"".$_POST['email']."","rp--Please enter your email" => "".$_POST['email']."","rp-2-Please enter your first name" => "".$_POST['firstName']."", "rp--Please enter your comments" => "".$_POST['comments']."", "rp--Please enter your phone" => "".$_POST['phone']."" ), $validation_ans_arr); if($firstName=="First Name"){ $form_check_alert.="
  • Please Enter Your First Name
  • "; } if($lastName=="Last Name"){ $form_check_alert.="
  • Please Enter Your Last Name
  • "; } if($phone=="Phone"){ $form_check_alert.="
  • Please Enter Your Phone
  • "; } if($email=="Email"){ $form_check_alert.="
  • Please Enter Your Email ID
  • "; } if($comments=="Comments"){ $form_check_alert.="
  • Please Enter Your comments
  • "; } if(!strlen($form_check_alert)>0){ checkHTTPREFERER(); $ipTrack=$_SERVER['REMOTE_ADDR']; mysql_query("insert into enquiry set firstName='$firstName',lastName='$lastName',email='$email',status='Y',recv_date=now(),ipTrack='$ipTrack',phone ='$phone',comments='$comments'"); $eID=mysql_insert_id(); ############# Send Email ########################## $mess=view_enquiry($eID); $ContactPerson=$firstName." ".$lastName; $admineMail=getAdminemail(); $subject="Enquiry ( Contact Us Page )"; sent_mail($ContactPerson,$email,$admineMail,$subject,$mess); sent_mail($ContactPerson,$email,"raj_monga@centum.ca",$subject,$mess); ############################################ if($_POST[page]=="contact"){ $_SESSION['message']=" *** Your Request has been received. We will get back to you soon. "; header("Location ".SITE_WS_PATH."/contact.htm"); exit; }else{ $msg=" *** Your Request has been received. We will get back to you soon. "; echo ""; exit; } } if($form_check_alert!=""){ $msg=html_head(); $msg.=$form_check_alert; $msg.=html_foot(); } } if($_POST['action']=="Send Request" && $_POST['page']=="arrange"){ $firstName=$_POST['firstName']; $lastName=$_POST['lastName']; $email=$_POST['email']; $phone=$_POST['phone']; $comments=$_POST['comments']; $phoneHome=$_POST['phoneHome']; $address=$_POST['address']; $city=$_POST['city']; $contactBy=$_POST['contactBy']; $enquiryFor=$_POST['enquiryFor']; if($contactBy=="Work/Cellular Number"){ $c1="selected"; }elseif($contactBy=="Email"){ $c2="selected"; } if($enquiryFor=="Renew"){ $e1="selected"; }elseif($enquiryFor=="Refinance"){ $e2="selected"; }elseif($enquiryFor=="Other"){ $e3="selected"; } $form_check_alert=dynamic_check_form_values(array("rp-2-Please enter your first name" => "".$_POST['firstName']."", "rp-2-Please enter your last name" => "".$_POST['lastName']."","p-4-Please enter valid email-ID" => "".$_POST['email']."","rp--Please enter your email" => "".$_POST['email']."", "rp--Please enter your comments / questions" => "".$_POST['comments']."", "rp--Please enter your home number" => "".$_POST['phone']."" ), $validation_ans_arr); if(!strlen($form_check_alert)>0){ checkHTTPREFERER(); $ipTrack=$_SERVER['REMOTE_ADDR']; mysql_query("insert into enquiry set firstName='$firstName',lastName='$lastName',email='$email',status='Y',recv_date=now(),ipTrack='$ipTrack',phone ='$phone',comments='$comments',phoneHome='$phoneHome',address='$address',city='$city',enquiryFor='$enquiryFor',contactBy='$contactBy',eType='A'"); $eID=mysql_insert_id(); ############# Send Email ########################## $mess=view_enquiry($eID); $ContactPerson=$firstName." ".$lastName; $admineMail=getAdminemail(); $subject="Arrange Call Back"; sent_mail($ContactPerson,$email,$admineMail,$subject,$mess); sent_mail($ContactPerson,$email,"raj_monga@centum.ca",$subject,$mess); ############################################ $_SESSION['message']=" *** Your Request has been received. We will get back to you soon. "; header("Location ".SITE_WS_PATH."/arrange-callback.htm"); exit; } if($form_check_alert!=""){ $msg=html_head(); $msg.=$form_check_alert; $msg.=html_foot(); } } echo mainHeader("Arrange A Call Back"); ?>
    CENTUM HiLite Mortgage Inc.
      *All Fields are mandatory
    First Name * Last Name *
    Address City
    Home Number  * Work / Cellular Number  *
    Email * Preferred Method of Contact
    Inquiring About *
    Comments / Questions *