Brindley Beach Vacations & Sales (190) -- Brindley Beach Rentals (11)

Visual Data Systems

manage - Brindley Beach Property Management Form

FormID: 782 AccountID: 11

MOBILE LEGACY Contents for config-manage.php file:
<?php $AccountID = 11; $formid = 782; $pageTitle = 'Request Brindley Beach Outer Banks Property Management Package '; $pageHeader = 'Request our Management Package '; $introText = '<p>We would like the opportunity to provide you our management package. Please fill in the form below, select the <strong>Submit</strong> button, and we will get back to you shortly. </p>'; $contactblock = "<li><label for='FirstName' class='inline'>First Name:</label> <input id='FirstName' type='text' required='required' placeholder='Required' name='FirstName' value='".(($_POST['FirstName'] <> "") ? htmlentities(stripslashes($_POST['FirstName']), ENT_QUOTES) : "")."' /></li> <li><label for='LastName' class='inline'>Last Name:</label> <input id='LastName' type='text' required='required' placeholder='Required' name='LastName' value='".(($_POST['LastName'] <> "") ? htmlentities(stripslashes($_POST['LastName']), ENT_QUOTES) : "")."' /></li> <li><label for='Email' class='inline'>Email:</label> <input id='email' type='email' required='required' placeholder='Required' name='Email' value='".(($_POST['Email'] <> "") ? htmlentities(stripslashes($_POST['Email']), ENT_QUOTES) : "")."' /></li> <li><label for='Phone' class='inline'>Phone:</label> <input id='tel' type='tel' required='required' placeholder='Required' name='Phone' value='".(($_POST['Phone'] <> "") ? htmlentities(stripslashes($_POST['Phone']), ENT_QUOTES) : "")."' /></li> <li><label for='Phone2' class='inline'>Alternate Phone:</label> <input id='tel' type='tel' name='Phone2' value='".(($_POST['Phone2'] <> "") ? htmlentities(stripslashes($_POST['Phone2']), ENT_QUOTES) : "")."' /></li> <li><label for='Address1' class='inline'>Address 1:</label> <input id='Address1' type='text' required='required' placeholder='Required' name='Address1' value='".(($_POST['Address1'] <> "") ? htmlentities(stripslashes($_POST['Address1']), ENT_QUOTES) : "")."' /></li> <li><label for='Address2' class='inline'>Address 2:</label> <input id='Address2' type='text' name='Address2' value='".(($_POST['Address2'] <> "") ? htmlentities(stripslashes($_POST['Address2']), ENT_QUOTES) : "")."' /></li> <li><label for='City' class='inline'>City:</label> <input id='City' type='text' required='required' placeholder='Required' name='City' value='".(($_POST['City'] <> "") ? htmlentities(stripslashes($_POST['City']), ENT_QUOTES) : "")."' /></li> <li><label for=\'State\'>State:</label><select name='State' size='1'><option value='' SELECTED>[State]</option><option value='ZZ'".(($_POST['State'] == 'ZZ') ? "selected" : "").">International</option><option value='AL'".(($_POST['State'] == 'AL') ? "selected" : "").">AL-Alabama</option><option value='AK'".(($_POST['State'] == 'AK') ? "selected" : "").">AK-Alaska</option><option value='AZ'".(($_POST['State'] == 'AZ') ? "selected" : "").">AZ-Arizona</option><option value='AR'".(($_POST['State'] == 'AR') ? "selected" : "").">AR-Arkansas</option><option value='CA'".(($_POST['State'] == 'CA') ? "selected" : "").">CA-California</option><option value='CO'".(($_POST['State'] == 'CO') ? "selected" : "").">CO-Colorado</option><option value='CT'".(($_POST['State'] == 'CT') ? "selected" : "").">CT-Connecticut</option><option value='DC'".(($_POST['State'] == 'DC') ? "selected" : "").">DC-Washington D.C.</option><option value='DE'".(($_POST['State'] == 'DE') ? "selected" : "").">DE-Delaware</option><option value='FL'".(($_POST['State'] == 'FL') ? "selected" : "").">FL-Florida</option><option value='GA'".(($_POST['State'] == 'GA') ? "selected" : "").">GA-Georgia</option><option value='HI'".(($_POST['State'] == 'HI') ? "selected" : "").">HI-Hawaii</option><option value='ID'".(($_POST['State'] == 'ID') ? "selected" : "").">ID-Idaho</option><option value='IL'".(($_POST['State'] == 'IL') ? "selected" : "").">IL-Illinois</option><option value='IN'".(($_POST['State'] == 'IN') ? "selected" : "").">IN-Indiana</option><option value='IA'".(($_POST['State'] == 'IA') ? "selected" : "").">IA-Iowa</option><option value='KS'".(($_POST['State'] == 'KS') ? "selected" : "").">KS-Kansas</option><option value='KY'".(($_POST['State'] == 'KY') ? "selected" : "").">KY-Kentucky</option><option value='LA'".(($_POST['State'] == 'LA') ? "selected" : "").">LA-Louisiana</option><option value='ME'".(($_POST['State'] == 'ME') ? "selected" : "").">ME-Maine</option><option value='MD'".(($_POST['State'] == 'MD') ? "selected" : "").">MD-Maryland</option><option value='MA'".(($_POST['State'] == 'MA') ? "selected" : "").">MA-Massachusetts</option><option value='MI'".(($_POST['State'] == 'MI') ? "selected" : "").">MI-Michigan</option><option value='MN'".(($_POST['State'] == 'MN') ? "selected" : "").">MN-Minnesota</option><option value='MS'".(($_POST['State'] == 'MS') ? "selected" : "").">MS-Mississippi</option><option value='MO'".(($_POST['State'] == 'MO') ? "selected" : "").">MO-Missouri</option><option value='MT'".(($_POST['State'] == 'MT') ? "selected" : "").">MT-Montana</option><option value='NE'".(($_POST['State'] == 'NE') ? "selected" : "").">NE-Nebraska</option><option value='NV'".(($_POST['State'] == 'NV') ? "selected" : "").">NV-Nevada</option><option value='NH'".(($_POST['State'] == 'NH') ? "selected" : "").">NH-New Hampshire</option><option value='NJ'".(($_POST['State'] == 'NJ') ? "selected" : "").">NJ-New Jersey</option><option value='NM'".(($_POST['State'] == 'NM') ? "selected" : "").">NM-New Mexico</option><option value='NY'".(($_POST['State'] == 'NY') ? "selected" : "").">NY-New York</option><option value='NC'".(($_POST['State'] == 'NC') ? "selected" : "").">NC-North Carolina</option><option value='ND'".