<% 'Process if trim(request.QueryString("Name")) <> "" then mailtext = "Seminar Registration Form " & vbcrlf mailtext = mailtext & "Name : " & request.QueryString("Name") & vbcrlf mailtext = mailtext & "Company : " & request.QueryString("Company") & vbcrlf mailtext = mailtext & "Address 1 : " & request.QueryString("Address") & vbcrlf mailtext = mailtext & "Address 2 : " & request.QueryString("address2") & vbcrlf mailtext = mailtext & "City : " & request.QueryString("City") & vbcrlf mailtext = mailtext & "Province/State : " & request.QueryString("Province/State") & vbcrlf mailtext = mailtext & "Country : " & request.QueryString("Country") & vbcrlf mailtext = mailtext & "e-Mail : " & request.QueryString("e-Mail") & vbcrlf mailtext = mailtext & "Phone : " & request.QueryString("Phone") & vbcrlf mailtext = mailtext & "Extension : " & request.QueryString("Extension") & vbcrlf mailtext = mailtext & "Seminar : " & request.QueryString("Seminar") & vbcrlf mailtext = mailtext & "Date : " & request.QueryString("Date") & vbcrlf mailtext = mailtext & "Fax : " & request.QueryString("Fax") & vbcrlf mailtext = mailtext & "Alergies : " & request.QueryString("Allergies") & vbcrlf mailtext = mailtext & "Vegetarian : " & request.QueryString("Veg") & vbcrlf mailtext = mailtext & "Comments : " & request.QueryString("Comments") & vbcrlf & vbcrlf mailtext = mailtext & "For invoicing purposes" & vbCrlf mailtext = mailtext & "Name : " & request.QueryString("invoice-name") & vbcrlf mailtext = mailtext & "Company : " & request.QueryString("invoice-company") & vbcrlf mailtext = mailtext & "Address 1 : " & request.QueryString("invoice-address") & vbcrlf mailtext = mailtext & "Address 2 : " & request.QueryString("invoice-address2") & vbcrlf mailtext = mailtext & "City : " & request.QueryString("invoice-city") & vbcrlf mailtext = mailtext & "Province/State : " & request.QueryString("invoice-Province") & vbcrlf mailtext = mailtext & "Country : " & request.QueryString("invoice-country") & vbcrlf mailtext = mailtext & "Postal / Zip Code : " & request.QueryString("invoice-postal_code") & vbcrlf mailtext = mailtext & "Reference : " & request.QueryString("invoice-reference") & vbcrlf & vbcrlf mailtext = mailtext & "Payment type : " & request.QueryString("payment") & vbCrlf mailtext = mailtext & "PO : " & request.QueryString("invoice-PO") & vbcrlf mailtext = mailtext & "PO # : " & request.QueryString("invoice-PON") & vbcrlf Set Mail=Server.CreateObject("Persits.MailSender") Mail.Host="WinMailSrv" Mail.Subject="Seminar Registration - English site" Mail.From="PPI_inscriptions@ajcwebtech.com" Mail.AddAddress "shavell@prestonphipps.com" Mail.AddBCC "john.couto@ajcwebtech.com" Mail.AddBCC "lpaterno@prestonphipps.com" Mail.Body= mailtext On Error Resume Next ' catch errors Mail.Send If Err <> 0 Then ' error occurred response.write("") else response.Write("") End If end if %> Preston Phipps
Seminar Registration Form
To enroll in one of our upcoming seminars, please complete the form below. Should you have any questions regarding the registration process or on our seminars in general, please contact Sandra Havell at (514) 333-5340 or by e-mail at shavell@prestonphipps.com.
* Denotes required field
Name*
Company*
Address 1*
Address 2
City*
Province/State*
Country*
e-Mail*
Phone* Ext.
Seminar*
Date*
Fax
Please let us know of any allergies:
Are you vegetarian:
Let us know if you have any questions or require special accommodations

For invoicing purposes, if you wish to use a different address, please complete this form:

Name
Company
Address 1
Address 2
City
Province/State
Country
Postal / Zip Code
Reference

How do you plan on paying for this course?

Check
Credit Card (We accept VISA or MasterCard)

Note: We do not process credit cards on-line. Once this form has been submitted, you will be contacted by phone to make payment arrangements.

Do you have a purchase order number?

Yes:
No