Kitty Dunes (371) -- Kitty Dunes OptIn (215)

Visual Data Systems

brochure - Kitty Dunes Guide Request

FormID: 191 AccountID: 215

LEGACY Contents for config-brochure.php file:
<?php $AccountID = 215; $formid = 191; $pageTitle = 'Request Kitty Guide | Kitty Dunes Rentals Company'; $pageHeader = 'Request our Kitty Guide'; $introText = '<p>Catalog Requests: <b>800.334.3863</b><br/> Reservations Hotline: <b>888.860.3863</b><br/> Fax: <b>252.261.4404</b></p><table class="brochureintro" cellpadding=0 cellspacing=0 border=0><tr><td>Mailing Address:</td><td>Kitty Dunes Rentals</td><td>Physical Address:</td><td>Kitty Dunes Rentals</td><td>Kitty Dunes Rentals - Corolla</td></tr><tr><td> </td><td>P O Box 275</td><td> </td><td>3620 N Croatan Hwy</td><td>1109 Ocean Trail, Ste A</td></tr><tr><td> </td><td>Kitty Hawk, SC 27949</td><td> </td><td>Kitty Hawk, NC 27949</td><td>Corolla, NC 27927</td></tr></table><p>Please fill in the following information so that we may send you our current vacation rental catalog. Once we receive your information we will send your Kitty Guide catalog as quickly as possible.</p>'; $template = $Root.'/Templates/page2.dwt'; $contactblock = "<tr><td colspan=4><table width=100%><tr><td align=right class=label>First Name:</td><td width=85%><input type='text' name='FirstName' value='".(($_POST['FirstName'] <> "") ? htmlentities(stripslashes($_POST['FirstName']), ENT_QUOTES) : "")."' size=24 maxlength=24 />$reqsymbol</td></tr> <tr><td align=right class=label>Last Name:</td><td width=85%><input type='text' name='LastName' value='".(($_POST['LastName'] <> "") ? htmlentities(stripslashes($_POST['LastName']), ENT_QUOTES) : "")."' size=32 maxlength=32 />$reqsymbol</td></tr> <tr><td align=right class=label>Company:</td><td width=85%><input type='text' name='Company' value='".(($_POST['Company'] <> "") ? htmlentities(stripslashes($_POST['Company']), ENT_QUOTES) : "")."' size=32 maxlength=64 /></td></tr> <tr><td align=right class=label>Email:</td><td width=85%><input type='text' name='Email' value='".(($_POST['Email'] <> "") ? htmlentities(stripslashes($_POST['Email']), ENT_QUOTES) : "")."' size=32 maxlength=64 />$reqsymbol</td></tr> <tr><td align=right class=label>Phone:</td><td width=85%><input type='text' name='Phone' value='".(($_POST['Phone'] <> "") ? htmlentities(stripslashes($_POST['Phone']), ENT_QUOTES) : "")."' size=16 maxlength=16 /></td></tr> <tr><td align=right class=label>Alternate Phone:</td><td width=85%><input type='text' name='Phone2' value='".(($_POST['Phone2'] <> "") ? htmlentities(stripslashes($_POST['Phone2']), ENT_QUOTES) : "")."' size=16 maxlength=16 /></td></tr> <tr><td align=right class=label>Address 1:</td><td width=85%><input type='text' name='Address1' value='".(($_POST['Address1'] <> "") ? htmlentities(stripslashes($_POST['Address1']), ENT_QUOTES) : "")."' size=44 maxlength=48 />$reqsymbol</td></tr> <tr><td align=right class=label>Address 2:</td><td width=85%><input type='text' name='Address2' value='".(($_POST['Address2'] <> "") ? htmlentities(stripslashes($_POST['Address2']), ENT_QUOTES) : "")."' size=44 maxlength=48 /></td></tr> <tr><td align=right class=label>City:</td><td width=85%><input type='text' name='City' value='".(($_POST['City'] <> "") ? htmlentities(stripslashes($_POST['City']), ENT_QUOTES) : "")."' size=24 maxlength=24 />$reqsymbol</td></tr> <tr><td align=right class=label>State:</td><td><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') ? 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"selected" : "").">WY-Wyoming</option></select>$reqsymbol</td></tr> <tr><td align=right class=label>Zip:</td><td width=85%><input type='text' name='Zip' value='".(($_POST['Zip'] <> "") ? htmlentities(stripslashes($_POST['Zip']), ENT_QUOTES) : "")."' size=10 maxlength=10 />$reqsymbol</td></tr> <tr><td align=right class=label>Country:</td><td><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'".(($_POST['Country'] == 'Algeria') ? 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"selected" : "").">Malaysia</option><option value='Maldives'".(($_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'".(($_POST['Country'] == 'Other - Not Shown') ? "selected" : "").">Other - Not Shown</option></select></td></tr> <tr><td colspan=2><table width=100%><tr><td colspan=3>Please indicate the methods by which we may contact you:</td></tr><tr><td><input type='checkbox' class=clear name='ApprovedContactEmail' value='1' ".