RVA, Resort Vacations (362) -- RVA - SWFL Regional Smart Captur (261)

Visual Data Systems

referral - RVA - SWFL Referral Form

FormID: 446 AccountID: 261

RESPONSIVE config-referral.php file:
<?php $arHandlebarView["template"] = "form-whatever"; if ($useThanks!=true) { $arHandlebarView["headerText"] = 'Contact Us For More Information'; $arHandlebarView["descriptionText"] = $reqmessage.'<p>To help us service you efficiently, please provide the following information.</p>'; $arHandlebarForm["hiddenSection"][] = array("name"=>"FormID","value"=>"0000000446"); $arHandlebarForm["hiddenSection"][] = array("name"=>"AID","value"=>"0000000261"); $arHandlebarForm["hiddenSection"][] = array("name"=>"ref","value"=>$_REQUEST['ref']); $arHandlebarForm["hiddenSection"][] = array("name"=>"ET","value"=>$_REQUEST['ET']); $arHandlebarForm["hiddenSection"][] = array("name"=>"FT","value"=>$_REQUEST['FT']); if ($_REQUEST['PID']<>"") $_REQUEST['Num']=$_REQUEST['PID']; if ($_REQUEST['Num']<>"") $arHandlebarForm["hiddenSection"][] = array("name"=>"PID","value"=>$_REQUEST['Num']); $arContactSection["FirstName"] = array("type"=>"input","required"=>1,"label"=>" First Name:","name"=>"FirstName","id"=>"FirstName","maxlength"=>24,"value"=>$_REQUEST["FirstName"]); $arContactSection["LastName"] = array("type"=>"input","required"=>1,"label"=>" Last Name:","name"=>"LastName","id"=>"LastName","maxlength"=>32,"value"=>$_REQUEST["LastName"]); $arContactSection["Email"] = array("type"=>"input","required"=>1,"label"=>" Email:","name"=>"Email","id"=>"Email","maxlength"=>64,"value"=>$_REQUEST["Email"]); $arContactSection["Phone"] = array("type"=>"input","required"=>1,"label"=>" Phone:","name"=>"Phone","id"=>"Phone","maxlength"=>16,"value"=>$_REQUEST["Phone"]); $arContactSection["Address1"] = array("type"=>"input","required"=>0,"label"=>" Address1:","name"=>"Address1","id"=>"Address1","maxlength"=>48,"value"=>$_REQUEST["Address1"]); $arContactSection["City"] = array("type"=>"input","required"=>0,"label"=>" City:","name"=>"City","id"=>"City","maxlength"=>24,"value"=>$_REQUEST["City"]); $arContactSection["State"] = array("type"=>"select","required"=>0,"label"=>" State:","name"=>"State","id"=>"State","data"=>array( array("value"=>"","label"=>"State/Province"),array("value"=>"AL","label"=>"Alabama","selected"=>(($URL_State=="AL")?1:0)),array("value"=>"AK","label"=>"Alaska","selected"=>(($URL_State=="AK")?1:0)),array("value"=>"AZ","label"=>"Arizona","selected"=>(($URL_State=="AZ")?1:0)),array("value"=>"AR","label"=>"Arkansas","selected"=>(($URL_State=="AR")?1:0)),array("value"=>"CA","label"=>"California","selected"=>(($URL_State=="CA")?1:0)),array("value"=>"CO","label"=>"Colorado","selected"=>(($URL_State=="CO")?1:0)),array("value"=>"CT","label"=>"Connecticut","selected"=>(($URL_State=="CT")?1:0)),array("value"=>"DE","label"=>"Delaware","selected"=>(($URL_State=="DE")?1:0)),array("value"=>"DC","label"=>"Dist. of Columbia","selected"=>(($URL_State=="DC")?1:0)),array("value"=>"FL","label"=>"Florida","selected"=>(($URL_State=="FL")?1:0)),array("value"=>"GA","label"=>"Georgia","selected"=>(($URL_State=="GA")?1:0)),array("value"=>"HI","label"=>"Hawaii","selected"=>(($URL_State=="HI")?1:0)),array("value"=>"ID","label"=>"Idaho","selected"=>(($URL_State=="ID")?1:0)),array("value"=>"IL","label"=>"Illinois","selected"=>(($URL_State=="IL")?1:0)),array("value"=>"IN","label"=>"Indiana","selected"=>(($URL_State=="IN")?1:0)),array("value"=>"IA","label"=>"Iowa","selected"=>(($URL_State=="IA")?1:0)),array("