(($_POST['State'] == 'ND') ? "selected" : "").">ND-North Dakota</option><option value='OH'".(($_POST['State'] == 'OH') ? "selected" : "").">OH-Ohio</option><option value='OK'".(($_POST['State'] == 'OK') ? "selected" : "").">OK-Oklahoma</option><option value='OR'".(($_POST['State'] == 'OR') ? "selected" : "").">OR-Oregon</option><option value='PA'".(($_POST['State'] == 'PA') ? "selected" : "").">PA-Pennsylvania</option><option value='PR'".(($_POST['State'] == 'PR') ? "selected" : "").">PR-Puerto Rico</option><option value='RI'".(($_POST['State'] == 'RI') ? "selected" : "").">RI-Rhode Island</option><option value='SC'".(($_POST['State'] == 'SC') ? "selected" : "").">SC-South Carolina</option><option value='SD'".(($_POST['State'] == 'SD') ? "selected" : "").">SD-South Dakota</option><option value='TN'".(($_POST['State'] == 'TN') ? "selected" : "").">TN-Tennessee</option><option value='TX'".(($_POST['State'] == 'TX') ? "selected" : "").">TX-Texas</option><option value='UT'".(($_POST['State'] == 'UT') ? "selected" : "").">UT-Utah</option><option value='VT'".(($_POST['State'] == 'VT') ? "selected" : "").">VT-Vermont</option><option value='VA'".(($_POST['State'] == 'VA') ? "selected" : "").">VA-Virginia</option><option value='WA'".(($_POST['State'] == 'WA') ? "selected" : "").">WA-Washington</option><option value='WV'".(($_POST['State'] == 'WV') ? "selected" : "").">WV-West Virginia</option><option value='WI'".(($_POST['State'] == 'WI') ? "selected" : "").">WI-Wisconsin</option><option value='WY'".(($_POST['State'] == 'WY') ? "selected" : "").">WY-Wyoming</option></select></li> <li><label for='Zip' class='inline'>Zip:</label> <input id='Zip' type='text' required='required' placeholder='Required' name='Zip' value='".(($_POST['Zip'] <> "") ? htmlentities(stripslashes($_POST['Zip']), ENT_QUOTES) : "")."' /></li> <li><label for=\'Country\'>Country:</label><select name='Country' size='1'><option value='' SELECTED>[Country]</option><option value='United States'".(($_POST['Country'] == 'United States') ? "selected" : "").">United States</option><option value='Canada'".(($_POST['Country'] == 'Canada') ? "selected" : "").">Canada</option><option value='Afghanistan'".(($_POST['Country'] == 'Afghanistan') ? "selected" : "").">Afghanistan</option><option value='Albania'".(($_POST['Country'] == 'Albania') ? "selected" : "").">Albania</option><option value='Algeria'".(($_POST['Country'] == 'Algeria') ? "selected" : "").">Algeria</option><option value='American Samoa'".(($_POST['Country'] == 'American Samoa') ? "selected" : "").">American Samoa</option><option value='Andorra'".(($_POST['Country'] == 'Andorra') ? "selected" : "").">Andorra</option><option value='Angola'".(($_POST['Country'] == 'Angola') ? "selected" : "").">Angola</option><option value='Anguilla'".(($_POST['Country'] == 'Anguilla') ? "selected" : "").">Anguilla</option><option value='Antarctica'".(($_POST['Country'] == 'Antarctica') ? "selected" : "").">Antarctica</option><option value='Antigua And Barbuda'".(($_POST['Country'] == 'Antigua And Barbuda') ? "selected" : "").">Antigua And Barbuda</option><option value='Argentina'".(($_POST['Country'] == 'Argentina') ? "selected" : "").">Argentina</option><option value='Armenia'".(($_POST['Country'] == 'Armenia') ? "selected" : "").">Armenia</option><option value='Aruba'".(($_POST['Country'] == 'Aruba') ? "selected" : "").">Aruba</option><option value='Australia'".(($_POST['Country'] == 'Australia') ? "selected" : "").">Australia</option><option value='Austria'".(($_POST['Country'] == 'Austria') ? "selected" : "").">Austria</option><option value='Azerbaijan'".(($_POST['Country'] == 'Azerbaijan') ? "selected" : "").">Azerbaijan</option><option value='Bahamas'".(($_POST['Country'] == 'Bahamas') ? "selected" : "").">Bahamas</option><option value='Bahrain'".(($_POST['Country'] == 'Bahrain') ? "selected" : "").">Bahrain</option><option value='Bangladesh'".(($_POST['Country'] == 'Bangladesh') ? "selected" : "").">Bangladesh</option><option value='Barbados'".(($_POST['Country'] == 'Barbados') ? "selected" : "").">Barbados</option><option value='Belarus'".(($_POST['Country'] == 'Belarus') ? "selected" : "").">Belarus</option><option value='Belgium'".(($_POST['Country'] == 'Belgium') ? "selected" : "").">Belgium</option><option value='Belize'".(($_POST['Country'] == 'Belize') ? "selected" : "").">Belize</option><option value='Benin'".(($_POST['Country'] == 'Benin') ? "selected" : "").">Benin</option><option value='Bermuda'".(($_POST['Country'] == 'Bermuda') ? "selected" : "").">Bermuda</option><option value='Bhutan'".(($_POST['Country'] == 'Bhutan') ? "selected" : "").">Bhutan</option><option value='Bolivia'".(($_POST['Country'] == 'Bolivia') ? "selected" : "").">Bolivia</option><option value='Bosnia And Herzegowina'".(($_POST['Country'] == 'Bosnia And Herzegowina') ? "selected" : "").">Bosnia And Herzegowina</option><option value='Botswana'".(($_POST['Country'] == 'Botswana') ? "selected" : "").">Botswana</option><option value='Bouvet Island'".(($_POST['Country'] == 'Bouvet Island') ? "selected" : "").">Bouvet Island</option><option value='Brazil'".(($_POST['Country'] == 'Brazil') ? "selected" : "").">Brazil</option><option value='British Indian Ocean Territory'".(($_POST['Country'] == 'British Indian Ocean Territory') ? "selected" : "").">British Indian Ocean Territory</option><option value='Brunei Darussalam'".(($_POST['Country'] == 'Brunei Darussalam') ? "selected" : "").">Brunei Darussalam</option><option value='Bulgaria'".(($_POST['Country'] == 'Bulgaria') ? "selected" : "").">Bulgaria</option><option value='Burkina Faso'".(($_POST['Country'] == 'Burkina Faso') ? "selected" : "").">Burkina Faso</option><option value='Burundi'".(($_POST['Country'] == 'Burundi') ? "selected" : "").">Burundi</option><option value='Cambodia'".