<% ' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit. On Error Resume Next Session("FP_OldCodePage") = Session.CodePage Session("FP_OldLCID") = Session.LCID Session.CodePage = 1252 Err.Clear strErrorUrl = "" If Request.ServerVariables("REQUEST_METHOD") = "POST" Then If Request.Form("VTI-GROUP") = "0" Then Err.Clear Set fp_conn = Server.CreateObject("ADODB.Connection") FP_DumpError strErrorUrl, "Cannot create connection" Set fp_rs = Server.CreateObject("ADODB.Recordset") FP_DumpError strErrorUrl, "Cannot create record set" fp_conn.Open Application("cancerdata_ConnectionString") FP_DumpError strErrorUrl, "Cannot open database" fp_rs.Open "Results", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable FP_DumpError strErrorUrl, "Cannot open record set" fp_rs.AddNew FP_DumpError strErrorUrl, "Cannot add new record set to the database" Dim arFormFields0(37) Dim arFormDBFields0(37) Dim arFormValues0(37) arFormFields0(0) = "Name" arFormDBFields0(0) = "Name" arFormValues0(0) = Request("Name") arFormFields0(1) = "Spouse" arFormDBFields0(1) = "Spouse" arFormValues0(1) = Request("Spouse") arFormFields0(2) = "Address" arFormDBFields0(2) = "Address" arFormValues0(2) = Request("Address") arFormFields0(3) = "City" arFormDBFields0(3) = "City" arFormValues0(3) = Request("City") arFormFields0(4) = "State" arFormDBFields0(4) = "State" arFormValues0(4) = Request("State") arFormFields0(5) = "Zip" arFormDBFields0(5) = "Zip" arFormValues0(5) = Request("Zip") arFormFields0(6) = "Phone" arFormDBFields0(6) = "Phone" arFormValues0(6) = Request("Phone") arFormFields0(7) = "Website" arFormDBFields0(7) = "Website" arFormValues0(7) = Request("Website") arFormFields0(8) = "Email" arFormDBFields0(8) = "Email" arFormValues0(8) = Request("Email") arFormFields0(9) = "Column1" arFormDBFields0(9) = "Column1" arFormValues0(9) = Request("Column1") arFormFields0(10) = "Column2" arFormDBFields0(10) = "Column2" arFormValues0(10) = Request("Column2") arFormFields0(11) = "Column3" arFormDBFields0(11) = "Column3" arFormValues0(11) = Request("Column3") arFormFields0(12) = "Column4" arFormDBFields0(12) = "Column4" arFormValues0(12) = Request("Column4") arFormFields0(13) = "Column5" arFormDBFields0(13) = "Column5" arFormValues0(13) = Request("Column5") arFormFields0(14) = "Column6" arFormDBFields0(14) = "Column6" arFormValues0(14) = Request("Column6") arFormFields0(15) = "Column7" arFormDBFields0(15) = "Column7" arFormValues0(15) = Request("Column7") arFormFields0(16) = "Column8" arFormDBFields0(16) = "Column8" arFormValues0(16) = Request("Column8") arFormFields0(17) = "Column9" arFormDBFields0(17) = "Column9" arFormValues0(17) = Request("Column9") arFormFields0(18) = "Column10" arFormDBFields0(18) = "Column10" arFormValues0(18) = Request("Column10") arFormFields0(19) = "Column11" arFormDBFields0(19) = "Column11" arFormValues0(19) = Request("Column11") arFormFields0(20) = "Column12" arFormDBFields0(20) = "Column12" arFormValues0(20) = Request("Column12") arFormFields0(21) = "Column13" arFormDBFields0(21) = "Column13" arFormValues0(21) = Request("Column13") arFormFields0(22) = "Column14" arFormDBFields0(22) = "Column14" arFormValues0(22) = Request("Column14") arFormFields0(23) = "Column15" arFormDBFields0(23) = "Column15" arFormValues0(23) = Request("Column15") arFormFields0(24) = "Column16" arFormDBFields0(24) = "Column16" arFormValues0(24) = Request("Column16") arFormFields0(25) = "Column17" arFormDBFields0(25) = "Column17" arFormValues0(25) = Request("Column17") arFormFields0(26) = "Column18" arFormDBFields0(26) = "Column18" arFormValues0(26) = Request("Column18") arFormFields0(27) = "Column19" arFormDBFields0(27) = "Column19" arFormValues0(27) = Request("Column19") arFormFields0(28) = "Column20" arFormDBFields0(28) = "Column20" arFormValues0(28) = Request("Column20") arFormFields0(29) = "Column21" arFormDBFields0(29) = "Column21" arFormValues0(29) = Request("Column21") arFormFields0(30) = "Column22" arFormDBFields0(30) = "Column22" arFormValues0(30) = Request("Column22") arFormFields0(31) = "Column23" arFormDBFields0(31) = "Column23" arFormValues0(31) = Request("Column23") arFormFields0(32) = "Column24" arFormDBFields0(32) = "Column24" arFormValues0(32) = Request("Column24") arFormFields0(33) = "Column25" arFormDBFields0(33) = "Column25" arFormValues0(33) = Request("Column25") arFormFields0(34) = "Column26" arFormDBFields0(34) = "Column26" arFormValues0(34) = Request("Column26") arFormFields0(35) = "Column27" arFormDBFields0(35) = "Column27" arFormValues0(35) = Request("Column27") arFormFields0(36) = "Column28" arFormDBFields0(36) = "Column28" arFormValues0(36) = Request("Column28") FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0 fp_rs.Update FP_DumpError strErrorUrl, "Cannot update the database" fp_rs.Close fp_conn.Close FP_FormConfirmationFromArrays "text/html; charset=windows-1252",_ "Form Confirmation",_ "Thank you for submitting the following information:",_ "submission_form.asp",_ "Return to the form.",_ arFormDBFields0,_ arFormValues0 End If End If Session.CodePage = Session("FP_OldCodePage") Session.LCID = Session("FP_OldLCID") %> <% Response.Buffer = True %> Results -- New
Submission Form
 | Submission Form | 



Name
 

Spouse
 

Address
 

City
 

State
 

Zip
 

Phone
 

Website
 

Email
 

Column1  What are your children's names?
 

Column2  What was the deciding factor for you to make the decision to buy this book?
 

Column3  Would you share this book with others?
 

Column4  Why would you share this book with others?
 

Column5   Where did you buy this book?
 

Column6   Which country do you live in?
 

Column7  How long have you been at your present address?
 

Column8  What type of work do you do?
 

Column9  What type of work does you spouse or partner do?
 

Column10  Have you had cancer before?
 

Column11  What kind of cancer?
 

Column12  Is the cancer gone?
 

Column13  How did you treat it?
 

Column14 How many times have you had cancer?
 

Column15  What type of other diseases do you deal with?
 

Column16  Do you try to live healthy?
 

Column17  Would you help me with my war effort to educate people about cancer?
 

Column18  What would you feel comfortable doing?
 

Column19  Would you place a banner on your home site or in your outgoing emails?
 

Column20  Do you have ideas to help me with my war to help educate people about cancer?
 

Column21  Do you have a business or a place you could place my book for others to purchase and would you place them there?
 

Column22  If you could buy some books to place in your business how many would you buy?
 

Column23  Would you buy some books to share with your friends and relatives?
 

Column24  If you bought books to share how many books would you buy?
 

Column25  Please give some comments sharing your feelings about the book. Keep it short.
 

Column26
 

Column27
 

Column28