<%@ Language=VBScript %> <%if Request.Form("Send")= "Send" then Dim ProdInfo If Request.Form("Frozen") = "on" then ProdInfo = "Frozen" End If If Request.Form("Par-Baked") = "on" then ProdInfo = ProdInfo & " " & "Par-Baked" End If If Request.Form("Shelf-Stable") = "on" then ProdInfo = ProdInfo & " " & "Shelf-Stable" End If Dim Mailer, Body, errorlog Set Mailer = Server.CreateObject("SMTPsvg.Mailer") Mailer.RemoteHost = "mail.imsarc.com" Mailer.FromName = Request.Form("Name") Mailer.FromAddress = Request.Form("Email") 'Mailer.AddRecipient "Sanjay", "sanjay@imsarc.com" Mailer.AddRecipient "Charlie's Specialties", "jthier@bkcompany.com" Mailer.Subject = "Charlie's Specialties Request for Product Information" Body= Now & vbnewline & vbnewline Body=Body & "From: " & Request.Form("Name") & vbnewline Body=Body & "Title: " & Request.Form("Title") & vbnewline Body=Body & "Company: " & Request.Form("Company") & vbnewline Body=Body & "Street: " & Request.Form("Street") & vbnewline Body=Body & "City: " & Request.Form("City") & vbnewline Body=Body & "State: " & Request.Form("State") & vbnewline Body=Body & "Zip: " & Request.Form("Zip") & vbnewline Body=Body & "Phone: " & Request.Form("Phone") & vbnewline Body=Body & "Fax: " & Request.Form("Fax") & vbnewline Body=Body & "Email: " & Request.Form("Email") & vbnewline Body=Body & "Web Site: " & Request.Form("Web") & vbnewline & vbnewline Body=Body & "Product Interest: " & ProdInfo & vbnewline Body=Body & "Type Business: " & Request.Form("Business") & vbnewline Body=Body & "Food Service: " & Request.Form("Service") & vbnewline Body=Body & "Retail Bakery: " & Request.Form("Retail") & vbnewline Body=Body & "Intermediate Wholesale Baker: " & Request.Form("Baker") & vbnewline Body=Body & "Distibutor/Dealer: " & Request.Form("Dealer") & vbnewline Body=Body & "Other Dealer: " & Request.Form("DealerOther") & vbnewline Body=Body & "Frozen: " & Request.Form("Frozen") & vbnewline & vbnewline Body=Body & "TaxID Number: " & Request.Form("Tax") & vbnewline Body=Body & "Title: " & Request.Form("TitleSpec") & vbnewline Body=Body & "Location: " & Request.Form("Location") & vbnewline Body=Body & "Number Of Units Operated: " & Request.Form("Units") & vbnewline Body=Body & "Annual Dollar Volume: " & Request.Form("Volume") & vbnewline Mailer.BodyText= Body if Mailer.SendMail= true then errorlog="" congrats else errorlog="Sorry, there was an error sending your email." end if else show_form end if %> <%sub show_form%> New Page 1
Please complete the form to receive more information about Charlie's Specialties products. * notes required information
*Name:
Title:
*Company:
*Street:
*City:
*State:
*Zip:
*Phone:
*Fax:
*Email:
Web Site:
 
*Product Interest:
Frozen Shelf-Stable
Par-Baked
 
Type Of Business:
Food Service:
Retail Bakery:
Intermediate Wholesale Baker: Yes No
Distributor/Dealer: Yes No
Other:
Are You Able Receive And
Store Frozen Products?		 Yes No
 
Tax ID Number:
Description Of Your Title
Location
Number Of Units Operated
Annual Dollar Volume
 
Charlie's Specialties, Inc.
2500 Freedland Road
Hermitage, PA 16148
724-346-2350
724-346-1110 FAX
 
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<% end sub%> <%sub congrats%> New Page 1
<%if errorlog <> "" then%> <%=Errorlog%> <%else%> Congratulations, your email was successfully sent! <%end if%>
<%end sub%>