ÿþ<html xmlns="http://www.w3.org/1999/xhtml"> <head> <title>CSI Technologies Request Information</title> <meta name="keywords" content="request, information, contact, sales"/> <meta name="description" content="Contact us today for more information."/> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"/> <script language="JavaScript" src="../scripts/common.js" type='text/javascript'></script> <script language="JavaScript" type='text/javascript'> //<!-- //<!------------- Comment for browser does not support java script function ValidateForm() { field = document.form1.name; if (isBlank(field, "Name")) return false; field = document.form1.email; if (isBlank(field, "Email Address")) return false; // if (!isEmail(field, "Email Address")) return false; if (!validateEmail(field)) { alert("Error: Invalid email address. Please type a valid email address for field \Email Address\."); field.focus(); return false; } return true; } function trimLeft(s) { var whitespaces = " \t\n\r"; for(n = 0; n < s.length; n++) { if (whitespaces.indexOf(s.charAt(n)) == -1) return (n > 0) ? s.substring(n, s.length) : s; } return(""); } function trimRight(s){ var whitespaces = " \t\n\r"; for(n = s.length - 1; n > -1; n--) { if (whitespaces.indexOf(s.charAt(n)) == -1) return (n < (s.length - 1)) ? s.substring(0, n+1) : s; } return(""); } function trim(s) {return ((s == null) ? "" : trimRight(trimLeft(s))); } function isBlank(field, strBodyHeader) { strTrimmed = trim(field.value); if (strTrimmed.length > 0) return false; alert("\"" + strBodyHeader + "\" is a required field. Please type a value."); field.focus(); return true; } function isEmail(field, strBodyHeader) { var strMsg = ""; var chAt = '@'; var chDot = '.'; var chSpace = ' '; var strEmailAddr = trim(field.value); if (strEmailAddr.length == 0) return true; if (strEmailAddr.indexOf(chSpace) == -1) { var iFirstAtPos = strEmailAddr.indexOf(chAt); var iLastAtPos = strEmailAddr.lastIndexOf(chAt); if (iFirstAtPos > 0 && iFirstAtPos < (strEmailAddr.length - 1) && iFirstAtPos == iLastAtPos) { // look for '.' there must be at least one char between '@' and '.' var iDotPos = strEmailAddr.indexOf(chDot, iFirstAtPos + 1); if (iDotPos > (iFirstAtPos + 1) && iDotPos < (strEmailAddr.length - 1)) return true; } } alert("Error: Invalid email address. Please type a valid email address for field \"" + strBodyHeader + "\"."); field.focus(); return false; } function validateEmail(field){ // var emailPattern = /^[a-zA-Z0-9._-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,4}$/; // var emailPattern = ^[\\w-_\.+]*[\\w-_\.]\@([\\w]+\\.)+[\\w]+[\\w]$; var emailPattern = /^((\w+\+*\-*)+\.?)+@((\w+\+*\-*)+\.?)*[\w-]+\.[a-z]{2,6}$/i; // var emailPattern = ^([A-Za-z0-9]{1,}([-_\.&'][A-Za-z0-9]{1,}){0,}){1,}@(([A-Za-z0-9]{1,}[-]{0,1})\.){1,}[A-Za-z]{2,6}$; // var emailPattern = /^([a-zA-Z0-9_.-])+@(([a-zA-Z0-9-])+.)+([a-zA-Z0-9]{2,4})+$/; // var emailPattern = /^[a-zA-Z0-9._-]+@([a-zA-Z0-9.-]+\.)+[a-zA-Z0-9.-]{2,4}$/; // var emailPattern = /^([a-zA-Z0-9_.-])+@([a-zA-Z0-9_.-])+\.([a-zA-Z])+([a-zA-Z])+/; // var emailPattern = /^.+@.+\..{2,3,4,6}$/; var strTrimmed = trim(field.value); return emailPattern.test(strTrimmed); } // ------- End of comment for browser does not support java script ----> //--> </script> <link href="../style/csi.css" rel="stylesheet" type="text/css"/> </head> <body onload="MM_preloadImages('../images/menu/products_over.gif','../images/menu/services_over.gif','../images/menu/company_over.gif','../images/buttons/needs_analysis_sml_over.gif','../images/buttons/req_info_over.gif','../images/menu/home_over.gif','../images/menu/contact_us_over.gif')"> <table style="height: 100%" width="800" border="0" cellspacing="0" cellpadding="0"> <tr style="height: 1%"> <td><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td><!-- #BeginLibraryItem "/Library/header.lbi" --><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td style="width: 1%"><a href="../index.html"><img src="../images/hdr/csi_logo2.gif" alt="CSI Technologies" width="111" height="92" border="0"/></a></td> <td style="width: 99%" valign="bottom"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td align="right"><img src="../images/hdr/ebsp.gif" alt="An Enterprise Business Solution Provider" width="238" height="26"/></td> </tr> <tr> <td><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td style="width: 1%"><a href="../index.html" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('home','','../images/menu/home_over.gif',1)"><img src="../images/menu/home.gif" name="home" width="101" height="23" border="0"></a></td> <td style="width: 1%"><a href="../products/index.html" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('products','','../images/menu/products_over.gif',1)"><img src="../images/menu/products.gif" id="products" style="border:0; height:23; width:101"></a></td> <td style="width: 1%"><a