<%@LANGUAGE="VBSCRIPT" CODEPAGE="1252"%> <% dim fname,lname,email dim recipAddress recipAddress="info@prokidscentral.com" if request.TotalBytes > 0 then school=request.Form("school") firstname=request.Form("firstname") lastname=request.Form("lastname") phone=request.Form("phone") fax=request.Form("fax") address=request.Form("address") city=request.Form("city") st=request.Form("st") zip=request.Form("zip") ad_type=request.Form("ad_type") email=request.Form("email") call_time=request.Form("call_time") comments=request.Form("comments") referral=request.Form("referral") info=request.Form("info") set MyCDONTSMail = CreateObject("CDONTS.NewMail") MyCDONTSMail.From= "contactform@prokidscentral.com" MyCDONTSMail.To= recipAddress MyCDONTSMail.Subject="ProKidsCentral.com Contact Form!" myBody=date & " " & time & vbcrlf myBody= mybody & "School: " & school & vbcrlf myBody = myBody & "First Name: " & firstname & vbcrlf myBody = myBody & "Last Name: " & lastname & vbcrlf myBody = myBody & "Phone: " & phone & vbcrlf myBody = myBody & "Fax: " & fax & vbcrlf myBody = myBody & "Address: " & address & vbcrlf myBody = myBody & "City: " & city & vbcrlf myBody = myBody & "State: " & st & vbcrlf myBody = myBody & "Zip: " & zip & vbcrlf myBody = myBody & "Address Type: " & ad_type & vbcrlf myBody = myBody & "Email: " & email & vbcrlf myBody = myBody & "Send Me Info: " & info & vbcrlf MyCDONTSMail.Body= MyBody MyCDONTSMail.Send set MyCDONTSMail=nothing response.Write("Thank you for your interest. One of our professionals will contact you shortly.") response.End() end if %>
   

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" method="post">
CONTACT INFORMATION:
   
School:
First Name:
Last Name:
Phone:
Fax:
Address:
City:
State, Zip:
,
Address Type:
Email:
   
ADDITIONAL INFORMATION
 
Best Time To Call:
   
Comments:
   
How Did You Hear About Us?
 
Yes! Please send me a free Pro-Kids Information Pack!
   
 
 




 


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