(($_POST['Country'] == 'Cambodia') ? "selected" : "").">Cambodia</option><option value='Cameroon'".(($_POST['Country'] == 'Cameroon') ? "selected" : "").">Cameroon</option><option value='Canada'".(($_POST['Country'] == 'Canada') ? "selected" : "").">Canada</option><option value='Cape Verde'".(($_POST['Country'] == 'Cape Verde') ? "selected" : "").">Cape Verde</option><option value='Cayman Islands'".(($_POST['Country'] == 'Cayman Islands') ? "selected" : "").">Cayman Islands</option><option value='Central African Republic'".(($_POST['Country'] == 'Central African Republic') ? "selected" : "").">Central African Republic</option><option value='Chad'".(($_POST['Country'] == 'Chad') ? "selected" : "").">Chad</option><option value='Chile'".(($_POST['Country'] == 'Chile') ? "selected" : "").">Chile</option><option value='China'".(($_POST['Country'] == 'China') ? "selected" : "").">China</option><option value='Christmas Island'".(($_POST['Country'] == 'Christmas Island') ? "selected" : "").">Christmas Island</option><option value='Cocos (Keeling) Islands'".(($_POST['Country'] == 'Cocos (Keeling) Islands') ? "selected" : "").">Cocos (Keeling) Islands</option><option value='Colombia'".(($_POST['Country'] == 'Colombia') ? "selected" : "").">Colombia</option><option value='Comoros'".(($_POST['Country'] == 'Comoros') ? "selected" : "").">Comoros</option><option value='Congo'".(($_POST['Country'] == 'Congo') ? "selected" : "").">Congo</option><option value='Cook Islands'".(($_POST['Country'] == 'Cook Islands') ? "selected" : "").">Cook Islands</option><option value='Costa Rica'".(($_POST['Country'] == 'Costa Rica') ? "selected" : "").">Costa Rica</option><option value='Cote D\'Ivoire'".(($_POST['Country'] == 'Cote D\'Ivoire') ? "selected" : "").">Cote D\'Ivoire</option><option value='Croatia'".(($_POST['Country'] == 'Croatia') ? "selected" : "").">Croatia</option><option value='Cuba'".(($_POST['Country'] == 'Cuba') ? "selected" : "").">Cuba</option><option value='Cyprus'".(($_POST['Country'] == 'Cyprus') ? "selected" : "").">Cyprus</option><option value='Czech Republic'".(($_POST['Country'] == 'Czech Republic') ? "selected" : "").">Czech Republic</option><option value='Denmark'".(($_POST['Country'] == 'Denmark') ? "selected" : "").">Denmark</option><option value='Djibouti'".(($_POST['Country'] == 'Djibouti') ? "selected" : "").">Djibouti</option><option value='Dominica'".(($_POST['Country'] == 'Dominica') ? "selected" : "").">Dominica</option><option value='Dominican Republic'".(($_POST['Country'] == 'Dominican Republic') ? "selected" : "").">Dominican Republic</option><option value='East Timor'".(($_POST['Country'] == 'East Timor') ? "selected" : "").">East Timor</option><option value='Ecuador'".(($_POST['Country'] == 'Ecuador') ? "selected" : "").">Ecuador</option><option value='Egypt'".(($_POST['Country'] == 'Egypt') ? "selected" : "").">Egypt</option><option value='El Salvador'".(($_POST['Country'] == 'El Salvador') ? "selected" : "").">El Salvador</option><option value='Equatorial Guinea'".(($_POST['Country'] == 'Equatorial Guinea') ? "selected" : "").">Equatorial Guinea</option><option value='Eritrea'".(($_POST['Country'] == 'Eritrea') ? "selected" : "").">Eritrea</option><option value='Estonia'".(($_POST['Country'] == 'Estonia') ? "selected" : "").">Estonia</option><option value='Ethiopia'".(($_POST['Country'] == 'Ethiopia') ? "selected" : "").">Ethiopia</option><option value='Falkland Islands'".(($_POST['Country'] == 'Falkland Islands') ? "selected" : "").">Falkland Islands</option><option value='Faroe Islands'".(($_POST['Country'] == 'Faroe Islands') ? "selected" : "").">Faroe Islands</option><option value='Fiji'".(($_POST['Country'] == 'Fiji') ? "selected" : "").">Fiji</option><option value='Finland'".(($_POST['Country'] == 'Finland') ? "selected" : "").">Finland</option><option value='France'".(($_POST['Country'] == 'France') ? "selected" : "").">France</option><option value='France, Metropolitan'".(($_POST['Country'] == 'France, Metropolitan') ? "selected" : "").">France, Metropolitan</option><option value='French Guiana'".(($_POST['Country'] == 'French Guiana') ? "selected" : "").">French Guiana</option><option value='French Polynesia'".(($_POST['Country'] == 'French Polynesia') ? "selected" : "").">French Polynesia</option><option value='French Southern Territories'".(($_POST['Country'] == 'French Southern Territories') ? "selected" : "").">French Southern Territories</option><option value='Gabon'".(($_POST['Country'] == 'Gabon') ? "selected" : "").">Gabon</option><option value='Gambia'".(($_POST['Country'] == 'Gambia') ? "selected" : "").">Gambia</option><option value='Georgia'".(($_POST['Country'] == 'Georgia') ? "selected" : "").">Georgia</option><option value='Germany'".(($_POST['Country'] == 'Germany') ? "selected" : "").">Germany</option><option value='Ghana'".(($_POST['Country'] == 'Ghana') ? "selected" : "").">Ghana</option><option value='Gibraltar'".(($_POST['Country'] == 'Gibraltar') ? "selected" : "").">Gibraltar</option><option value='Greece'".(($_POST['Country'] == 'Greece') ? "selected" : "").">Greece</option><option value='Greenland'".(($_POST['Country'] == 'Greenland') ? "selected" : "").">Greenland</option><option value='Grenada'".(($_POST['Country'] == 'Grenada') ? "selected" : "").">Grenada</option><option value='Guadeloupe'".(($_POST['Country'] == 'Guadeloupe') ? "selected" : "").">Guadeloupe</option><option value='Guam'".(($_POST['Country'] == 'Guam') ? "selected" : "").">Guam</option><option value='Guatemala'".(($_POST['Country'] == 'Guatemala') ? "selected" : "").">Guatemala</option><option value='Guinea'".(($_POST['Country'] == 'Guinea') ? "selected" : "").">Guinea</option><option value='Guinea-Bissau'".(($_POST['Country'] == 'Guinea-Bissau') ? "selected" : "").">Guinea-Bissau</option><option value='Guyana'".