Garage Door Service Request

<% dim lError dim lErrArr dim lClientName dim lAddress dim lCity dim lHomePhone dim lEmail lError = request("Error") 'If errors were found trying to update if (lError <> "") then lErrArr = split(Session("Error"),"|$|") end if %> Garage Door Service Request

G ARAGE D OOR S ERVICE R EQUEST F ORM

Please Provide the Following Information:
* Indicates required field

<% '******************************************************************************************** ' Display the Error messages to the user '******************************************************************************************** If lError <> "" Then %>

<% 'Display Required Field Error Messages if instr(lError, "00") > 0 then %> Name is required
<% End If if instr(lError, "01") > 0 then %> Address is required
<% End If if instr(lError, "02") > 0 then %> City is required
<% End If if instr(lError, "03") > 0 then %> Home Phone is required
<% End If if instr(lError, "04") > 0 then %> A valid Email Address is required
<% End If %>

<% End If %>

Name*:

Project Address*:

City*:

State:

Zip:

Home Phone*:

Work Phone:

E-mail*:

Preferred Appointment Time: *

The problem appears to be in:

Will the garage door open by hand?:

My garage door springs:

My garage door spring(s) appear to be:

The door is stuck in the:

The door is crooked in the opening:

Describe the problem as completely as possible.

Name:*
Project Address:*
City:*
State:
Zip:
Home Phone:*
Work Phone:
E-mail:*

Preferred Appointment Time: *

The problem appears to be in:
Will the garage door open by hand?:
My garage door springs:
My garage door spring(s) appear to be:
The door is stuck in the:
The door is crooked in the opening:
Describe the problem as completely as possible.