Seaside Vacations (292) -- Seaside Brochure Requests (109)

Visual Data Systems

poolspa - Seaside Vacations Owner Services Pool and Spa Form Submission

FormID: 826 AccountID: 109

MOBILE LEGACY Contents for config-poolspa.php file:
<?php $AccountID = 109; $formid = 826; $pageTitle = 'Owner Services Pool and Spa Form'; $pageHeader = 'Owner Services Pool and Spa '; $introText = ''; $contactblock = "<li><label for='FirstName' class='inline'>First Name:</label> <input id='FirstName' type='text' required='required' placeholder='Required' name='FirstName' value='".(($_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($_POST['Email']), ENT_QUOTES) : "")."' /></li> <li><label for='Phone' class='inline'>Phone:</label> <input id='tel' type='tel' name='Phone' value='".(($_POST['Phone'] <> "") ? htmlentities(stripslashes($_POST['Phone']), ENT_QUOTES) : "")."' /></li> <li><label for='Address1' class='inline'>Address 1:</label> <input id='Address1' type='text' name='Address1' value='".(($_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($_POST['Address2']), ENT_QUOTES) : "")."' /></li> <li><label for='City' class='inline'>City:</label> <input id='City' type='text' name='City' value='".(($_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' name='Zip' value='".(($_POST['Zip'] <> "") ? htmlentities(stripslashes($_POST['Zip']), ENT_QUOTES) : "")."' /></li> <li><td colspan=2><table width=100%><tr><td colspan=3>Please indicate the methods by which we may contact you:</td></tr><tr><td><input type='checkbox' class=clear name='ApprovedContactEmail' value='1' ".(($_POST['ApprovedContactEmail'] == "1") ? "CHECKED" : "CHECKED")." />email</td><td><input type='checkbox' class=clear name='ApprovedContactPhone' value='1' ".(($_POST['ApprovedContactPhone'] == "1") ? "CHECKED" : "CHECKED")." />phone</td><td><input type='checkbox' class=clear name='ApprovedContactPost' value='1' ".(($_POST['ApprovedContactPost'] == "1") ? "CHECKED" : "CHECKED")." />post</td></tr></table></li> "; $questionblock = "<li><label for='MAID:0000005234' class='oneline'>Property Address</label><input type='text' class='oneline' name='TEXT:0000005234' value='".(($_POST['TEXT:0000005234'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000005234']), ENT_QUOTES) : '')."' /></li> <li><label for='MAID:0000005235' class='oneline'>Property City, State, Zip</label><input type='text' class='oneline' name='TEXT:0000005235' value='".(($_POST['TEXT:0000005235'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000005235']), ENT_QUOTES) : '')."' /></li> <li><label class='oneline checkfirst'> <input type='checkbox' class=clear name='MAID:0000005195' value='0000054372' CHECKED /> Email me specials and announcements.</label></li> <li><label for='MAID:0000005236'>Where is your home located? </label><select class='item' name='MAID:0000005236' size='1'><option value='0000054517' ".(($_POST['MAID:0000005236'] == '0000054517') ? "selected":"").">-select one-</option><option value='0000054518' ".(($_POST['MAID:0000005236'] == '0000054518') ? "selected":"").">Corolla</option><option value='0000054519' ".(($_POST['MAID:0000005236'] == '0000054519') ? "selected":"").">Duck</option><option value='0000054520' ".(($_POST['MAID:0000005236'] == '0000054520') ? "selected":"").">Southern Shores</option><option value='0000054521' ".(($_POST['MAID:0000005236'] == '0000054521') ? "selected":"").">Kitty Hawk</option><option value='0000054522' ".(($_POST['MAID:0000005236'] == '0000054522') ? "selected":"").">Kill Devil Hills</option><option value='0000054523' ".(($_POST['MAID:0000005236'] == '0000054523') ? "selected":"").">Nags Head</option></select></li> <li><label for='MAID:0000005237'>Does your home have </label><select class='item' name='MAID:0000005237' size='1'><option value='0000054524' ".(($_POST['MAID:0000005237'] == '0000054524') ? "selected":"").">-select one-</option><option value='0000054525' ".(($_POST['MAID:0000005237'] == '0000054525') ? "selected":"").">Pool</option><option value='0000054526' ".(($_POST['MAID:0000005237'] == '0000054526') ? "selected":"").">Spa</option><option value='0000054527' ".(($_POST['MAID:0000005237'] == '0000054527') ? "selected":"").">Both</option></select></li> <li><label for='MAID:0000005238' class='oneline'>Is your pool and/or spa new construction? </label><br/></li><li><input type='radio' class=clear name='MAID:0000005238' value='0000054528' />Yes </li><li><input type='radio' class=clear name='MAID:0000005238' value='0000054529' />No </li> <li><label for='MAID:0000005239' class='oneline'>Are you looking to have your pool or spa serviced by a company? </label><br/></li><li><input type='radio' class=clear name='MAID:0000005239' value='0000054530' />Yes </li><li><input type='radio' class=clear name='MAID:0000005239' value='0000054531' />No </li> <li><label for='MAID:0000005240' class='oneline'>Is your pool or spa currently maintained by a company? </label><br/></li><li><input type='radio' class=clear name='MAID:0000005240' value='0000054532' />Yes </li><li><input type='radio' class=clear name='MAID:0000005240' value='0000054533' />No </li> <li><label for='MAID:0000005241' class='oneline'>If you currently have a company servicing your pool or spa, are you considering a new company to work with? </label><br/></li><li><input type='radio' class=clear name='MAID:0000005241' value='0000054534' />Yes </li><li><input type='radio' class=clear name='MAID:0000005241' value='0000054535' />No </li> <li><label for='MAID:0000005243'>If you are considering different options for pool and spa service, what timeframe are you looking to make a change? </label><select class='item' name='MAID:0000005243' size='1'><option value='0000054538' ".(($_POST['MAID:0000005243'] == '0000054538') ? "selected":"").">-select one-</option><option value='0000054539' ".(($_POST['MAID:0000005243'] == '0000054539') ? "selected":"").">In the next 30 days</option><option value='0000054540' ".(($_POST['MAID:0000005243'] == '0000054540') ? "selected":"").">1-3 months</option><option value='0000054541' ".(($_POST['MAID:0000005243'] == '0000054541') ? "selected":"").">3-6 months</option><option value='0000054542' ".(($_POST['MAID:0000005243'] == '0000054542') ? "selected":"").">6-9 months</option><option value='0000054543' ".(($_POST['MAID:0000005243'] == '0000054543') ? "selected":"").">9-12 months</option><option value='0000054544' ".(($_POST['MAID:0000005243'] == '0000054544') ? "selected":"").">More than a year</option></select></li> "; $thanksTitle = 'Thank You'; $thanksHeader = 'Thanks for your time!'; $thanksText = '';