(($_POST['Country'] == 'Guyana') ? "selected" : "").">Guyana</option><option value='Haiti'".(($_POST['Country'] == 'Haiti') ? "selected" : "").">Haiti</option><option value='Heard And Mc Donald Islands'".(($_POST['Country'] == 'Heard And Mc Donald Islands') ? "selected" : "").">Heard And Mc Donald Islands</option><option value='Honduras'".(($_POST['Country'] == 'Honduras') ? "selected" : "").">Honduras</option><option value='Hong Kong'".(($_POST['Country'] == 'Hong Kong') ? "selected" : "").">Hong Kong</option><option value='Hungary'".(($_POST['Country'] == 'Hungary') ? "selected" : "").">Hungary</option><option value='Iceland'".(($_POST['Country'] == 'Iceland') ? "selected" : "").">Iceland</option><option value='India'".(($_POST['Country'] == 'India') ? "selected" : "").">India</option><option value='Indonesia'".(($_POST['Country'] == 'Indonesia') ? "selected" : "").">Indonesia</option><option value='Iran'".(($_POST['Country'] == 'Iran') ? "selected" : "").">Iran</option><option value='Iraq'".(($_POST['Country'] == 'Iraq') ? "selected" : "").">Iraq</option><option value='Ireland'".(($_POST['Country'] == 'Ireland') ? "selected" : "").">Ireland</option><option value='Israel'".(($_POST['Country'] == 'Israel') ? "selected" : "").">Israel</option><option value='Italy'".(($_POST['Country'] == 'Italy') ? "selected" : "").">Italy</option><option value='Jamaica'".(($_POST['Country'] == 'Jamaica') ? "selected" : "").">Jamaica</option><option value='Japan'".(($_POST['Country'] == 'Japan') ? "selected" : "").">Japan</option><option value='Jordan'".(($_POST['Country'] == 'Jordan') ? "selected" : "").">Jordan</option><option value='Kazakhstan'".(($_POST['Country'] == 'Kazakhstan') ? "selected" : "").">Kazakhstan</option><option value='Kenya'".(($_POST['Country'] == 'Kenya') ? "selected" : "").">Kenya</option><option value='Kiribati'".(($_POST['Country'] == 'Kiribati') ? "selected" : "").">Kiribati</option><option value='North Korea (People\'s Republic Of Korea)'".(($_POST['Country'] == 'North Korea (People\'s Republic Of Korea)') ? "selected" : "").">North Korea (People\'s Republic Of Korea)</option><option value='South Korea (Republic Of Korea)'".(($_POST['Country'] == 'South Korea (Republic Of Korea)') ? "selected" : "").">South Korea (Republic Of Korea)</option><option value='Kuwait'".(($_POST['Country'] == 'Kuwait') ? "selected" : "").">Kuwait</option><option value='Kyrgyzstan'".(($_POST['Country'] == 'Kyrgyzstan') ? "selected" : "").">Kyrgyzstan</option><option value='Lao People\'s Republic'".(($_POST['Country'] == 'Lao People\'s Republic') ? "selected" : "").">Lao People\'s Republic</option><option value='Latvia'".(($_POST['Country'] == 'Latvia') ? "selected" : "").">Latvia</option><option value='Lebanon'".(($_POST['Country'] == 'Lebanon') ? "selected" : "").">Lebanon</option><option value='Lesotho'".(($_POST['Country'] == 'Lesotho') ? "selected" : "").">Lesotho</option><option value='Liberia'".(($_POST['Country'] == 'Liberia') ? "selected" : "").">Liberia</option><option value='Libyan Arab Jamahiriya'".(($_POST['Country'] == 'Libyan Arab Jamahiriya') ? "selected" : "").">Libyan Arab Jamahiriya</option><option value='Liechtenstein'".(($_POST['Country'] == 'Liechtenstein') ? "selected" : "").">Liechtenstein</option><option value='Lithuania'".(($_POST['Country'] == 'Lithuania') ? "selected" : "").">Lithuania</option><option value='Luxembourg'".(($_POST['Country'] == 'Luxembourg') ? "selected" : "").">Luxembourg</option><option value='Macau'".(($_POST['Country'] == 'Macau') ? "selected" : "").">Macau</option><option value='Macedonia'".(($_POST['Country'] == 'Macedonia') ? "selected" : "").">Macedonia</option><option value='Madagascar'".(($_POST['Country'] == 'Madagascar') ? "selected" : "").">Madagascar</option><option value='Malawi'".(($_POST['Country'] == 'Malawi') ? "selected" : "").">Malawi</option><option value='Malaysia'".(($_POST['Country'] == 'Malaysia') ? "selected" : "").">Malaysia</option><option value='Maldives'".(($_POST['Country'] == 'Maldives') ? "selected" : "").">Maldives</option><option value='Mali'".(($_POST['Country'] == 'Mali') ? "selected" : "").">Mali</option><option value='Malta'".(($_POST['Country'] == 'Malta') ? "selected" : "").">Malta</option><option value='Marshall Islands'".(($_POST['Country'] == 'Marshall Islands') ? "selected" : "").">Marshall Islands</option><option value='Martinique'".(($_POST['Country'] == 'Martinique') ? "selected" : "").">Martinique</option><option value='Mauritania'".(($_POST['Country'] == 'Mauritania') ? "selected" : "").">Mauritania</option><option value='Mauritius'".(($_POST['Country'] == 'Mauritius') ? "selected" : "").">Mauritius</option><option value='Mayotte'".(($_POST['Country'] == 'Mayotte') ? "selected" : "").">Mayotte</option><option value='Mexico'".(($_POST['Country'] == 'Mexico') ? "selected" : "").">Mexico</option><option value='Micronesia'".(($_POST['Country'] == 'Micronesia') ? "selected" : "").">Micronesia</option><option value='Moldova'".(($_POST['Country'] == 'Moldova') ? "selected" : "").">Moldova</option><option value='Monaco'".(($_POST['Country'] == 'Monaco') ? "selected" : "").">Monaco</option><option value='Mongolia'".(($_POST['Country'] == 'Mongolia') ? "selected" : "").">Mongolia</option><option value='Montserrat'".(($_POST['Country'] == 'Montserrat') ? "selected" : "").">Montserrat</option><option value='Morocco'".(($_POST['Country'] == 'Morocco') ? "selected" : "").">Morocco</option><option value='Mozambique'".(($_POST['Country'] == 'Mozambique') ? "selected" : "").">Mozambique</option><option value='Myanmar'".(($_POST['Country'] == 'Myanmar') ? "selected" : "").">Myanmar</option><option value='Namibia'".(($_POST['Country'] == 'Namibia') ? "selected" : "").">Namibia</option><option value='Nauru'".