ON-LINE REQUEST FORM


Pathix ASP provides a number of products and services to improve your business. If you have any questions about them, are looking for a quote for a particular service, or just want to drop us a line, please use the following form.

Name
Email
Comments
     
Pathix Web Site - On-Line Request for Information Submission

The following on-line request for information has been submitted from the Pathix Web Site. Details are as follows:


Name: $nameFromForm
Email: $emailFromForm
Comments: $commentsFromForm
Host Name / IP Address: $remhost / $ip
Date/Time: $regdate

"; /* To send HTML mail, you can set the Content-type header. */ $headers = "MIME-Version: 1.0\r\n"; $headers .= "Content-type: text/html; charset=iso-8859-1\r\n"; /* additional headers */ $headers .= "From: Pathix Web Site \r\n"; /* and now mail it */ mail($to, $emailsubject, $message, $headers); echo "

Thank you for your submission.

"; echo "

Should you require a response, you will be contacted in 1 business day.

"; echo "

"; echo "

Click here to return to the main page.

"; } else { // errors found // print as list echo "

The following errors were encountered:
"; echo "

    "; for ($x=0; $x$errorList[$x]"; } echo "

"; echo "

"; echo "

Please contact the site administrator with this error.

"; } } ?>

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