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<% Dim FirstName, LastName, EmailAddress, message, strMsg, contact_email, Zip if(Request("actionType") = "Submit") then FirstName = Request("FirstName") LastName = Request("LastName") EmailAddress = Request("EmailAddress") SPM_AddNewUser "GSC_bmrinsurance", SPM_SqlEsc(FirstName), SPM_SqlEsc(LastName), SPM_SqlEsc(Request("City")), SPM_SqlEsc(Request("State")), SPM_SqlEsc(EmailAddress), SPM_SqlEsc(Request("Zip")), SPM_SqlEsc("Y") SaveContactInfo() EmailInfo "forms@bmrins.com", "BMR Insurance Website Contact" EmailInfo EmailAddress, "A Copy of Your BMR Insurance Website Contact" strMsg = "Your Message Has Been Successfully Sent" Response.Redirect "thank_you.asp?FirstName=" & Server.URLEncode(FirstName) & "&LastName=" & Server.URLEncode(LastName) end if function SaveContactInfo() Dim strSql strSql = "insert into contact (" & _ "FirstName, " & _ "LastName, " & _ "EmailAddress, " & _ "PhoneNumber, " & _ "Interests, " & _ "PreferredContactMethod, " & _ "PreferredContactTime, " & _ "Message) values (" & _ SPM_SqlEsc(Request("FirstName")) &", " & _ SPM_SqlEsc(Request("LastName")) &", " & _ SPM_SqlEsc(Request("EmailAddress")) &", " & _ SPM_SqlEsc(Request("PhoneNumber")) &", " & _ SPM_SqlEsc(Request("Interests")) &", " & _ SPM_SqlEsc(Request("preferredContactMethod")) &", " & _ SPM_SqlEsc(Request("preferredContactTime")) &", " & _ SPM_SqlEsc(Request("Message")) &") " Set conn = Server.CreateObject("ADODB.Connection") conn.Open DB_CONNECTION conn.Execute strSQL, lngRecs, 1 conn.Close() set conn = nothing end function function EmailInfo(byval toEmail, byval subject) dim strBody, strSubject, strFrom, strFromName, strTo, strAttachFilename, oEmailHelper, strCC, strBCC set oEmailHelper = new clsEmailHelper strFromName = FirstName & " " & LastName strFrom = EmailAddress strTo = toEmail strAttachFilename = "" strSubject = subject strCC = "" strBCC = "" strBody = "" strBody = strBody & "--------------------------------------------------------------------------------------------------------------"& vbCrLF strBody = strBody & "First Name: " & Request("FirstName") & vbCrLF strBody = strBody & "Last Name: " & Request("LastName") & vbCrLF strBody = strBody & "Email Address: " & Request("EmailAddress") & vbCrLF strBody = strBody & "Phone: " & Request("PhoneNumber") & vbCrLF strBody = strBody & "I am Interested In: " & Request("Interests") & vbCrLF strBody = strBody & "Preferred Contact Method: " & Request("preferredContactMethod") & vbCrLF strBody = strBody & "Preferred Contact Time: " & Request("preferredContactTime") & vbCrLF strBody = strBody & "Message: " & Request("Message") & vbCrLF strBody = strBody & vbCrLF & vbCrLF '(byval strFrom, byval strFromName, byval strTo, byval strSubject, byval strBody, byval strAttachFilename, byval bccAddress, byval bccName, byval ccAddress, byval ccName) oEmailHelper.SendMailImp strFrom, strFromName, strTo, strSubject, strBody, strAttachFilename, "", "" end function %> Contact Us | BMR Insurance
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Thank you for your interest in BMR Insurance Agency services. We make a personal commitment to ensure the highest quality of each customer interaction, and are dedicated to providing value to our customers though the services we offer. If you have questions or comments, please feel free to contact us. We appreciate the opportunity to serve you.

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