<% videorequest = "-over" refpage = request.querystring("refpage") %> <% if request.form <> "" then 'Get the referring page to set up navigation RefPage = request.querystring("refpage") if request.querystring("refpage") = "custserv" then HeaderFile = "custserv_r1_c2.gif" Cardtab = "home/home_r2_c6.gif" Custtab = "sub/cust_tab.gif" HtmlNav = " Apply For An Account  |  Equipment Programs  |  Tax Forms  |  Oil Sampling  |  MSDS
Technical Sheets  |  Card Requests  |   Video Surveillance  |  Service Request" StripeHeight = "37" else HeaderFile = "cardlock_r1_c2.gif" Cardtab = "sub/card_tab.gif" Custtab = "home/home_r2_c7.gif" StripeHeight = "37" HtmlNav = " Using the Card  |  Apply For An Account  |  New Card Request  |  Card Modifications
Video Surveillance" end if Dim Mailer Dim LetterInfo Name = request.form("name") Company = request.form("Company") Account =request.form("Account") Address = request.form("Address") City = request.form("City") Zip = request.form("Zip") State = request.form("State") Phone = request.form("Phone") Email = request.form("Email") LetterInfo = "Name: " & Name & vbcrlf _ & "Company: " & company & vbcrlf _ & "Account Number: " & account & vbcrlf _ & "Address: " & address & vbcrlf & city _ & ", " & state & " " & zip & vbcrlf & vbcrlf _ & "Phone: " & phone & vbcrlf _ & "Email: " & email & vbcrlf _ & "Date of Transaction: " & request.form("transdate") & vbcrlf _ & "Location of Transaction: " & request.form("translocation") & vbcrlf _ & "Pump Number: " & request.form("pump") & vbcrlf _ & "Invoice Number: " & request.form("invoice") & vbcrlf _ & "Comments: " & request.form("comments") Subject = "Brown Evans - Video Request" 'Send email%%%%%%%% ' Set objMail = CreateObject("CDONTS.NewMail") ' if email = "" then email = "none" ' objMail.From = email ' objMail.To = "ron@mammothmedia.com" ' objMail.Subject = Subject ' objMail.Body = Letterinfo ' objMail.Send ' Set objMail = Nothing Set Mailer = Server.CreateObject("SMTPsvg.Mailer") toAddress = "videoreq@brownevans.com" myto="videoreq" if Contact = "" then Contact = "Contact Request" if email = "" then email = "mark@brownevans.com" Mailer.FromName = Contact Mailer.FromAddress = email Mailer.RemoteHost = "smtp.brownevans.com" Mailer.AddRecipient myto,toAddress Mailer.Subject = Subject Mailer.BodyText = LetterInfo If Mailer.SendMail then Msg = "mail sent sucessfully!" Else Msg = "mail not sent sucessfully" msg = msg & "
" & mailer.response End If LetterInfo = Msg & "

" & LetterInfo set mailer=nothing 'Send email%%%%%%%% LetterInfo = replace(LetterInfo,vbCrLf,"
") PageContent = "You have submitted the following information:

" & LetterInfo & "

To submit another video request, fill the form out below:

" state = lcase(state) end if %> <% select case lcase(refpage) %> <%case "lubricants"%> <%case "fuel"%> <%case "cardlock"%> <%case "custservice"%> <% case else %> <% end select %>
 Video Tape Request
<%= PageContent %>

By requesting a video tape record/picture of your transaction, a pictorial of your transaction can be viewed and is helpful to ensure it is your vehicle and employee fueling. Please complete the form below with as much information as possible. We will confirm your request by an email receipt and contact you when the tape has been retrieved and is available for viewing.

Company: Name:
Account Number:
Address:
City: State:
Zip:
Phone: Email:
Date of Transaction: Location Of Transaction:
Card Number: Time of Transaction:
Pump Number: Invoice Number:
Additional Comments: