RQ - NWFL Regional (337) -- RQ - NWFL Regional OptIn (293)

contact - RQ - NWFL Regional Contact Us

FormID: 651 AccountID: 293

RESPONSIVE config-contact.php file: <?php $arHandlebarView["template"] = "form-whatever"; if ($useThanks!=true) { $arHandlebarView["headerText"] = 'Contact Us for More Information'; $arHandlebarView["descriptionText"] = $reqmessage.'<p>We would like the opportunity to provide you with more information. Please fill in the form below, select the <strong>Submit</strong> button, and we will get back to you shortly.</p>'; $arHandlebarForm["hiddenSection"][] = array("name"=>"FormID","value"=>"0000000651"); $arHandlebarForm["hiddenSection"][] = array("name"=>"AID","value"=>"0000000293"); $arHandlebarForm["hiddenSection"][] = array("name"=>"ref","value"=>$_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']); $arContactSection["FirstName"] = array("type"=>"input","required"=>0,"label"=>" First Name:","name"=>"FirstName","id"=>"FirstName","maxlength"=>24,"value"=>$_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"]); $arContactSection["Phone"] = array("type"=>"input","required"=>0,"label"=>" Phone:","name"=>"Phone","id"=>"Phone","maxlength"=>16,"value"=>$_REQUEST["Phone"]); $arContactSection["Phone2"] = array("type"=>"input","required"=>0,"label"=>" Phone2:","name"=>"Phone2","id"=>"Phone2","maxlength"=>16,"value"=>$_REQUEST["Phone2"]); $arContactSection["Address1"] = array("type"=>"input","required"=>0,"label"=>" Address1:","name"=>"Address1","id"=>"Address1","maxlength"=>48,"value"=>$_REQUEST["Address1"]); $arContactSection["Address2"] = array("type"=>"input","required"=>0,"label"=>" Address2:","name"=>"Address2","id"=>"Address2","maxlength"=>48,"value"=>$_REQUEST["Address2"]); $arContactSection["City"] = 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Island","selected"=>(($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"]); $arContactSection["Country"] = array("type"=>"select","required"=>0,"label"=>" Country:","name"=>"Country","id"=>"Country","data"=>array( array("value"=>"","label"=>"Country"),array("value"=>"United States of America","label"=>"United States of America","selected"=>(($URL_Country=="United States of America")?1:0)),array("value"=>"Canada","label"=>"Canada","selected"=>(($URL_Country=="Canada")?1:0)),array("value"=>"United Kingdom","label"=>"United Kingdom","selected"=>(($URL_Country=="United Kingdom")?1:0)),array("value"=>"Afghanistan","label"=>"Afghanistan","selected"=>(($URL_Country=="Afghanistan")?1:0)),array("value"=>"Aland Islands","label"=>"Aland Islands","selected"=>(($URL_Country=="Aland 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A representative will be responding to your on-line request shortly. We appreciate your business and will do our best to serve your needs! </p>'; $arHandlebarView["form"] = ''; }

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