(($_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></td></tr> </table></td></tr>"; $questionblock = "<tr><td class=label colspan=2><b>Please keep me informed on:</b></td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000001943:0' value='0000039169' ".(($_POST['MAID:0000001943:0'] == '0000039169') ? "checked='checked'":"")." />Rate Reductions </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000001943:1' value='0000040973' ".(($_POST['MAID:0000001943:1'] == '0000040973') ? "checked='checked'":"")." />Special Offers </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000001943:2' value='0000040974' ".(($_POST['MAID:0000001943:2'] == '0000040974') ? "checked='checked'":"")." />New Listings </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000001943:3' value='0000040975' ".(($_POST['MAID:0000001943:3'] == '0000040975') ? "checked='checked'":"")." />Properties for Sale </td></tr> <tr><td colspan=2><input type='checkbox' class=clear name='MAID:0000001658' value='0000037701' CHECKED /><b>Please send me your Kitty Guide (catalog request requires full mailing address).<br/>(Current year catalog available until Thanksgiving. Catalog requests after Thanksgiving receive next year's catalog)</b></td></tr> <tr><td colspan=2><input type='checkbox' class=clear name='MAID:0000001653' value='0000037681' CHECKED /><b>Please add me to your email mailing list.</b></td></tr> <tr><td class=label colspan=2><b>How did you find us?</b></td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:0' value='0000042029' ".(($_POST['MAID:0000002569:0'] == '0000042029') ? "checked='checked'":"")." />Travel Guide Ad </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:1' value='0000042030' ".(($_POST['MAID:0000002569:1'] == '0000042030') ? "checked='checked'":"")." />Billboard </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:2' value='0000042031' ".(($_POST['MAID:0000002569:2'] == '0000042031') ? "checked='checked'":"")." />Rental Sign on House </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:3' value='0000042032' ".(($_POST['MAID:0000002569:3'] == '0000042032') ? "checked='checked'":"")." />Referral </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:4' value='0000042033' ".(($_POST['MAID:0000002569:4'] == '0000042033') ? "checked='checked'":"")." />Internet Search (which search engine?) <input type='text' size='32' maxlength='64' name='FILL:0000042033' value='".(($_POST['FILL:0000042033'] != "") ? htmlentities($_POST['FILL:0000042033'], ENT_QUOTES):"")."' </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:5' value='0000042034' ".(($_POST['MAID:0000002569:5'] == '0000042034') ? "checked='checked'":"")." />Link from other website (which site)? <input type='text' size='32' maxlength='64' name='FILL:0000042034' value='".(($_POST['FILL:0000042034'] != "") ? htmlentities($_POST['FILL:0000042034'], ENT_QUOTES):"")."' </td></tr><tr><td colspan=2>   <input type='checkbox' class=clear name='MAID:0000002569:6' value='0000042035' ".(($_POST['MAID:0000002569:6'] == '0000042035') ? "checked='checked'":"")." />Other (explain) <input type='text' size='32' maxlength='64' name='FILL:0000042035' value='".(($_POST['FILL:0000042035'] != "") ? htmlentities($_POST['FILL:0000042035'], ENT_QUOTES):"")."' </td></tr> <tr><td colspan=2 width=100%><b>Have you rented with Kitty Dunes Rentals in the past?</b></td></tr><tr><td colspan=2 align=left><input type='radio' class=clear name='MAID:0000002350' value='0000040958' ".(($_POST['MAID:0000002350'] == '0000040958') ? "checked='checked'":"")." />Yes  <input type='radio' class=clear name='MAID:0000002350' value='0000040959' ".(($_POST['MAID:0000002350'] == '0000040959') ? "checked='checked'":"")." />No  </td></tr> <tr><td><b>If yes, how many years have you been renting with us?</b></td><td><select class='item' name='MAID:0000002351' size='1'><option value='0000040960' ".(($_POST['MAID:0000002351'] == '0000040960') ? "selected":"").">-select one-</option><option value='0000040961' ".(($_POST['MAID:0000002351'] == '0000040961') ? "selected":"").">1</option><option value='0000040962' ".(($_POST['MAID:0000002351'] == '0000040962') ? "selected":"").">2</option><option value='0000040963' ".(($_POST['MAID:0000002351'] == '0000040963') ? "selected":"").">3</option><option value='0000040964' ".