<%
' Website Contact Form Generator 
' http://www.tele-pro.co.uk/scripts/contact_form/ 
' This script is free to use as long as you  
' retain the credit link  

' declare variables
Dim EmailFrom
Dim EmailTo
Dim Subject
Dim Salutation
Dim FirstName
Dim LastName
Dim EmailAddress
Dim Address
Dim PostCode
Dim City
Dim State
Dim Tel
Dim HomeTel

' get posted data into variables
EmailFrom = "website@smilesofcarolina.com"
EmailTo = "appointment@smilesofcarolina.com"
Subject = "Appointment request from web site"
Salutation = Trim(Request.Form("Salutation")) 
FirstName = Trim(Request.Form("FirstName")) 
LastName = Trim(Request.Form("LastName")) 
EmailAddress = Trim(Request.Form("EmailAddress")) 
Address = Trim(Request.Form("Address")) 
PostCode = Trim(Request.Form("PostCode")) 
City = Trim(Request.Form("City")) 
State = Trim(Request.Form("State")) 
Tel = Trim(Request.Form("Tel")) 
HomeTel = Trim(Request.Form("HomeTel")) 

' validation
Dim validationOK
validationOK=true
If (validationOK=false) Then Response.Redirect("error.htm?" & EmailFrom)

' prepare email body text
Dim Body
Body = Body & "Salutation: " & Salutation & VbCrLf
Body = Body & "FirstName: " & FirstName & VbCrLf
Body = Body & "LastName: " & LastName & VbCrLf
Body = Body & "Address: " & Address & VbCrLf
Body = Body & "PostCode: " & PostCode & VbCrLf
Body = Body & "City: " & City & VbCrLf
Body = Body & "State: " & State & VbCrLf
Body = Body & "Tel: " & Tel & VbCrLf
Body = Body & "HomeTel: " & HomeTel & VbCrLf

' send email 
Dim mail
Set mail = Server.CreateObject("CDONTS.NewMail") 
mail.To = EmailTo
mail.From = EmailFrom
mail.Subject = Subject
mail.Body = Body
mail.Send 

' redirect to success page 
Response.Redirect("ok.htm?" & EmailFrom)
%>