href="../services/index.html" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('services','','../images/menu/services_over.gif',1)"><img src="../images/menu/services.gif" id="services" style="border:0; height:23; width:101"></a></td> <td style="width: 1%"><a href="../company/index.html" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('company','','../images/menu/company_over.gif',1)"><img src="../images/menu/company.gif" id="company" style="border:0; height:23; width:101"></a></td> <td style="width: 1%"><a href="../company/contact_us.htm" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('contact_us','','../images/menu/contact_us_over.gif',1)"><img src="../images/menu/contact_us.gif" id="contact_us" style="border:0; height:23; width:101"></a></td> <td align="right" style="width: 95%; background:../images/menu/bkg.gif"> <img src="../images/menu/blue_line.gif" alt="" width="1" height="23"/></td> </tr> </table></td> </tr> </table></td> </tr> </table> <!-- #EndLibraryItem --> </td> </tr> <tr> <td style="background-color: #10238C"><img src="../images/misc/transparent.gif" alt="" width="1" height="1"/></td> </tr> <tr> <td style="background-color:#000000;padding-left:0px;padding-top:0px;padding-bottom:0px;padding-right:1px"> <!-- #BeginLibraryItem "/Library/company_hdr.lbi" --> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td style="width:1%"><img src="../images/hdr/company.jpg" alt="" width="290" height="64"/></td> <td style="width:1%"><img src="../images/hdr/gears.jpg" alt="" width="331" height="64"/></td> <td style="width:98%;background-color:#C5C9DC"> <img src="../images/misc/transparent.gif" alt="" width="1" height="1"/></td> </tr> </table> <!-- #EndLibraryItem --></td> </tr> <tr> <td style="background-color:#10238C"> <img src="../images/misc/transparent.gif" alt="" width="1" height="1"/></td> </tr> <tr> <td align="right" background="../images/hdr/bkg2.gif"><img src="../images/hdr/blue_line2.gif" alt="" width="1" height="8"/></td> </tr></table> </td> </tr> <tr style="height:99%"> <td><table width="100%" style="height:100%" border="0" cellspacing="0" cellpadding="0"> <tr style="height:100%"> <td style="background-color:#10238C;padding-left:0px;padding-top:0px;padding-right:1px;padding-bottom:1px"> <table width="100%" style="height:100%" border="0" cellspacing="0" cellpadding="0"> <tr style="height:100%"> <td style="background-color:#FFFFFF"> <table width="100%" style="height:100%" border="0" cellspacing="0" cellpadding="0"> <tr style="height:100%"> <td valign="top"><table width="100%" style="height:100%" border="0" cellspacing="16" cellpadding="0"> <tr style="height:99%"> <td style="width:1%" valign="top"> <!-- #BeginLibraryItem "/Library/company_menu.lbi" --> <table border="0" cellspacing="0" cellpadding="0"> <tr> <td><img src="../images/titles/lm_company.gif" alt="Company" width="133" height="24"/></td> </tr> <tr> <td><table width="100%" border="0" cellspacing="8" cellpadding="0"> <tr> <td style="width:1%"><img src="../images/menu/blue_box.gif" alt="" width="5" height="5"/></td> <td style="width:99%" class="menu1"><a href="../company/index.html" class="menu1link">About Us </a></td> </tr> <tr> <td style="width:1%"><img src="../images/menu/blue_box.gif" alt="" width="5" height="5"/></td> <td style="width:99%" class="menu1"><a href="../company/team/index.html" class="menu1link">Our Team </a></td> </tr> <tr> <td style="width:1%"><img src="../images/menu/blue_box.gif" alt="" width="5" height="5"/></td> <td style="width:99%" class="menu1"><a href="../company/contact_us.htm" class="menu1link">Contact Us </a></td> </tr> </table></td> </tr> </table><!-- #EndLibraryItem --></td> <td valign="top" style="padding:16px"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td><img src="../images/titles/contact_us.gif" alt="Contact Us" width="180" height="25"/></td> </tr> <tr> <td class="text1"><img src="../images/misc/transparent.gif" alt="" width="6" height="6"/></td> </tr> <tr> <td background="../images/misc/line_bkg.gif"><img src="../images/misc/line.gif" alt="" width="13" height="20"/></td> </tr> <tr> <td class="text1"><img src="../images/misc/transparent.gif" alt="" width="6" height="6"/></td> </tr> <tr> <td valign="top" class="text1" style="padding:4px"> <p class="hdr1">Request Information Form</p> <table width="100%" border="0" cellspacing="0" cellpadding="4"> <form name="form1" method="POST" action="sendmail.php" onsubmit="return ValidateForm()"> <tr> <td colspan="2" class="text1">Thank you for your interest in CSI Technolgies. By answering a few brief questions we will be able to provide you with prompt and informative service. <br> <i>(Please note that a * indicates a Required Field)</i> </td> </tr> <tr> <td colspan="2"><img src="../images/misc/transparent.gif" alt="" width="10" height="10"/></td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">* Name</td> <td style="width:74%" class="text1"><input name="name" type="text" class="text1" id="name" size="30" maxlength="20"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">*Email