(($_POST['Country'] == 'Nauru') ? "selected" : "").">Nauru</option><option value='Nepal'".(($_POST['Country'] == 'Nepal') ? "selected" : "").">Nepal</option><option value='Netherlands'".(($_POST['Country'] == 'Netherlands') ? "selected" : "").">Netherlands</option><option value='Netherlands Antilles'".(($_POST['Country'] == 'Netherlands Antilles') ? "selected" : "").">Netherlands Antilles</option><option value='New Caledonia'".(($_POST['Country'] == 'New Caledonia') ? "selected" : "").">New Caledonia</option><option value='New Zealand'".(($_POST['Country'] == 'New Zealand') ? "selected" : "").">New Zealand</option><option value='Nicaragua'".(($_POST['Country'] == 'Nicaragua') ? "selected" : "").">Nicaragua</option><option value='Niger'".(($_POST['Country'] == 'Niger') ? "selected" : "").">Niger</option><option value='Nigeria'".(($_POST['Country'] == 'Nigeria') ? "selected" : "").">Nigeria</option><option value='Niue'".(($_POST['Country'] == 'Niue') ? "selected" : "").">Niue</option><option value='Norfolk Island'".(($_POST['Country'] == 'Norfolk Island') ? "selected" : "").">Norfolk Island</option><option value='Northern Mariana Islands'".(($_POST['Country'] == 'Northern Mariana Islands') ? "selected" : "").">Northern Mariana Islands</option><option value='Norway'".(($_POST['Country'] == 'Norway') ? "selected" : "").">Norway</option><option value='Oman'".(($_POST['Country'] == 'Oman') ? "selected" : "").">Oman</option><option value='Pakistan'".(($_POST['Country'] == 'Pakistan') ? "selected" : "").">Pakistan</option><option value='Palau'".(($_POST['Country'] == 'Palau') ? "selected" : "").">Palau</option><option value='Panama'".(($_POST['Country'] == 'Panama') ? "selected" : "").">Panama</option><option value='Papua New Guinea'".(($_POST['Country'] == 'Papua New Guinea') ? "selected" : "").">Papua New Guinea</option><option value='Paraguay'".(($_POST['Country'] == 'Paraguay') ? "selected" : "").">Paraguay</option><option value='Peru'".(($_POST['Country'] == 'Peru') ? "selected" : "").">Peru</option><option value='Philippines'".(($_POST['Country'] == 'Philippines') ? "selected" : "").">Philippines</option><option value='Pitcairn'".(($_POST['Country'] == 'Pitcairn') ? "selected" : "").">Pitcairn</option><option value='Poland'".(($_POST['Country'] == 'Poland') ? "selected" : "").">Poland</option><option value='Portugal'".(($_POST['Country'] == 'Portugal') ? "selected" : "").">Portugal</option><option value='Puerto Rico'".(($_POST['Country'] == 'Puerto Rico') ? "selected" : "").">Puerto Rico</option><option value='Qatar'".(($_POST['Country'] == 'Qatar') ? "selected" : "").">Qatar</option><option value='Reunion'".(($_POST['Country'] == 'Reunion') ? "selected" : "").">Reunion</option><option value='Romania'".(($_POST['Country'] == 'Romania') ? "selected" : "").">Romania</option><option value='Russian Federation'".(($_POST['Country'] == 'Russian Federation') ? "selected" : "").">Russian Federation</option><option value='Rwanda'".(($_POST['Country'] == 'Rwanda') ? "selected" : "").">Rwanda</option><option value='Saint Kitts And Nevis'".(($_POST['Country'] == 'Saint Kitts And Nevis') ? "selected" : "").">Saint Kitts And Nevis</option><option value='Saint Lucia'".(($_POST['Country'] == 'Saint Lucia') ? "selected" : "").">Saint Lucia</option><option value='Saint Vincent And The Grenadines'".(($_POST['Country'] == 'Saint Vincent And The Grenadines') ? "selected" : "").">Saint Vincent And The Grenadines</option><option value='Samoa'".(($_POST['Country'] == 'Samoa') ? "selected" : "").">Samoa</option><option value='San Marino'".(($_POST['Country'] == 'San Marino') ? "selected" : "").">San Marino</option><option value='Sao Tome And Principe'".(($_POST['Country'] == 'Sao Tome And Principe') ? "selected" : "").">Sao Tome And Principe</option><option value='Saudi Arabia'".(($_POST['Country'] == 'Saudi Arabia') ? "selected" : "").">Saudi Arabia</option><option value='Senegal'".(($_POST['Country'] == 'Senegal') ? "selected" : "").">Senegal</option><option value='Seychelles'".(($_POST['Country'] == 'Seychelles') ? "selected" : "").">Seychelles</option><option value='Sierra Leone'".(($_POST['Country'] == 'Sierra Leone') ? "selected" : "").">Sierra Leone</option><option value='Singapore'".(($_POST['Country'] == 'Singapore') ? "selected" : "").">Singapore</option><option value='Slovakia'".(($_POST['Country'] == 'Slovakia') ? "selected" : "").">Slovakia</option><option value='Slovenia'".(($_POST['Country'] == 'Slovenia') ? "selected" : "").">Slovenia</option><option value='Solomon Islands'".(($_POST['Country'] == 'Solomon Islands') ? "selected" : "").">Solomon Islands</option><option value='Somalia'".(($_POST['Country'] == 'Somalia') ? "selected" : "").">Somalia</option><option value='South Africa'".(($_POST['Country'] == 'South Africa') ? "selected" : "").">South Africa</option><option value='South Georgia And The South Sandwich Islands'".(($_POST['Country'] == 'South Georgia And The South Sandwich Islands') ? "selected" : "").">South Georgia And The South Sandwich Islands</option><option value='Spain'".(($_POST['Country'] == 'Spain') ? "selected" : "").">Spain</option><option value='Sri Lanka'".(($_POST['Country'] == 'Sri Lanka') ? "selected" : "").">Sri Lanka</option><option value='St Helena'".(($_POST['Country'] == 'St Helena') ? "selected" : "").">St Helena</option><option value='St Pierre and Miquelon'".(($_POST['Country'] == 'St Pierre and Miquelon') ? "selected" : "").">St Pierre and Miquelon</option><option value='Sudan'".(($_POST['Country'] == 'Sudan') ? "selected" : "").">Sudan</option><option value='Suriname'".(($_POST['Country'] == 'Suriname') ? "selected" : "").">Suriname</option><option value='Svalbard And Jan Mayen Islands'".(($_POST['Country'] == 'Svalbard And Jan Mayen Islands') ? "selected" : "").">Svalbard And Jan Mayen Islands</option><option value='Swaziland'".