<% IF Request.Form="" or not isvalidemail(request.form("email")) Then %>
           

 

Please, take a few seconds to fill out the following form to receive additional information about our products.

Enter your email, so we can send you the samples tracking number. Without this information, your request will not be processed.
Enter your e-mail address:
(* obligatory field )
Mr Mrs Ms
Name Lastname
">
Company Name
Address1 Address2
City Postal Code County
Country
Telephone Number  Fax Number 
Web Site/Page
Prefered contact Method
E-mail  Phone Mail Fax

 
a.- What kind of Upgrade are you thinking about?
Refurbishment  New Facility
b.- About the flooring in your Health Club
  Interested on a quotation Actual Flooring

Approx surface beign considered 
Weight Room/Cardio
 Si   No
Choose the units 
m² Sq ft  
Aerobics
 Si  No
Changing room
 Si  No
Kids area
 Si  No
Other
 Si  No
c.- Projected installation date Preferred Colors
d.- Where did you learn about Kemil?

Comments:
Yes, I'd like to receive some Kemil Literature.

 

Copyright © 2000 Kemil Pavimentos.  Kemil is a registered trademark ; .
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Thank you <%=request.form("Dear")%><%=" "%> for requesting information about Kemil Health Club flooring.

The form has been sent succesfully

 

"I wish <%=request.form("Dear")%><%=" "%><%=request.form("Lastname")%> you have enjoyed our web page"

 

Alvaro Benito

Managing Director

<% END IF %> <% Function IsValidEmail(strEmail) Dim bIsValid bIsValid = True If Len(strEmail)< 5 Then bIsValid = False Else If Instr(1, strEmail, " ") <> 0 Then bIsValid = False Else If InStr(1, strEmail, "@", 1) < 2 Then bIsValid = False Else If InStrRev(strEmail, ".") < InStr(1, strEmail, "@", 1) + 2 Then bIsValid = False End If End If End If End If IsValidEmail = bIsValid End Function %>