_single_quote(Request.Form("Zip")) if(country="India")then state=escape_single_quote(Request.Form("state")) else state=escape_single_quote(Request.Form("stateval")) end if teloffice=escape_single_quote(Request.Form("teloffice")) mobile=escape_single_quote(Request.Form("mobile")) Fax=escape_single_quote(Request.Form("Fax")) Cmethod=escape_single_quote(Request.Form("Cmethod")) ContactTime=escape_single_quote(Request.Form("ContactTime")) web=escape_single_quote(Request.Form("web")) jobdetail=escape_single_quote(Request.Form("jobdetail")) comments=escape_single_quote(Request.Form("comments")) query="insert into tbl_Request_quote (First_Name,Last_Name,Company_Name,Email_Address,Address_1,Address_2,City,State,Zip,Country,Tel_Office,Tel_Mobile,Fax,Contact,Contact_Time,Web_URL,Job_Detalis,Comments,status) values ('"&firstname&"','"&lastname&"','"&companyname&"','"&email&"','"&Address1&"','"&Address2&"','"&City&"','"&state&"','"&Zip&"','"&country&"','"&teloffice&"','"&mobile&"','"&Fax&"','"&Cmethod&"','"&ContactTime&"','"&web&"','"&jobdetail&"','"&comments&"','approved')" 'response.write query & "
" conn.execute query 'body="
 
  
First Name : "& firstname &"
 
Last Name : "& lastname &"
 
Company Name : "& companyname &"
 
Email : "& email &"
 
Address 1 : "& Address1 &"
 
Address 2 : "& Address2 &"
 
City : "& City &"
 
Country : "& country &"
 
Zip : "& Zip &"
 
State : "& state &"
 
Tel. Office : "& teloffice &"
 
Mobile : "& mobile &"
 
Fax : "& Fax &"
 
Contact Method : "& Cmethod &"
 
Contact Time : "& ContactTime &"
 
Web URL : "& web &"
 
Job Detail : "& jobdetail &"
 
  
" body="
 
  
First Name : "& firstname &"
 
Last Name : "& lastname &"
 
Company Name : "& companyname &"
 
Email : "& email &"
 
City : "& City &"
 
Country : "& country &"
 
Tel. Office : "& teloffice &"
 
Mobile : "& mobile &"
 
Job Detail : "& jobdetail &"
 
  
" 'response.write body send_mail email,body msg="yes" end if %> Welcome to Centrix Healthcare
Request for Quote
<% if(msg<>"yes")then %>
If you need know our pricings, then please fill in this short form and submit. We shall get back to you soon.
* Required Fields
*First Name *Last Name
*Company's Name *E-mail Address
*City *Country
*Tel. Office *Tel. Mobile
*Quote Required(Job Detail)

<%else%>


Your request has been sent successfully. Someone from our Business Development Team will get in touch with you shortly.


Business Development Team
Centrix Technologies


<% end if %>



<% sub send_mail(email,body) Set Mail = Server.CreateObject("cdo.message") Mail.Sender="CentrixHealthcare" 'Mail.From = "info@centrixhealthcare.com" 'Specify sender''s address 'Mail.to=email Mail.From = email 'Specify sender''s address Mail.to="info@centrixhealthcare.com" Mail.Cc="saravanan_centrixtech@yahoo.com" 'Mail.Cc="ritesh@centrixhealthcare.com,saravanan@centrixhealthcare.com" Mail.Subject = "Request for a quote" body_content=body 'body_content="
"& name &" has been requested following article(s).

"& content &"
" 'response.write body_content ' 'response.end 'response.write body_content Mail.HTMLBody=body_content Mail.Send end sub %>