Beta Benefits Insurance Services

<% @LANGUAGE = VBScript %> <% Option Explicit %> <% ' name attribute of submit button If Request.Form("Submit")<>"" then Dim strName, strEmail, strQuery strName = Trim(Request.Form("lastName")) strEmail = Trim(Request.Form("email")) strQuery = "" &_ "First Name - " & Request.Form("firstName") & VbCrlf &_ "Last Name - " & Request.Form("lastName") & VbCrlf &_ "Address - " & Request.Form("street") & VbCrlf &_ "City - " & Request.Form("city") & VbCrlf &_ "State - " & Request.Form("state") & VbCrlf &_ "Zip - " & Request.Form("zip") & VbCrlf &_ "Phone - " & Request.Form("phone") & VbCrlf &_ "Work Phone - " & Request.Form("work") & VbCrlf &_ "Email - " & Request.Form("email") & VbCrlf 'response.write(strQuery & "
") 'response.end if (strName <> "" And strEmail <> "") Then on error resume next ' disable Error Handler Dim objMail Set objMail = Server.CreateObject("CDONTS.NewMail") objMail.From = "info@hsa4you.com" objMail.To = "phil@betabenefits.com" objMail.Subject = "Your Inquiry " & strName objMail.Body = strQuery objMail.Send Set objMail = Nothing if err.number<>0 then response.write(err.description) end if on error GOTO 0 ' restore to default behavior(HALT) Response.Redirect("thanks.htm") end if Else ' FORM SUBMIT %> Beta Benefits Insurance Services

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