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17th Annual KER Conference Registration

<% 'for each x in Request.ServerVariables ' response.write("

" + x + ": " + Request.ServerVariables (x) + "

") 'next %> <% if request.form("submit") = "Submit" then %> <% 'there be data process %> <% 'generate and send registrationinformation via email MessageBody = "" MessageBody = MessageBody + "Name " + request.Form("Name") + vbCrLf MessageBody = MessageBody + "Title " + request.Form("Title") + vbCrLf MessageBody = MessageBody + "Company " + request.Form("Company") + vbCrLf MessageBody = MessageBody + "Address " + request.Form("Address") + vbCrLf MessageBody = MessageBody + "City " + request.Form("City") + vbCrLf MessageBody = MessageBody + "State " + request.Form("State") + vbCrLf MessageBody = MessageBody + "Postal Code " + request.Form("PostalCode") + vbCrLf MessageBody = MessageBody + "Country " + request.Form("Country") + vbCrLf MessageBody = MessageBody + "Phone " + request.Form("Phone") + vbCrLf MessageBody = MessageBody + "Fax " + request.Form("Fax") + vbCrLf MessageBody = MessageBody + "E-mail " + request.Form("E-mail") + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "Registration Type" + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "RegType " + request.Form("RegType") + vbCrLf MessageBody = MessageBody + "MemberOfUSEF " + request.Form("MemberOfUSEF") + vbCrLf MessageBody = MessageBody + "MemberOfUSEA " + request.Form("MemberOfUSEA") + vbCrLf MessageBody = MessageBody + "MemberOfUSDF " + request.Form("MemberOfUSDF") + vbCrLf MessageBody = MessageBody + "MemberOfUSHJA " + request.Form("MemberOfUSHJA") + vbCrLf MessageBody = MessageBody + "MemberOfAERC " + request.Form("MemberOfAERC") + vbCrLf MessageBody = MessageBody + "MemberOfKHJA " + request.Form("MemberOfKHJA") + vbCrLf MessageBody = MessageBody + "MemberOfKDA " + request.Form("MemberOfKDA") + vbCrLf MessageBody = MessageBody + "MemberOfMSEDA " + request.Form("MemberOfMSEDA") + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "FutureEdicatinalContact " + request.Form("FutureEdicatinalContact") + vbCrLf MessageBody = MessageBody + "MoreAboutKER " + request.Form("MoreAboutKER") + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "Billing Information" + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "Credit Card " + request.Form("CC") + vbCrLf MessageBody = MessageBody + "CCNameOnCard " + request.Form("CCNameOnCard") + vbCrLf MessageBody = MessageBody + "CCNumber " + request.Form("CCNumber") + vbCrLf MessageBody = MessageBody + "CCExpDate " + request.Form("CCExpDate") + vbCrLf MessageBody = MessageBody + "BillingAddressSame " + request.Form("BillingAddressSame") + vbCrLf MessageBody = MessageBody + "BillingAddress " + request.Form("BillingAddress") + vbCrLf MessageBody = MessageBody + "BillingCity " + request.Form("BillingCity") + vbCrLf MessageBody = MessageBody + "BillingStateme " + request.Form("BillingState") + vbCrLf MessageBody = MessageBody + "BillingPostalCode " + request.Form("BillingPostalCode") + vbCrLf MessageBody = MessageBody + "BillingCountry " + request.Form("BillingCountry") + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf MessageBody = MessageBody + "------------------------------------------------------------------" + vbCrLf MessageBody = MessageBody + vbCrLf + vbCrLf for each x in request.Form MessageBody = MessageBody + x + ": " + request.Form(x) + vbCrLf next Set myMail=CreateObject("CDO.Message") myMail.Subject="2010 Conference Registration" myMail.From="Conference Registration Form " myMail.To="Eileen Phethean " myMail.Cc="Brian Lauer " myMail.TextBody=MessageBody myMail.Send %>

Thanks for registering.

2010 Nutrition Conference

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Yes, I would like to register for the 2010 KER Conference!

Name " />
Title " />
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Registration Type

Two Day

/> Regular - $500.00
/> Early Bird (prior to March 26th) - $450
/> Academia/Government - $300
/> AAEP Member - $300
/> Student - $250

One Day - Monday, April 26th

/> Day One Only - $300

Horsemen's Day - Tuesday, April 27th

/> Horsemen's Day Only - $150
Nutritional Management of Sport Horses: Different Systems for Different Disciplines /> Horsemen's Day Only - Affiliation Member - $100

Specify member of:

USEF # " />
USEA # " />
USDF # " />
USHJA # " />
AERC # " />
KHJA # " />
KDA # " />
MSEDA # " />
/> Please contact me regarding future educational opportunities from Kentucky Equine Research.
/> I would like to hear more about Kentucky Equine Research products and services.

Billing Information

Please charge my /> Visa
/> MC
/> Am Ex
Name On Card " />
Card# " />
Exp. Date " />

Billing Address

/> Same as above
Address " />
City " />
State " />
Postal Code " />
Country " />
<% end if %>