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<head>
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<title>Employer Needs: Jacobs & Associates, Inc.</title>
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<tr>
<td class="logo" colspan="3" height="68px"><img src="images/logo.gif"></td>
</tr>
<tr>
<td class="l-side-bar" width="137" valign="top" height="35px"><img src="images/l-side-bar.gif"><br></td>
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<td class="l-side-bar" valign="top" height="85%"><p><a href="home.asp" onmouseover="document.h.src = hOff.src" onmouseout="document.h.src = hOn.src"><img src="images/h-btn.gif" name="h" border="0"></a><br>
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<div class="innerText">
<%
Dim action
action = Request.QueryString("action")
Dim aName, aCName, aEmail, aTele, aAdd, aCity, aState, aZip, aFax, aEmp, aCPos, aEdu
Dim aCons, aComp, aDPos, aSal, aChg, aExp
aName = Request.Form("Name")
aCName = Request.Form("cName")
aEmail = Request.Form("E-Mail")
aTele = Request.Form("Telephone")
aAdd = Request.Form("Address")
aCity = Request.Form("City")
aState = Request.Form("State")
aZip = Request.Form("Zip")
aFax = Request.Form("Fax")
aOpen = Request.Form("Opennings")
If action = "send" AND (aName <> "" AND aTele <> "") Then
' Populate Email Response
Dim br, messageSend
br = "<br>"
messageSend = messageSend & "<p><strong>Employer Contact Information</strong>"
messageSend = messageSend & "<hr size='1' width='100%'>"
messageSend = messageSend & "Company Contact: " & aName & br
if aCName <> "" then
messageSend = messageSend & "Company Name: " & aCName & br
end if
if aEmail <> "" then
messageSend = messageSend & "Company Email Address: " & aEmail & br
end if
messageSend = messageSend & "Company Telephone: " & aTele & br
if aAdd <> "" then
messageSend = messageSend & "Address: " & aAdd & br
end if
if aCity <> "" then
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end if
if aState <> "" then
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end if
if aZip <> "" then
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end if
if aFax <> "" then
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end if
messageSend = messageSend & "</p>"
if aOpen <> "" then
messageSend = messageSend & "<p><strong>Current Employment Needs</strong>"
messageSend = messageSend & "<hr size='1' width='100%'>"
messageSend = messageSend & "Current Opennings and Salary Requirements: " & aOpen & br
messageSend = messageSend & "</p>"
end if
Set Mailer = Server.CreateObject("SMTPsvg.Mailer")
Mailer.FromName = "Contact Request Form Results"
Mailer.FromAddress= "[email protected]"
Mailer.RemoteHost = "smtp.rcn.com"
Mailer.AddRecipient "[email protected]", "[email protected]"
Mailer.Subject = "Employer Info Request Form: " & date()
Mailer.BodyText = messageSend
if Mailer.SendMail then
Response.Write "<fieldset><legend>Your Information Has Been Sent</legend>" & br
Response.Write (messageSend)
Response.Write "</fieldset>"
else
Response.Write "Mail send failure. Error was " & Mailer.Response
end if
Else
%>
<form method="POST" action="employer_needs.asp?action=send">
<fieldset>
<p><b> Jacobs & Associates Client Information Form </b></p>
<p> Jacobs & Associates is an outstanding source, supplying the Tri-State area's Real Estate marketplace with the most qualified and compelling candidates.</p>
<p><i>Please fill out the form below and give us some details per how we can best tend to your needs.</i></p>
<legend>Your Business Contact Information:</legend>
<table width="100%" cellpadding="5">
<tr>
<td width="30%">Company Contact Name:</td>
<td width="1%"><font color="#FF0000">*</font></td>
<td width="69%"><input type="text" name="Name" style="width:100%;"></td>
</tr>
<tr>
<td>Company Name:</td>
<td> </td>
<td><input type="text" MAXLENGTH="40" name="cName" style="width:100%;"></td>
</tr>
<tr>
<td>Company E-Mail:</td>
<td> </td>
<td><input type="text" MAXLENGTH="40" name="E-Mail" style="width:100%;"></td>
</tr>
<tr>
<td>Company Telephone:</td>
<td><font color="#FF0000">*</font></td>
<td><input type="text" name="Telephone" style="width:100%;"></td>
</tr>
<tr>
<td>Company Address:</td>
<td> </td>
<td><input TYPE="TEXT" MAXLENGTH="40" NAME="Address" style="width:100%;"></td>
</tr>
<tr>
<td>City:</td>
<td> </td>
<td><input TYPE="TEXT" MAXLENGTH="40" NAME="City" style="width:100%;"></td>
</tr>
<tr>
<td>State:</td>
<td> </td>
<td><input TYPE="TEXT" MAXLENGTH="20" NAME="State" style="width:100%;"></td>
</tr>
<tr>
<td>Zip:</td>
<td> </td>
<td><input TYPE="TEXT" MAXLENGTH="20" NAME="Zip" style="width:100%;"></td>
</tr>
<tr>
<td>Company Fax Number:</td>
<td> </td>
<td><input type="text" MAXLENGTH="40" NAME="Fax" style="width:100%;"></td>
</tr>
</table>
</fieldset>
<fieldset>
<legend>Your Company Employment Needs:</legend>
<table width="100%" cellpadding="5">
<tr>
<td>
<p>Enter current Job Openings with Salary Requirements. Please include benefits information and job description:</p>
<textarea name="Opennings" rows="10" style="width:100%;"></textarea>
<p>We will contact you for details on the position(s) and time requirements immediately.</p>
</td>
</tr>
<tr>
<td align="center"><p><br></p>
<input TYPE="SUBMIT" VALUE="Submit Info." class="send"> <input NAME="Reset Info." TYPE="RESET" VALUE="Reset Info." class="send"></td>
</tr>
</table>
</fieldset>
</form>
<%
End If
%>
</div>
<img src="images/empty.gif" width="698" height="1">
</td>
<td class="r-side-bar" valign="top"><img src="images/r-side-image.gif"></td>
</tr>
<tr>
<td valign="top" height="49px"><img src="images/biz-plate-02.gif"></td>
<td class="copyright"><p style="padding-left:15px; font:7pt/8pt verdana; color:rgb(0,51,51);"><a href="home.htm">Home</a> | <a href="about_us.htm">About Us</a> | <a href="contact_us.htm">Contact Us</a> | <a href="employer_needs.asp">Employer Needs</a> | <a href="candidate_needs.asp">Candidate Needs</a>
<br>© 2002 Jacobs & Associates, Inc. - The Source In Real Estate Placement</p></td>
<td class="copyright" align="right"><a href="http://www.3flexstudios.com"><img src="images/3flexlogo.gif" border="0"></a></td>
</tr>
</table>
</body>
</html>