Driving Ambition, Inc.
1311 N. Shadeland Ave, Suite D
Indianapolis, IN 46219
Phone: 317-352-0306
Fax: 317-352-0766
Toll Free: 877-259-4963

info@drivingambitioninc.com

Or fill out the form below:

 

<% ' ****** Set variables ************ dim Pertitle dim Fname dim Lname dim company dim address dim city dim statel dim zip dim phone dim fax dim email dim issue dim done dim ErrorMessage dim message Pertitle = Request.Form ("pertitle") Fname = Request.Form ("fname") Lname = Request.Form ("lname") company = Request.Form ("company") address = Request.Form ("maddress") city = Request.Form ("city") statel = Request.Form ("statel") zip = Request.Form ("zip") phone = Request.Form ("phone") fax = Request.Form ("fax") email = Request.Form ("email") issue = Request.Form ("issue") done = Request.Form ("done") Select case done case "done"' ******** They already clicked Submit ********** ' *********************** Check for Errors ******************************** 'ErrorMessage="" 'if Fname = "" then ErrorMessage = "

First name is required.

" 'if Lname = "" then ErrorMessage = ErrorMessage & "

Last name is required.

" 'if address = "" then ErrorMessage = ErrorMessage & "

You need to provide either an Email address, or mailing address.

" 'if phone = "" then ErrorMessage = ErrorMessage & "

A valid Phone number is required.

" ' ***************************************************************************** Select case ErrorMessage case "" ' ** No errors were found.** message = message & "Pertitle: " & pertitle & VBCrLf message = message & "FName: " & fname & VBCrLf message = message & "LName: " & lname & VBCrLf message = message & "Company: " & company & VBCrLf message = message & "Address: " & address & VBCrLf message = message & "City: " & city & VBCrLf message = message & "State1: " & state1 & VBCrLf message = message & "Zip: " & zip & VBCrLf message = message & "Phone: " & phone & VBCrLf message = message & "Fax: " & fax & VBCrLf message = message & "Email: " & email & VBCrLf message = message & "Issue: " & issue & VBCrLf set smtp = Server.CreateObject("Bamboo.SMTP") 'You only need to change the smtp.Rcpt ans smpt.from part to your email address smtp.Server = "mail.drivingambitioninc.com" smtp.Rcpt = "jeremy@drivingambitioninc.com" smtp.From = "drivers@drivingambitioninc.com" smtp.FromName = Request.ServerVariables("HTTP_REFERER") smtp.Subject = "Contact web form - " & Request.ServerVariables("HTTP_REFERER") smtp.Message = message on error resume next smtp.Send 'response.write message if err then response.Write err.Description Else Response.Write "
" ' ** Start table ** Response.Write "

Thank you " & fname & ".

Your message was sent succesfully." Response.Write "
" ' ** End table ** end if set smtp = Nothing Pertitle = "" Fname = "" Lname = "" company = "" address = "" city = "" statel = "" zip = "" phone = "" fax = "" email = "" issue = "" done = "" case else ' ** An error was found ** response.write "
" ' ** Start table ** response.write ErrorMessage response.write "
" ' ** End table ** end select case else ' ***** They haven't clicked on Done yet... ****** Pertitle = "" Fname = "" Lname = "" company = "" address = "" city = "" statel = "" zip = "" phone = "" fax = "" email = "" issue = "" done = "" end select '************************** Display Main Table ******************* %>
Mr/Mrs/Ms: 
First Name:    
Last Name:  
Company:   
Address:    
City:  
State:  
Zip/Postal Code: 
Phone #:   
Fax #:  
Email:   

 

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