value"=>"KS","label"=>"Kansas","selected"=>(($URL_State=="KS")?1:0)),array("value"=>"KY","label"=>"Kentucky","selected"=>(($URL_State=="KY")?1:0)),array("value"=>"LA","label"=>"Louisiana","selected"=>(($URL_State=="LA")?1:0)),array("value"=>"ME","label"=>"Maine","selected"=>(($URL_State=="ME")?1:0)),array("value"=>"MD","label"=>"Maryland","selected"=>(($URL_State=="MD")?1:0)),array("value"=>"MA","label"=>"Massachusetts","selected"=>(($URL_State=="MA")?1:0)),array("value"=>"MI","label"=>"Michigan","selected"=>(($URL_State=="MI")?1:0)),array("value"=>"MN","label"=>"Minnesota","selected"=>(($URL_State=="MN")?1:0)),array("value"=>"MS","label"=>"Mississippi","selected"=>(($URL_State=="MS")?1:0)),array("value"=>"MO","label"=>"Missouri","selected"=>(($URL_State=="MO")?1:0)),array("value"=>"MT","label"=>"Montana","selected"=>(($URL_State=="MT")?1:0)),array("value"=>"NE","label"=>"Nebraska","selected"=>(($URL_State=="NE")?1:0)),array("value"=>"NV","label"=>"Nevada","selected"=>(($URL_State=="NV")?1:0)),array("value"=>"NH","label"=>"New Hampshire","selected"=>(($URL_State=="NH")?1:0)),array("value"=>"NJ","label"=>"New Jersey","selected"=>(($URL_State=="NJ")?1:0)),array("value"=>"NM","label"=>"New Mexico","selected"=>(($URL_State=="NM")?1:0)),array("value"=>"NY","label"=>"New York","selected"=>(($URL_State=="NY")?1:0)),array("value"=>"NC","label"=>"North Carolina","selected"=>(($URL_State=="NC")?1:0)),array("value"=>"ND","label"=>"North Dakota","selected"=>(($URL_State=="ND")?1:0)),array("value"=>"OH","label"=>"Ohio","selected"=>(($URL_State=="OH")?1:0)),array("value"=>"OK","label"=>"Oklahoma","selected"=>(($URL_State=="OK")?1:0)),array("value"=>"OR","label"=>"Oregon","selected"=>(($URL_State=="OR")?1:0)),array("value"=>"PA","label"=>"Pennsylvania","selected"=>(($URL_State=="PA")?1:0)),array("value"=>"RI","label"=>"Rhode Island","selected"=>(($URL_State=="RI")?1:0)),array("value"=>"SC","label"=>"South Carolina","selected"=>(($URL_State=="SC")?1:0)),array("value"=>"SD","label"=>"South Dakota","selected"=>(($URL_State=="SD")?1:0)),array("value"=>"TN","label"=>"Tennessee","selected"=>(($URL_State=="TN")?1:0)),array("value"=>"TX","label"=>"Texas","selected"=>(($URL_State=="TX")?1:0)),array("value"=>"UT","label"=>"Utah","selected"=>(($URL_State=="UT")?1:0)),array("value"=>"VT","label"=>"Vermont","selected"=>(($URL_State=="VT")?1:0)),array("value"=>"VA","label"=>"Virginia","selected"=>(($URL_State=="VA")?1:0)),array("value"=>"WA","label"=>"Washington","selected"=>(($URL_State=="WA")?1:0)),array("value"=>"WV","label"=>"West Virginia","selected"=>(($URL_State=="WV")?1:0)),array("value"=>"WI","label"=>"Wisconsin","selected"=>(($URL_State=="WI")?1:0)),array("value"=>"WY","label"=>"Wyoming","selected"=>(($URL_State=="WY")?1:0)),array("value"=>"GU","label"=>"Guam","selected"=>(($URL_State=="GU")?1:0)),array("value"=>"PR","label"=>"Puerto Rico","selected"=>(($URL_State=="PR")?1:0)),array("value"=>"VI","label"=>"Virgin Island","selected"=>(($URL_State=="VI")?1:0)),array("value"=>"AB","label"=>"Alberta","selected"=>(($URL_State=="AB")?1:0)),array("value"=>"BC","label"=>"British Columbia","selected"=>(($URL_State=="BC")?1:0)),array("value"=>"MB","label"=>"Manitoba","selected"=>(($URL_State=="MB")?1:0)),array("value"=>"NB","label"=>"New Brunswick","selected"=>(($URL_State=="NB")?1:0)),array("value"=>"NF","label"=>"Newfoundland","selected"=>(($URL_State=="NF")?1:0)),array("value"=>"NT","label"=>"NW Territories","selected"=>(($URL_State=="NT")?1:0)),array("value"=>"NS","label"=>"Nova