(($_POST['Country'] == 'Swaziland') ? "selected" : "").">Swaziland</option><option value='Sweden'".(($_POST['Country'] == 'Sweden') ? "selected" : "").">Sweden</option><option value='Switzerland'".(($_POST['Country'] == 'Switzerland') ? "selected" : "").">Switzerland</option><option value='Syrian Arab Republic'".(($_POST['Country'] == 'Syrian Arab Republic') ? "selected" : "").">Syrian Arab Republic</option><option value='Taiwan'".(($_POST['Country'] == 'Taiwan') ? "selected" : "").">Taiwan</option><option value='Tajikistan'".(($_POST['Country'] == 'Tajikistan') ? "selected" : "").">Tajikistan</option><option value='Tanzania'".(($_POST['Country'] == 'Tanzania') ? "selected" : "").">Tanzania</option><option value='Thailand'".(($_POST['Country'] == 'Thailand') ? "selected" : "").">Thailand</option><option value='Togo'".(($_POST['Country'] == 'Togo') ? "selected" : "").">Togo</option><option value='Tokelau'".(($_POST['Country'] == 'Tokelau') ? "selected" : "").">Tokelau</option><option value='Tonga'".(($_POST['Country'] == 'Tonga') ? "selected" : "").">Tonga</option><option value='Trinidad And Tobago'".(($_POST['Country'] == 'Trinidad And Tobago') ? "selected" : "").">Trinidad And Tobago</option><option value='Tunisia'".(($_POST['Country'] == 'Tunisia') ? "selected" : "").">Tunisia</option><option value='Turkey'".(($_POST['Country'] == 'Turkey') ? "selected" : "").">Turkey</option><option value='Turkmenistan'".(($_POST['Country'] == 'Turkmenistan') ? "selected" : "").">Turkmenistan</option><option value='Turks And Caicos Islands'".(($_POST['Country'] == 'Turks And Caicos Islands') ? "selected" : "").">Turks And Caicos Islands</option><option value='Tuvalu'".(($_POST['Country'] == 'Tuvalu') ? "selected" : "").">Tuvalu</option><option value='Uganda'".(($_POST['Country'] == 'Uganda') ? "selected" : "").">Uganda</option><option value='Ukraine'".(($_POST['Country'] == 'Ukraine') ? "selected" : "").">Ukraine</option><option value='United Arab Emirates'".(($_POST['Country'] == 'United Arab Emirates') ? "selected" : "").">United Arab Emirates</option><option value='United Kingdom'".(($_POST['Country'] == 'United Kingdom') ? "selected" : "").">United Kingdom</option><option value='United States'".(($_POST['Country'] == 'United States') ? "selected" : "").">United States</option><option value='United States Minor Outlying Islands'".(($_POST['Country'] == 'United States Minor Outlying Islands') ? "selected" : "").">United States Minor Outlying Islands</option><option value='Uruguay'".(($_POST['Country'] == 'Uruguay') ? "selected" : "").">Uruguay</option><option value='Uzbekistan'".(($_POST['Country'] == 'Uzbekistan') ? "selected" : "").">Uzbekistan</option><option value='Vanuatu'".(($_POST['Country'] == 'Vanuatu') ? "selected" : "").">Vanuatu</option><option value='Vatican City State'".(($_POST['Country'] == 'Vatican City State') ? "selected" : "").">Vatican City State</option><option value='Venezuela'".(($_POST['Country'] == 'Venezuela') ? "selected" : "").">Venezuela</option><option value='Viet Nam'".(($_POST['Country'] == 'Viet Nam') ? "selected" : "").">Viet Nam</option><option value='Virgin Islands (British)'".(($_POST['Country'] == 'Virgin Islands (British)') ? "selected" : "").">Virgin Islands (British)</option><option value='Virgin Islands (U.S.)'".(($_POST['Country'] == 'Virgin Islands (U.S.)') ? "selected" : "").">Virgin Islands (U.S.)</option><option value='Wallis And Futuna Islands'".(($_POST['Country'] == 'Wallis And Futuna Islands') ? "selected" : "").">Wallis And Futuna Islands</option><option value='Western Sahara'".(($_POST['Country'] == 'Western Sahara') ? "selected" : "").">Western Sahara</option><option value='Yemen'".(($_POST['Country'] == 'Yemen') ? "selected" : "").">Yemen</option><option value='Zaire'".(($_POST['Country'] == 'Zaire') ? "selected" : "").">Zaire</option><option value='Zambia'".(($_POST['Country'] == 'Zambia') ? "selected" : "").">Zambia</option><option value='Zimbabwe'".(($_POST['Country'] == 'Zimbabwe') ? "selected" : "").">Zimbabwe</option><option value='Other - Not Shown'".(($_POST['Country'] == 'Other - Not Shown') ? "selected" : "").">Other - Not Shown</option></select></li> "; $questionblock = "<li><label for='MAID:0000000001'>How did you find us?</label><select class='item' name='MAID:0000000001' size='1'><option value='0000000001' ".(($_POST['MAID:0000000001'] == '0000000001') ? "selected":"").">--Select One--</option><option value='0000000002' ".(($_POST['MAID:0000000001'] == '0000000002') ? "selected":"").">Property Manager</option><option value='0000000003' ".(($_POST['MAID:0000000001'] == '0000000003') ? "selected":"").">Another Homeowner</option><option value='0000041682' ".(($_POST['MAID:0000000001'] == '0000041682') ? "selected":"").">Direct Mail Flyer</option><option value='0000041683' ".(($_POST['MAID:0000000001'] == '0000041683') ? "selected":"").">Internet Search Engine</option><option value='0000041689' ".(($_POST['MAID:0000000001'] == '0000041689') ? "selected":"").">Other</option></select></li> <li><label for='MAID:0000004803' class='oneline'>Do you currently own this property?</label><br/></li><li><input type='radio' class=clear name='MAID:0000004803' value='0000052843' />Yes </li><li><input type='radio' class=clear name='MAID:0000004803' value='0000052844' />No </li><li><input type='radio' class=clear name='MAID:0000004803' value='0000052845' />Under Contract to Purchase </li> <li><label for='MAID:0000004804' class='oneline'>Property Street Address: </label><input type='text' required='required' placeholder='Required' class='oneline' name='TEXT:0000004804' value='".(($_POST['TEXT:0000004804'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000004804']), ENT_QUOTES) : '')."' /></li> <li><label for='MAID:0000004805' class='oneline'>Subdivision: </label><input type='text' required='required' placeholder='Required' class='oneline' name='TEXT:0000004805' value='".