NY Wellness Guide Contact Us Form

New

New York Wellness Calendar
	View NY Events Add Your Event

Contact Form

<% IF request.Form("submitform")<>"yes" THEN %>

Name:
Email:
Website:
Location:

Feedback Type:
I want to advertise
I want to contribute
I want to add/change listings
Interested in design services
Website Comments
Suggestions
Other: Explain below

Description/Comments:

<% ELSE %> Thank you for sending the following information:

Name: <%=Request.Form("userName")%>
Email: <%=Request.Form("email")%>
Website: <%=Request.Form("website")%>
Location: <%=Request.Form("location")%>
Feedback Type: <%=Request.Form("feedbacktype")%>
Comments: <%=Request.Form("moreAboutYou")%>
<% IF Request.Form("understand")="Yes" THEN Response.Write"" ELSE Response.Write"

" END IF Response.Write"Thank you, your comments are greatly appreciated." Set MyCDONTSMail = CreateObject("CDONTS.NewMail") MyCDONTSMail.From= "info@nywellnessguide.com" ' ****************************************************** ' change the email address below to whoever you want the email to go to ' ****************************************************** MyCDONTSMail.To= "info@nywellnessguide.com" MyCDONTSMail.Subject="NY Wellness Guide Contact Form" MyBody = Request.Form("userName") & " has sent an email." & vbCrLf MyBody = MyBody & "Email: " & Request.Form("email") & vbCrLf MyBody = MyBody & "Website: " & Request.Form("website") & vbCrLf MyBody = MyBody & "Location: " & Request.Form("location") & vbCrLf MyBody = MyBody & "Feedback: " & Request.Form("feedbacktype") & vbCrLf MyBody = MyBody & "Comments: " & Request.Form("moreAboutYou") & vbCrLf IF Request.Form("understand")="Yes" THEN MyBody = MyBody & "" & vbCrLf ELSE MyBody = MyBody & "" & vbCrLf END IF MyCDONTSMail.Body= MyBody MyCDONTSMail.Send set MyCDONTSMail=nothing END IF %>

If you have problems viewing this page, you can email us at:
info at nywellnessguide.com (replace at with @).