:: Shehzad Roy ::

<% set rs= server.createobject("adodb.recordset") Rs.ActiveConnection = obj Rs.CursorType = 0 Rs.LockType = 1 valid = request ("valid") %> :: Shehzad Roy ::

<%if request("Occupation") = "Other" then%> <%end if%>


Information with an * is required.

First Name	"> *
Last Name	"> *
Address	*
Country	*
Town/City	<% if request("Country") = "Pakistan" or request("Country") = "" then %> <%else%> <%end if%> *
Zip Code	"> *
Phone	">
Mobile/Cell	">
Gender
Age Group
E-Mail	"> *
Occupation
Other	">
Comments	<%=request("Message")%>