(($_POST['TEXT:0000004805'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000004805']), ENT_QUOTES) : '')."' /></li> <li><label for='MAID:0000004806'>Location to Beach: </label><select class='item' name='MAID:0000004806' size='1'><option value='0000052848' ".(($_POST['MAID:0000004806'] == '0000052848') ? "selected":"").">-select one-</option><option value='0000052849' ".(($_POST['MAID:0000004806'] == '0000052849') ? "selected":"").">Oceanfront</option><option value='0000052850' ".(($_POST['MAID:0000004806'] == '0000052850') ? "selected":"").">Semi-Oceanfront</option><option value='0000052851' ".(($_POST['MAID:0000004806'] == '0000052851') ? "selected":"").">Oceanside</option><option value='0000052852' ".(($_POST['MAID:0000004806'] == '0000052852') ? "selected":"").">Soundside</option><option value='0000052853' ".(($_POST['MAID:0000004806'] == '0000052853') ? "selected":"").">Soundfront</option></select></li> <li><label for='MAID:0000004807'>Number of Bedrooms:</label><select class='item' name='MAID:0000004807' size='1'><option value='0000052854' ".(($_POST['MAID:0000004807'] == '0000052854') ? "selected":"").">-select one-</option><option value='0000052855' ".(($_POST['MAID:0000004807'] == '0000052855') ? "selected":"").">1</option><option value='0000052856' ".(($_POST['MAID:0000004807'] == '0000052856') ? "selected":"").">2</option><option value='0000052857' ".(($_POST['MAID:0000004807'] == '0000052857') ? "selected":"").">3</option><option value='0000052858' ".(($_POST['MAID:0000004807'] == '0000052858') ? "selected":"").">4</option><option value='0000052859' ".(($_POST['MAID:0000004807'] == '0000052859') ? "selected":"").">5</option><option value='0000052860' ".(($_POST['MAID:0000004807'] == '0000052860') ? "selected":"").">6</option><option value='0000052861' ".(($_POST['MAID:0000004807'] == '0000052861') ? "selected":"").">7</option><option value='0000052862' ".(($_POST['MAID:0000004807'] == '0000052862') ? "selected":"").">8</option><option value='0000052863' ".(($_POST['MAID:0000004807'] == '0000052863') ? "selected":"").">9</option><option value='0000052864' ".(($_POST['MAID:0000004807'] == '0000052864') ? "selected":"").">10</option><option value='0000052865' ".(($_POST['MAID:0000004807'] == '0000052865') ? "selected":"").">11</option><option value='0000052866' ".(($_POST['MAID:0000004807'] == '0000052866') ? "selected":"").">12</option><option value='0000052867' ".(($_POST['MAID:0000004807'] == '0000052867') ? "selected":"").">13</option><option value='0000052868' ".(($_POST['MAID:0000004807'] == '0000052868') ? "selected":"").">14</option><option value='0000052869' ".(($_POST['MAID:0000004807'] == '0000052869') ? "selected":"").">15</option><option value='0000052870' ".(($_POST['MAID:0000004807'] == '0000052870') ? "selected":"").">16</option><option value='0000052871' ".(($_POST['MAID:0000004807'] == '0000052871') ? "selected":"").">17</option><option value='0000052872' ".(($_POST['MAID:0000004807'] == '0000052872') ? "selected":"").">18</option><option value='0000052873' ".(($_POST['MAID:0000004807'] == '0000052873') ? "selected":"").">19</option><option value='0000052874' ".(($_POST['MAID:0000004807'] == '0000052874') ? "selected":"").">20</option></select></li> <li><label for='MAID:0000004808'>Number of Bathrooms:</label><select class='item' name='MAID:0000004808' size='1'><option value='0000052875' ".(($_POST['MAID:0000004808'] == '0000052875') ? "selected":"").">-select one-</option><option value='0000052876' ".(($_POST['MAID:0000004808'] == '0000052876') ? "selected":"").">1</option><option value='0000052877' ".(($_POST['MAID:0000004808'] == '0000052877') ? "selected":"").">2</option><option value='0000052878' ".(($_POST['MAID:0000004808'] == '0000052878') ? "selected":"").">3</option><option value='0000052879' ".(($_POST['MAID:0000004808'] == '0000052879') ? "selected":"").">4</option><option value='0000052880' ".(($_POST['MAID:0000004808'] == '0000052880') ? "selected":"").">5</option><option value='0000052881' ".(($_POST['MAID:0000004808'] == '0000052881') ? "selected":"").">6</option><option value='0000052882' ".(($_POST['MAID:0000004808'] == '0000052882') ? "selected":"").">7</option><option value='0000052883' ".(($_POST['MAID:0000004808'] == '0000052883') ? "selected":"").">8</option><option value='0000052884' ".(($_POST['MAID:0000004808'] == '0000052884') ? "selected":"").">9</option><option value='0000052885' ".(($_POST['MAID:0000004808'] == '0000052885') ? "selected":"").">10</option><option value='0000052886' ".(($_POST['MAID:0000004808'] == '0000052886') ? "selected":"").">11</option><option value='0000052887' ".(($_POST['MAID:0000004808'] == '0000052887') ? "selected":"").">12</option><option value='0000052888' ".(($_POST['MAID:0000004808'] == '0000052888') ? "selected":"").">13</option><option value='0000052889' ".(($_POST['MAID:0000004808'] == '0000052889') ? "selected":"").">14</option><option value='0000052890' ".(($_POST['MAID:0000004808'] == '0000052890') ? "selected":"").">15</option><option value='0000052891' ".(($_POST['MAID:0000004808'] == '0000052891') ? "selected":"").">16</option><option value='0000052892' ".(($_POST['MAID:0000004808'] == '0000052892') ? "selected":"").">17</option><option value='0000052893' ".(($_POST['MAID:0000004808'] == '0000052893') ? "selected":"").">18</option><option value='0000052894' ".(($_POST['MAID:0000004808'] == '0000052894') ? "selected":"").">19</option><option value='0000052895' ".(($_POST['MAID:0000004808'] == '0000052895') ? "selected":"").">20</option></select></li> <li><label for='MAID:0000004809'>Number of Master Bedrooms, have private attached bathroom:</label><select class='item' name='MAID:0000004809' size='1'><option value='0000052896' ".