Address</td> <td style="width:74%" class="text1"><input name="email" type="text" class="text1" id="email" size="30" maxlength="50"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Company</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="company" size="30" maxlength="50"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Address 1</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="add1" size="30" maxlength="50"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Address 2</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="add2" size="30" maxlength="50"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">City</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="city" size="30" maxlength="50"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">State</td> <td style="width:74%" class="text1"><select name="state" class="text1"> <option value="" selected>Select</option> <option value="AK">Alaska </option> <option value="AL">Alabama</option> <option value="AR">Arkansas</option> <option value="AZ">Arizona</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DC">District of Columbia</option> <option value="DE">Delaware</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="IA">Iowa</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="MA">Massachusetts</option> <option value="MD">Maryland</option> <option value="ME">Maine</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MO">Missouri</option> <option value="MS">Mississippi</option> <option value="MT">Montana</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="NE">Nebraska</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NV">Nevada</option> <option value="NY">New York</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VA">Virginia</option> <option value="VT">Vermont</option> <option value="WA">Washington</option> <option value="WI">Wisconsin</option> <option value="WV">West Virginia</option> <option value="WY">Wyoming</option> </select> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Zip Code</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="zip" size="8" maxlength="10"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Phone</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="phone" size="20" maxlength="20"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Fax</td> <td style="width:74%" class="text1"><input class="text1" type="text" name="fax" size="20" maxlength="20"/> </td> </tr> <tr valign="top"> <td style="width:26%" class="text1" align="right">Comments</td> <td style="width:74%" class="text1"><textarea class="text1" name="comments" rows="6" cols="40"></textarea> </td> </tr> <tr> <td colspan="2" class="text1" align="right"><img src="../images/misc/transparent.gif" width="10" height="10"></td> </tr> <tr> <td style="width:26%" class="text1" align="right">&nbsp;</td> <td style="width:74%" class="text1"> <input type="hidden" name="recipient" value="mtashman@csiti.com, fwilliams@csiti.com"/> <input type="hidden" name="fromemail" value="fwilliams@csiti.com"/> <input type="hidden" name="returnpage" value="http://dev.csiti.com/forms/thanks.htm"/> <input type="hidden" name="subject" value="Request For Information - CSI Technologies"/> <input type="hidden" name="process" value="1"/> <input type="submit" name="submit" value="Submit Online"/>&nbsp; <input type="reset" name="res" value="Reset"/> </td> </tr> </form> <tr> <td colspan="2" class="text1" align="right"><img src="../images/misc/transparent.gif" alt="" width="10" height="10"/></td> </tr> </table> </td> </tr> </table></td> </tr> <tr style="height:1%"> <td colspan="2" class="text2"><!-- #BeginLibraryItem "/Library/footer.lbi" --><span class="footer">&copy; 2004 CSI Technologies. All rights reserved. <a href="../company/privacy.htm">Privacy Policy</a>. <a href="../company/terms.htm">Terms of Use</a>.</span><!-- #EndLibraryItem --></td> </tr> </table></td> <td valign="top" background="../images/misc/side_bkg.gif" style="width:1%;padding-left:10px;padding-top:10px;padding-bottom:10px;padding-right:6px"> <!-- #BeginLibraryItem "/Library/right_side_ad.lbi" --><table border="0" cellspacing="0" cellpadding="2"> <tr> <td><a href="../company/needs.htm" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('needs_analysis_sml','','../images/buttons/needs_analysis_sml_over.gif',1)"><img src="../images/buttons/needs_analysis_sml.gif" name="needs_analysis_sml" width="155" height="34" border="0"></a></td> </tr> <tr> <td><a href="request.htm" onmouseout="MM_swapImgRestore()" onmouseover="MM_swapImage('req_info','','../images/buttons/req_info_over.gif',1)"><img src="../images/buttons/req_info.gif" name="req_info" width="155" height="34" border="0"></a></td> </tr> <tr> <td><img src="../images/misc/transparent.gif" alt="" width="20" height="20"/></td> </tr> </table><!-- #EndLibraryItem --></td> </tr> </table></td> </tr> </table></td> </tr> </table></td> </tr> </table> </body> </html>