Online Warranty Registration Please submit your online warranty registration here. * compulsory field Title   Select one Mr Ms Mrs Mdm Dr * Surname   * Given Names   * Address   * Postal Code   * Contact No.   * Email   * Model No.   * Serial No.   * Type No. (if any)   Place of Purchase   * Date of Purchase   DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM Jan Feb Mar Apr May Jun Jul Auy Sep Oct Nov Dec YYYY 2008 2009 2010 2011 2012 *   By submitting this online warranty registration, I am agreeable to the warranty terms and conditions.   NOTE: If the registration is successful, a confirmation email will be sent to you in due course.

<% 'If the form has been submitted execute the following code   Else 'receive the form values Dim title, firstname, lastname, address, postal, contact, email, model, serial, typeno, placeofpurchase, dateofpurchase, monthofpurchase, yearofpurchase stitle=Request.Form("title") sfirstname=Request.Form("firstname") slastname=Request.Form("lastname") saddress=Request.Form("address") spostal=Request.Form("postal") scontact=Request.Form("contact") semail=Request.Form("email") smodel=Request.Form("model") sserial=Request.Form("serial") stypeno=Request.Form("typeno") splaceofpurchase=Request.Form("placeofpurchase") sdateofpurchase=Request.Form("dateofpurchase") smonthofpurchase=Request.Form("monthofpurchase") syearofpurchase=Request.Form("yearofpurchase") ' create the HTML formatted email text Dim sEmailText sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "Title: " & stitle & "
" sEmailText = sEmailText & "First name: " & sfirstname & "
" sEmailText = sEmailText & "Last name: " & slastname & "
" sEmailText = sEmailText & "Address: " & saddress & "
" sEmailText = sEmailText & "Postal: " & spostal & "
" sEmailText = sEmailText & "Contact: " & scontact & "
" sEmailText = sEmailText & "Email: " & semail & "
" sEmailText = sEmailText & "Model: " & smodel & "
" sEmailText = sEmailText & "Serial: " & sserial & "
" sEmailText = sEmailText & "Type no: " & stypeno & "
" sEmailText = sEmailText & "Place of purchase: " & splaceofpurchase & "
" sEmailText = sEmailText & "Date of purchase: " & sdateofpurchase & "
" sEmailText = sEmailText & "Month of purchase: " & smonthofpurchase & "
" sEmailText = sEmailText & "Year of purchase: " & syearofpurchase & "
" sEmailText = sEmailText & "Date & Time: " & Now() & "
" 'sEmailText = sEmailText & "IP : " & Request.ServerVariables("REMOTE_ADDR") sEmailText = sEmailText & "" sEmailText = sEmailText & "" sEmailText = sEmailText & "" 'create the mail object Set NewMailObj=Server.CreateObject("CDONTS.NewMail") NewMailObj.From=sEmail 'This is the email of the feedback sender NewMailObj.To = "enquiry@midom.com.sg" 'change to your address NewMailObj.Subject = "Online Warranty Registration" NewMailObj.Body = sEmailText 'you need to add these 2 lines for the mail to be sent in HTML format 'remove them and the email will be sent in Text format NewMailObj.BodyFormat = 0 NewMailObj.MailFormat = 0 NewMailObj.Send Set NewMailObj=Nothing Response.write "" Response.write "" Response.write "" Response.write "" Response.write"

Thank you for submitting your warranty registration.

" End If %>