PAS Metal - Information Request

<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> <% If Request.QueryString("Submit") = "Submit" and Request.QueryString("FName") <> "" and Request.QueryString("LName") <> "" and Request.QueryString("Address1") <> "" and Request.QueryString("City") <> "" and Request.QueryString("State") <> "" and Request.QueryString("Zip") <> "" and Request.QueryString("Phone") <> "" and Request.QueryString("EMail") <> "" and Request.QueryString("Age") <> "" and Request.QueryString("Replace") <> "" and Request.QueryString("Refer") <> "" then If Request.QueryString("Leak") = "1" then xLeak = "YES" else xLeak = "NO" end if xMessage = "Name - " & Request.QueryString("FName") & " " & Request.QueryString("LName") & vbcrlf xMessage = xMessage & "Address " & Request.QueryString("Address1") & vbcrlf xMessage = xMessage & "Address " & Request.QueryString("Address2") & vbcrlf xMessage = xMessage & "City " & Request.QueryString("City") & vbcrlf xMessage = xMessage & "State " & Request.QueryString("State") & vbcrlf xMessage = xMessage & "Zip Code " & Request.QueryString("Zip") & vbcrlf xMessage = xMessage & "Phone # " & Request.QueryString("Phone") & vbcrlf xMessage = xMessage & "E-Mail Address " & Request.QueryString("EMail") & vbcrlf xMessage = xMessage & "Leaking " & xLeak & vbcrlf xMessage = xMessage & "Roof Age " & Request.QueryString("Age") & vbcrlf xMessage = xMessage & "Replacement Timeline " & Request.QueryString("Replace") & vbcrlf xMessage = xMessage & "Reference Type " & Request.QueryString("Refer") & vbcrlf Set Mail = Server.CreateObject("SMTPsvg.Mailer") 'create an Asp mail component. Mail.FromName = "webuser@pasmetal.com" Mail.FromAddress= "webuser@pasmetal.com" Mail.RemoteHost = "mrelay.perfora.net" ' The mail server you have to use with Asp Mail Mail.AddRecipient "Michael LaMaster", "mlamaster@cfl.rr.com" Mail.AddCC "Michael LaMaster", "mlamaster@cfl.rr.com" Mail.Subject = "PAS Metal - Information Request" Mail.BodyText = xMessage Response.Redirect("ClosePopups.asp") end if %> PAS Metal - Information Request

After you have submitted the form we will contact you within 2 business days to set up an appointment or answer any questions you might have. Thank you for visiting our site! We look forward to doing business with you.

First Name <%If Request.QueryString("FName") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Last Name <%If Request.QueryString("LName") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Address <%If Request.QueryString("Address1") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Address 2

" size="50" />

City <%If Request.QueryString("City") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

State <%If Request.QueryString("State") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Zip Code <%If Request.QueryString("Zip") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Phone # <%If Request.QueryString("Phone") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

E-Mail <%If Request.QueryString("EMail") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

" size="50" />

Are you currently leaking

YES	NO

Roof Age <%If Request.QueryString("Age") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

When do you anticipate replacing the roof <%If Request.QueryString("Replace") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>

How did you hear about Prestige Aluminum Systems Inc. <%If Request.QueryString("Refer") = "" and Request.QueryString("Submit") = "Submit" then%> REQUIRED! <%End if%>