Scotia","selected"=>(($URL_State=="NS")?1:0)),array("value"=>"ON","label"=>"Ontario","selected"=>(($URL_State=="ON")?1:0)),array("value"=>"PE","label"=>"Prince Edward Isl","selected"=>(($URL_State=="PE")?1:0)),array("value"=>"QB","label"=>"Quebec","selected"=>(($URL_State=="QB")?1:0)),array("value"=>"SK","label"=>"Saskatchewan","selected"=>(($URL_State=="SK")?1:0)),array("value"=>"YT","label"=>"Yukon Territory","selected"=>(($URL_State=="YT")?1:0)) ) ); $arContactSection["Zip"] = array("type"=>"input","required"=>0,"label"=>" Zip:","name"=>"Zip","id"=>"Zip","maxlength"=>10,"value"=>$_REQUEST["Zip"]); $arHandlebarForm["contactSection"] = $arContactSection; $arQuestionSection["MAID:0000003044"] = array("select"=>1,"name"=>"MAID:0000003044","id"=>"MAID:0000003044","required"=>0,"label"=>"Your preferred method of communication:","data"=>array ( array('value'=>'0000044011','label'=>'-select one-'), array('value'=>'0000044012','label'=>'Email'), array('value'=>'0000044013','label'=>'Phone'))); $arQuestionSection["MAID:0000003021"] = array("checkbox"=>1,"name"=>"MAID:0000003021","id"=>"MAID:0000003021","required"=>0,"label"=>"What services are you interested in?","data"=>array ( array('name'=>'MAID:0000003021:0','value'=>'0000043932','label'=>'Buying','checked'=>(($_REQUEST["MAID:0000003021:0"]=="0000043932")?1:0)), array('name'=>'MAID:0000003021:1','value'=>'0000043933','label'=>'Selling','checked'=>(($_REQUEST["MAID:0000003021:1"]=="0000043933")?1:0)), array('name'=>'MAID:0000003021:2','value'=>'0000043934','label'=>'Renting','checked'=>(($_REQUEST["MAID:0000003021:2"]=="0000043934")?1:0)), array('name'=>'MAID:0000003021:3','value'=>'0000044435','label'=>'Prospective Homeowner','checked'=>(($_REQUEST["MAID:0000003021:3"]=="0000044435")?1:0)))); $arQuestionSection["TEXT:0000003022"] = array("input"=>1,"required"=>0,"label"=>"Desired Location:","name"=>"TEXT:0000003022","id"=>"TEXT:0000003022","maxlength"=>64,"value"=>$_REQUEST["TEXT:0000003022"]); $arQuestionSection["TEXT:0000003024"] = array("textarea"=>1,"required"=>0,"label"=>"Additional Comments:","name"=>"TEXT:0000003024","id"=>"TEXT:0000003024","value"=>$_REQUEST["TEXT:0000003024"]); $arQuestionSection["TEXT:0000003199"] = array("input"=>1,"required"=>0,"label"=>"Referring Agent","name"=>"TEXT:0000003199","id"=>"TEXT:0000003199","maxlength"=>64,"value"=>$_REQUEST["TEXT:0000003199"]); $arQuestionSection["TEXT:0000003258"] = array("input"=>1,"required"=>0,"label"=>"Agent Email:","name"=>"TEXT:0000003258","id"=>"TEXT:0000003258","maxlength"=>64,"value"=>$_REQUEST["TEXT:0000003258"]); $arQuestionSection["MAID:0000003210"] = array("select"=>1,"name"=>"MAID:0000003210","id"=>"MAID:0000003210","required"=>0,"label"=>"Inquiry Source","data"=>array ( array('value'=>'0000044682','label'=>'-select one-'), array('value'=>'0000044683','label'=>'Walk-in'), array('value'=>'0000044684','label'=>'Telephone'), array('value'=>'0000044685','label'=>'Email'), array('value'=>'0000044686','label'=>'Other'))); $arHandlebarForm["questionSection"] = $arQuestionSection; $arHandlebarView["form"] = array("name"=>"referral_form","id"=>"referral_form","action"=>"/contact/form_referral","method"=>"post","onsubmit"=>$formOnSubmit,"submitID"=>"submitform","fields"=>$arHandlebarForm); } else { $arHandlebarView["headerText"] = ' '; $arHandlebarView["descriptionText"] = '<P>Thank you for your inquiry. A service representative from RVA will respond to your inquiry within 24 hours.</p>'; $arHandlebarView["form"] = ''; }