<% ' change to address of your own SMTP server strHost = "localhost" If Request("Send") <> "" Then lcBody = chr(13) & chr(10) Set Mail = Server.CreateObject("Persits.MailSender") ' enter valid SMTP host Mail.Host = strHost Mail.From = "wayne@nwpixs.com" ' From address Mail.FromName = "NW Pixs Web Site Request" Mail.AddAddress Request("emailaddress") Mail.AddAddress "admin@nwpixs.com" Mail.AddAddress "wayne@nwpixs.com" Mail.IsHTML = true ' message subject Mail.Subject = "NW Pixs Web Site Request" lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) ' message body lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "" & chr(13) & chr(10) lcBody = lcBody & "
Agent First Name: " & Request("Agent First Name") & "
Agent Last Name: " & Request("Agent Last Name") & chr(13) & "
Agent Cell: " & Request("Agent Cell") & "
Agent e-mail: " & Request("Agent e-mail") & chr(13) & "
Agent second e-mail: " & Request("Agent second e-mail") & "
Company: " & Request("Company") & "
Branch: " & Request("Branch") & "
Office Phone: " & Request("Office Phone") & "
Coordinators First: " & Request("Coordinators First") & "
Coordinators Last: " & Request("Coordinators Last") & "
Coordinators Phone: " & Request("Coordinators Phone") & "
Coordinators E-mail: " & Request("Coordinators E-mail") & "
Property Address: " & Request("Property Address") & "
Street Address: " & Request("Street Address") & "
City: " & Request("city") & "
State: " & Request("state") & "
Zip Code: " & Request("zipcode") & "
Home Size: " & Request("Home Size") & "
Lotsize: " & Request("Lotsize") & "
Comments: " & Request("comments") & "
Additional Contact First: " & Request("Additional Contact First") & "
Additional Contact Last: " & Request("Additional Contact Last") & "
Additional Contact Phone: " & Request("Additional Contact Phone") & "
Additional Contact E-mail: " & Request("Additional Contact E-mail") & "
Standard Virtual Tour: " & Request("Standard Virtual Tour") & "
Stills: " & Request("Stills") & "
Stills and Tour: " & Request("Stills and Tour") & "
" Mail.Body = lcBody strErr = "" bSuccess = False On Error Resume Next ' catch errors Mail.Send ' send message If Err <> 0 Then ' error occurred strErr = Err.Description else bSuccess = True 'remove the single quote below to activate Response.Redirect("/contactus/contact_confirmation.asp") End If End If %>
NWPIXS.com Order Form

Please fill in the following form and a member of our team will contact you within 1 business day.

Note: Business Hours - Monday-Friday 9:00 AM to 4:00 PM Pacific Time

CAUTION: Do not hit "Enter" when filling out this form, use your arrow keys or "Tab" to move to the next field.


Required Field *

Agents First Name*                      Agents Last Name*
Agents Cell*
Agents E-Mail*
Agents  Alternate E-Mail

 

Real Estate Company*                                 Office/Branch
Office/Branch Phone

 

Coordinators First Name            Coordinators Last Name
Coordinators Phone
Coordinators E-Mail

 

Property Address *        Street Address*
City* State* Zip Code*
Home Size (Square Foot) Lot Size (Square Foot)
Special Instructions and or Thomas Guide Coordinates:  
 

Additional Contact First Name           Additional Contact Last Name

Additional Contact Phone
Additional Contact E-Mail

 *Required Field*

Place an "X" on the package you would like to order:

Standard Virtual Tour Package
Stills Package
Stills and Virtual Tour Package