<% ' change to address of your own SMTP server dim strHost strHost = "mail.chocolatetamales.com" '"63.99.224.76" If Request("btnSubmit") <> "" Then Set Mail = Server.CreateObject("Persits.MailSender") ' enter valid SMTP host Mail.Host = strHost dim strNameOfCompany, strAddress, strCity, strState, strZipCode dim strPhone, strFax, strEmailAddress, strContactPerson, strYearsInBusiness dim strResaleNumber, strBusinessDesc, strTypeOfProducts strNameOfCompany = Request("NameOfCompany") strAddress = Request("Address") strCity = Request("City") strState = Request("State") strZipCode = Request("ZipCode") strPhone = Request("Phone") strFax = Request("Fax") strEmailAddress = Request("EmailAddress") strContactPerson = Request("ContactPerson") strYearsInBusiness = Request("YearsInBusiness") strResaleNumber = Request("ResaleNumber") strBusinessDesc = Request("BusinessDesc") strTypeOfProducts = Request("TypeOfProducts") strFromAddress = strEmailAddress strFromName = strContactPerson strToAddress = "NewAccounts@chocolatetamales.com" Mail.From = strFromAddress ' From address Mail.FromName = strFromName ' optional Mail.AddAddress strToAddress ' message subject Mail.Subject = "New Account Request: " & strNameOfCompany ' message body dim strBody, theTime theTime = now strBody = "Email Sent: " & theTime & vbCrLf & vbCrLf strBody = strBody & "A new account has been requested by: " & strContactPerson & " of " & strNameOfCompany & vbCrLf strBody = strBody & "Address: " & strAddress & vbCrLf strBody = strBody & "City: " & strCity & vbCrLf strBody = strBody & "State: " & strState & vbCrLf strBody = strBody & "Zip: " & strZipCode & vbCrlf strBody = strBody & "Phone: " & strPhone & vbCrLf strBody = strBody & "Fax: " & strFax & vbCrLf strBody = strBody & "Email: " & strEmailAddress & vbCrLf strBody = strBody & "Years In Business: " & strYearsInBusiness & vbCrLf strBody = strBody & "Resale Permit Number: " & strResaleNumber & vbCrLf strBody = strBody & "Business Description: " & strBusinessDesc & vbCrLf strBody = strBody & "Type of Products Sold: " & strTypeOfProducts & vbCrLf Mail.Body = strBody strErr = "" bSuccess = False On Error Resume Next ' catch errors Mail.Send ' send message If Err <> 0 Then ' error occurred strErr = Err.Description else bSuccess = True End If End If %> RESALE APPLICATION <% If strErr <> "" Then %>

RESALE APPLICATION

** All fields are required **

Name of Company:
Address:
City:
State: Zip Code:
Phone:
Fax:
Email Address:
Contact Person:
Years in Business:
Resale Permit Number:
Applying for:
Description of your business:
Type of products sold:
 

* Additional Requirements:

  • A hard copy of your resale certificate must be provided (to 604 S. Main St. Pleasanton, TX 78064)
  • Texas Resale Certificate Form number 01-339 - available HERE
  • An active credit card number must be on file at Ashur Products.  Credit cards accepted are:  Visa, MasterCard and American Express.
  • Your application will be processed and your account will be set up as soon as we receive the necessary information.