<%@LANGUAGE="VBSCRIPT"%> <%option explicit%> <% dim booSubmitted dim booValid booSubmitted = false booValid = false if Request.Form("FormSubmitted") = "FormSubmitted" then ' the form was submitted booSubmitted = true if TestCaptcha("ASPCAPTCHA", Request.Form("captchacode")) then ' the captcha code was valid booValid = true end if end if function TestCaptcha(byval valSession, byval valCaptcha) dim tmpSession valSession = Trim(valSession) valCaptcha = Trim(valCaptcha) if (valSession = vbNullString) or (valCaptcha = vbNullString) then TestCaptcha = false else tmpSession = valSession valSession = Trim(Session(valSession)) Session(tmpSession) = vbNullString if valSession = vbNullString then TestCaptcha = false else valCaptcha = Replace(valCaptcha,"i","I") if StrComp(valSession,valCaptcha,1) = 0 then TestCaptcha = true else TestCaptcha = false end if end if end if end function function SendEmail() dim Message dim objMail Message = Message & "Agent Registration" Message = Message & "
Agent Registration
" Message = Message & "
 
A website visitor has submitted an Agent Registration form:
  
Title:" & Request.Form("Title") & "
Forename:" & Request.Form("Forename") & "
Surname:" & Request.Form("Surname") & "
Company Name:" & Request.Form("Company_Name") & "
  
Address1:" & Request.Form("Corresp_Address_1") & "
Address2:" & Request.Form("Corresp_Address_2") & "
Address3:" & Request.Form("Corresp_Address_3") & "
Address4:" & Request.Form("Corresp_Address_4") & "
Post Code:" & Request.Form("Owners_Post_Code") & "
Telephone:" & Request.Form("Telephone") & "
Fax:" & Request.Form("Fax") & "
Email:" & Request.Form("Email") & "
Website:" & Request.Form("Website") & "
Are you authorised and regulated by the FSA:" & Request.Form("FSA") & "
FSA Registration Number:" & Request.Form("FSA_Number") & "

" Message = Message & "" Set objMail = Server.CreateObject("CDONTS.Newmail") objMail.From = "enquiries@ipsdirect.com" ' objMail.To = "adam@streamweb.co.uk" objMail.To = "insurance@ipsdirect.com" objMail.Subject = "Website Agent Registration " objMail.Body = Message objMail.BodyFormat = 0 ' objMail.MailFormat = 0 objMail.Send Set objMail = Nothing end function %> How to become an IPS Direct Landlords Insurance Agent <% ' if the form has been successfully submitted, ' it will display a confirmation message and redirect to the section homepage after 10 seconds if booValid = true then %> <% end if %>

“Introducing Landlords Insurance business to IPS has added another income stream to our business over the past 5 years.”

Avtar Singh - Wolverhampton

<% ' success - display a confirmation and send an email if booValid = true then %>

Thanks for registering to become an IPS Agent

One of our customer service representatives will contact you within 2 working days.

<% SendEmail else ' either the form hasn't been submitted, or it was submitted with an invalid captcha code - so display the form %>

Agent Registration

If you would like to register to become an IPS agent, please complete the short form below.

<% ' the form was submitted, but the captcha code was invalid if booSubmitted = true and booValid = false then Response.Write("" & vbCrLf) end if %>
Title (Mr/Mrs/Miss) *
Forename *
Surname *
Company Name
Name *
Company Address
Enter Postcode  
Address 1 *
Address 2
Address 3
Address 4
Postcode *
Telephone Number *
Fax Number
Email Address *
Website Address
FSA Details
FSA Registered?
 
Yes No
FSA Registration Number

  Please enter the security number shown opposite
  Submit
 ") Response.Write("Security value did not match.") Response.Write("

Sections marked with a * must be completed.
<% end if %>
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