<%@ language=VBScript %> <% Option Explicit %> <% Dim companyname Dim contactname Dim staddress Dim city Dim state Dim zip Dim country Dim phone Dim fax Dim email Dim date Dim daterequired Dim liquid Dim flowrate Dim dischagrge Dim viscmin Dim viscmax Dim viscnormal Dim netinlet Dim suction Dim pumpmin Dim pumpmax Dim solidpercent Dim solidsize Dim solidgravity Dim solidphlevel Dim type1 Dim seltype Dim discharge Dim material Dim relief Dim mounting Dim odp Dim enclosure Dim class1 Dim phase Dim frequency Dim voltage Dim require Dim submitform Dim sch Dim strMessage Dim objCDOConfig Dim objCDOMessage submitform=false companyname = Request.Form("txtcompanyname") contactname = Request.Form("txtcontactname") staddress = Request.Form("txtstaddress") city = Request.Form("txtcity") state = Request.Form("txtstate") zip = Request.Form("txtzip") country = Request.Form("txtcountry") phone = Request.Form("txtphone") fax = Request.Form("txtfax") email = Request.Form("txtemail") date = Request.Form("txtdate") daterequired = Request.Form("txtdaterequired") liquid = Request.Form("txtliquid") flowrate = Request.Form("txtflowrate") discharge = Request.Form("txtdischarge") viscmin = Request.Form("txtviscmin") viscmax = Request.Form("txtviscmax") viscnormal = Request.Form("txtviscnormal") netinlet = Request.Form("txtnetinlet") suction = Request.Form("txtsuction") pumpmin = Request.Form("txtpumpmin") pumpmax = Request.Form("txtpumpmax") solidpercent = Request.Form("txtsolidpercent") solidsize = Request.Form("txtsolidsize") solidgravity = Request.Form("txtspecgravity") solidphlevel = Request.Form("txtphlevel") type1 = Request.Form("rdtype") material = Request.Form("rdmaterial") relief = Request.Form("rdrelief") mounting = Request.Form("rdmounting") enclosure = Request.Form("rdenclosure") class1 = Request.Form("txtclass") phase = Request.Form("txtphase") frequency = Request.Form("txtfreq") voltage = Request.Form("txtvolt") require = Request.Form("txtrequire") If Not companyname="" Then submitform=True If submitform Then strMessage = "

" strMessage = strMessage & "Company Name : " & companyname & "
" strMessage = strMessage & "Contact Name: " & contactname & "
" strMessage = strMessage & "Street Address : " & staddress & "
" strMessage = strMessage & "Country : " & country & "
" strMessage = strMessage & "Phone : " & phone & "
" strMessage = strMessage & "Fax : " & fax & "
" strMessage = strMessage & "Email : " & email & "
" strMessage = strMessage & "Street : " & staddress & "
" strMessage = strMessage & "date : " & date & "
" strMessage = strMessage & "Other Requitements : " & Replace(require, vbCrLf, "
") & "

" strMessage = strMessage & "

" sch = "http://schemas.microsoft.com/cdo/configuration/" Set objCDOConfig = Server.CreateObject("CDO.Configuration") objCDOConfig.Fields.Item(sch & "sendusing") = 2 objCDOConfig.Fields.Item(sch & "smtpserver") = "smtp.brandaid.co.in" objCDOConfig.Fields.update Set objCDOMessage = Server.CreateObject("CDO.Message") Set objCDOMessage.Configuration = objCDOConfig objCDOMessage.To = "hitaxi@brandaid.co.in" objCDOMessage.From = contactname & "<" & email & ">" objCDOMessage.Subject = "Inquiry for Fluid Tech Systems" objCDOMessage.HTMLBody = strMessage objCDOMessage.Send End If %> :: Inquiry : Fluid Tech Systems :: <%If Not submitform Then%> <%End If%>
 
 
 
 
 
 
Home > Inquiry
 
<%If submitform Then%>
Thank you <%=contactname%> ,
Your mail has successfully been sent.
<%Else%>
Application Request Form
(All Applicable Fields Below Are Required)
Company Name Contact Name
Street Address City
State Zip Code
Country Phone
Fax E-mail
Date (mm/dd/yyyy) Date Required (mm/dd/yyyy)
 
Liquid
Flow Rate
Discharge Pressure (PSIG) kg/cm2
Viscosity Minimum Maximum Normal
Net Inlet Pressure Available (PSIA) Suction Pressure
Pumping Temperature Minimum Maximum
Solids % Size Specific Gravity Ph Level
 
Type of Pump :
Gear Lobe Twin Gear Pump Fuel Pump
 
Materials of Construction :
Cast Iron Ductile Iron (gear only) <%If material="ductile iron" then Response.Write "Checked"%> Steel (screw only)
Stainless Steel Packing Mechanical Seal
 
Relief Valve : yes no
 
Mounting :
Foot Flange
 
Motor Data Requirement :
Enclosure: TEFC Explosion Proof *
Class*  Phase Frequency Voltage
List Other Requirements:
After the submission of this form you will be returned to our home page.
Thank You!

 
<%End If%>

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