(($_POST['MAID:0000002351'] == '0000040964') ? "selected":"").">4</option><option value='0000040965' ".(($_POST['MAID:0000002351'] == '0000040965') ? "selected":"").">5</option><option value='0000040966' ".(($_POST['MAID:0000002351'] == '0000040966') ? "selected":"").">6</option><option value='0000040967' ".(($_POST['MAID:0000002351'] == '0000040967') ? "selected":"").">7</option><option value='0000040968' ".(($_POST['MAID:0000002351'] == '0000040968') ? "selected":"").">8</option><option value='0000040969' ".(($_POST['MAID:0000002351'] == '0000040969') ? "selected":"").">9</option><option value='0000040970' ".(($_POST['MAID:0000002351'] == '0000040970') ? "selected":"").">10+</option></select></td></tr> <tr><td class=label colspan=2><b>Please indicate any special interests:</b></td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001655:0' value='0000037690' ".(($_POST['MAID:0000001655:0'] == '0000037690') ? "checked='checked'":"")." />Sport Fishing </td><td>   <input type='checkbox' class=clear name='MAID:0000001655:1' value='0000037691' ".(($_POST['MAID:0000001655:1'] == '0000037691') ? "checked='checked'":"")." />Golfing </td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001655:2' value='0000037692' ".(($_POST['MAID:0000001655:2'] == '0000037692') ? "checked='checked'":"")." />Shopping / Dining </td><td>   <input type='checkbox' class=clear name='MAID:0000001655:3' value='0000037695' ".(($_POST['MAID:0000001655:3'] == '0000037695') ? "checked='checked'":"")." />Local Events </td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001655:4' value='0000037694' ".(($_POST['MAID:0000001655:4'] == '0000037694') ? "checked='checked'":"")." />Water Sports </td><td>   <input type='checkbox' class=clear name='MAID:0000001655:5' value='0000040971' ".(($_POST['MAID:0000001655:5'] == '0000040971') ? "checked='checked'":"")." />Outdoors / Wildlife Adventures </td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001655:6' value='0000037693' ".(($_POST['MAID:0000001655:6'] == '0000037693') ? "checked='checked'":"")." />Lighthouses / Historical Sites </td><td>   <input type='checkbox' class=clear name='MAID:0000001655:7' value='0000040972' ".(($_POST['MAID:0000001655:7'] == '0000040972') ? "checked='checked'":"")." />Other <input type='text' size='32' maxlength='64' name='FILL:0000040972' value='".(($_POST['FILL:0000040972'] != "") ? htmlentities($_POST['FILL:0000040972'], ENT_QUOTES):"")."' </td></tr> <tr><td class=label colspan=2><b>In what seasons are you most likely to visit?</b></td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001656:0' value='0000037696' ".(($_POST['MAID:0000001656:0'] == '0000037696') ? "checked='checked'":"")." />Summer </td><td>   <input type='checkbox' class=clear name='MAID:0000001656:1' value='0000037697' ".(($_POST['MAID:0000001656:1'] == '0000037697') ? "checked='checked'":"")." />Fall </td></tr><tr><td>   <input type='checkbox' class=clear name='MAID:0000001656:2' value='0000037698' ".(($_POST['MAID:0000001656:2'] == '0000037698') ? "checked='checked'":"")." />Winter </td><td>   <input type='checkbox' class=clear name='MAID:0000001656:3' value='0000037699' ".(($_POST['MAID:0000001656:3'] == '0000037699') ? "checked='checked'":"")." />Spring </td></tr> <tr><td><b>How far in advance do you usually reserve your vacations?</b></td><td><select class='item' name='MAID:0000002352' size='1'><option value='0000040976' ".(($_POST['MAID:0000002352'] == '0000040976') ? "selected":"").">-select one-</option><option value='0000040977' ".(($_POST['MAID:0000002352'] == '0000040977') ? "selected":"").">8 - 12 months</option><option value='0000040978' ".(($_POST['MAID:0000002352'] == '0000040978') ? "selected":"").">4 - 7 months</option><option value='0000040979' ".(($_POST['MAID:0000002352'] == '0000040979') ? "selected":"").">3 months or less</option><option value='0000040980' ".(($_POST['MAID:0000002352'] == '0000040980') ? "selected":"").">I wait for the last minute specials</option></select></td></tr> <tr><td colspan=2><b>Comments or Questions?</b></td></tr><tr><td colspan=2><textarea cols=60 rows=5 name='TEXT:0000001657'>".(($_POST['TEXT:0000001657'] <> "") ? htmlentities(stripslashes($_POST['TEXT:0000001657']), ENT_QUOTES) : htmlentities(stripslashes(""), ENT_QUOTES))."</textarea></td></tr> "; $thanksTitle = 'Thank You'; $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>';