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Contact Information:

 

Your Name*

Company Name

Address 1*

Address 2

Phone*

Fax

Email*

Project Information:

 

Length of recorded hours*

Number of tapes/files*

 

Subject matter
(choose all that apply):

Please note: Whenever possible, include agenda, list of attendees, slide printout, or other documentation to facilitate transcription.

 

Preferred turnaround:*

Please insert the numbers
that appear on the right.

 
HERE; } else { $to = 'pat@mwptranscripts.com'; $subject = "Request Estimate"; $headers = "From: Request Estimate \r\n\r\n"; $message = <<< HERE Name: $_POST[name] Company: $_POST[company] Address: $_POST[address1] Address: $_POST[address2] Phone: $_POST[phone] Fax: $_POST[fax] Email: $_POST[email] Length of recorded hours: $_POST[length] Number of tapes/files: $_POST[files] Medical: $_POST[medical] Nonmedical: $_POST[nonmedical] Interview: $_POST[interview] Focus group: $_POST[focus_group] Board meeting: $_POST[board_meeting] Symposium: $_POST[symposium] Other: $_POST[other] Verbatim: $_POST[verbatim] Time Coding: $_POST[time_code] Turnaround: $_POST[turnaround] HERE; if (!empty($_POST['validator']) && $_POST['validator'] == $_SESSION['rand_code']) { unset($_SESSION['rand_code']);} mail($to,$subject,$message,$headers); print <<< HERE

Thank you. We will reply shortly with your estimate.

HERE; } ?>
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