(($_POST['MAID:0000004809'] == '0000052896') ? "selected":"").">-select one-</option><option value='0000052897' ".(($_POST['MAID:0000004809'] == '0000052897') ? "selected":"").">1</option><option value='0000052898' ".(($_POST['MAID:0000004809'] == '0000052898') ? "selected":"").">2</option><option value='0000052899' ".(($_POST['MAID:0000004809'] == '0000052899') ? "selected":"").">3</option><option value='0000052900' ".(($_POST['MAID:0000004809'] == '0000052900') ? "selected":"").">4</option><option value='0000052901' ".(($_POST['MAID:0000004809'] == '0000052901') ? "selected":"").">5</option><option value='0000052902' ".(($_POST['MAID:0000004809'] == '0000052902') ? "selected":"").">6</option><option value='0000052903' ".(($_POST['MAID:0000004809'] == '0000052903') ? "selected":"").">7</option><option value='0000052904' ".(($_POST['MAID:0000004809'] == '0000052904') ? "selected":"").">8</option><option value='0000052905' ".(($_POST['MAID:0000004809'] == '0000052905') ? "selected":"").">9</option><option value='0000052906' ".(($_POST['MAID:0000004809'] == '0000052906') ? "selected":"").">10</option><option value='0000052907' ".(($_POST['MAID:0000004809'] == '0000052907') ? "selected":"").">11</option><option value='0000052908' ".(($_POST['MAID:0000004809'] == '0000052908') ? "selected":"").">12</option><option value='0000052909' ".(($_POST['MAID:0000004809'] == '0000052909') ? "selected":"").">13</option><option value='0000052910' ".(($_POST['MAID:0000004809'] == '0000052910') ? "selected":"").">14</option><option value='0000052911' ".(($_POST['MAID:0000004809'] == '0000052911') ? "selected":"").">15</option><option value='0000052912' ".(($_POST['MAID:0000004809'] == '0000052912') ? "selected":"").">16</option><option value='0000052913' ".(($_POST['MAID:0000004809'] == '0000052913') ? "selected":"").">17</option><option value='0000052914' ".(($_POST['MAID:0000004809'] == '0000052914') ? "selected":"").">18</option><option value='0000052915' ".(($_POST['MAID:0000004809'] == '0000052915') ? "selected":"").">19</option><option value='0000052916' ".(($_POST['MAID:0000004809'] == '0000052916') ? "selected":"").">20</option></select></li> <li><label for='MAID:0000004810' class='oneline'>Private Pool:</label><br/></li><li><input type='radio' class=clear name='MAID:0000004810' value='0000052917' />Yes </li><li><input type='radio' class=clear name='MAID:0000004810' value='0000052918' />No </li> <li><label for='MAID:0000004811' class='oneline'>Hot Tub: </label><br/></li><li><input type='radio' class=clear name='MAID:0000004811' value='0000052919' />Yes </li><li><input type='radio' class=clear name='MAID:0000004811' value='0000052920' />No </li> <li><label for='MAID:0000004812' class='oneline'>Recroom:</label><br/></li><li><input type='radio' class=clear name='MAID:0000004812' value='0000052921' />Yes </li><li><input type='radio' class=clear name='MAID:0000004812' value='0000052922' />No </li> <li><label for='MAID:0000004813' class='oneline'>Theater Room: </label><br/></li><li><input type='radio' class=clear name='MAID:0000004813' value='0000052923' />Yes </li><li><input type='radio' class=clear name='MAID:0000004813' value='0000052924' />No </li> <li><label for='MAID:0000004814' class='oneline'>Elevator: </label><br/></li><li><input type='radio' class=clear name='MAID:0000004814' value='0000052925' />Yes </li><li><input type='radio' class=clear name='MAID:0000004814' value='0000052926' />No </li> <li><label for='MAID:0000004815' class='oneline'>Pets Welcome:</label><br/></li><li><input type='radio' class=clear name='MAID:0000004815' value='0000052927' />Yes </li><li><input type='radio' class=clear name='MAID:0000004815' value='0000052928' />No </li> <li><label for='MAID:0000004816'>Property Type:</label><select class='item' name='MAID:0000004816' size='1'><option value='0000052929' ".(($_POST['MAID:0000004816'] == '0000052929') ? "selected":"").">-select one-</option><option value='0000052930' ".(($_POST['MAID:0000004816'] == '0000052930') ? "selected":"").">Existing Rental Property</option><option value='0000052931' ".(($_POST['MAID:0000004816'] == '0000052931') ? "selected":"").">Not Currently Rented</option><option value='0000052932' ".(($_POST['MAID:0000004816'] == '0000052932') ? "selected":"").">New Construction</option></select></li> <li><label for='MAID:0000004817' class='oneline'>Is your home currently listed with a Rental Management Company?</label><br/></li><li><input type='radio' class=clear name='MAID:0000004817' value='0000052933' />Yes </li><li><input type='radio' class=clear name='MAID:0000004817' value='0000052934' />No </li> <li><label for='MAID:0000004818' class='oneline'>If yes, please list the agency and your property's identifying number and name: </label><input type='text' class='oneline' name='TEXT:0000004818' value='".(($_POST['TEXT:0000004818'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000004818']), ENT_QUOTES) : '')."' /></li> <li><label for='MAID:0000004819' class='oneline'>Please let us know the best way and time to contact you: </label><input type='text' class='oneline' name='TEXT:0000004819' value='".(($_POST['TEXT:0000004819'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000004819']), ENT_QUOTES) : '')."' /></li> <li> <label for='TEXT:0000004820' class='oneline'>Questions and Comments:</label><textarea cols=60 rows=5 name='TEXT:0000004820'>".(($_POST['TEXT:0000004820'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000004820']), ENT_QUOTES) : htmlentities(stripslashes(""), ENT_QUOTES))."</textarea></li> "; $thanksTitle = 'Thank You for Requesting a Property Management Package'; $thanksHeader = 'Thanks for your time!'; $thanksText = '<P>Many thanks for contacting us. 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>';