trim; $name->trim; if( $name == '' || $email == '' || $addr1 == '' || $city == '' || $state == '' || $zip == '' || $phone == '' || $card_type == '' || $card_num == '' || $mo_expires == '' || $yr_expires == '' || $mo_expires == '' || $illegible == '' && $card_id == ''); $valError->(insert: 1 = 'Missing required items for billing.'); /if; $card_id == 0 ? var:'card_id'=''; ($card_id == '' && $illegible == '') ? $valError->(insert: 7 = 'A valid card id choice needs to be chosen.'); !(valid_creditcard:(var:'card_num')) ? $valError->(insert: 3 = 'The credit card number entered is invalid.'); $now > $exp_date ? $valError->(insert: 8 = 'Your card doesn\'t have a valid expiry date.'); if(abc_checkEmail:$email == false); $valError->(insert:2='Please check your email address.'); /if; if($valError->size ==0); $displayForm = false; // recipient to send email to var:'sec_card_id'; (var:'card_id')!='' ? var: 'sec_card_id' = (Encrypt_BlowFish: $card_id, -Seed=($blow_seed)); var: 'sec_card_num' = (Encrypt_BlowFish: $card_num, -Seed=($blow_seed)); var: 'sec_mo_expires' = (Encrypt_BlowFish: $mo_expires, -Seed=($blow_seed)); var: 'sec_yr_expires' = (Encrypt_BlowFish: $yr_expires, -Seed=($blow_seed)); var: 'sec_card_type' = (Encrypt_BlowFish: $card_type, -Seed=($blow_seed)); ///* Inline: $connection, -table='customers', 'email'=(var:'email'), 'phone'=(var:'phone'), 'heard'=(var:'heard'), 'practice'=(var:'practice'), 'fax'=(var:'fax'), 'name'=(var:'name'), 'addr1'=(var:'addr1'), 'addr2'=(var:'addr2'), 'city'=(var:'city'), 'state'=(var:'state'), 'zip'=(var:'zip'), 'comments'=(var:'comments'), 'add_date'=$now, 'status'='pending', -keyField='id', -Add; var:'custID'=(keyField_value); _db_error; Inline: $connection, -table='customers_ext', 'custID'=$custID, 'mo_expires'=$sec_mo_expires, 'yr_expires'=$sec_yr_expires, 'card_num'=$sec_card_num, 'card_type'=$sec_card_type, 'card_id'=$sec_card_id, 'illegible'=$illegible, 'add_date'=$now, -keyField='id', -add; _db_error; /inline; /inline; // */ //.................................................................................// // EMAIL section //*/ var('to' = 'Christi@SchedulingInstitute.com, Kimeran@SchedulingInstitute.com'); //var('to' = 'alex@flagshiphosting.com'); var('emailBody' = 'The following order has been submitted via the web site.\n Name: ' + $name+' Email: ' + $email+' Address: \n'+$addr1+' ' +$addr2+' '+ $city+', '+$state+' '+ $zip+'\n Phone: '+$phone+'\n Fax: '+$fax+'\n\n' +$comments+'\n Go to the order admin to view the customer details.'); var('subject'='Your Scheduling Institute Order'); var('emailCustbody' = 'Thank you for joining the Scheduling Institute. Your Staff Training Kit will be shipped within 24 hours of receiving your order.\n If you have any questions please call us at: 770-518-7575'); email_send( -to=$to, -bcc='alex@flagshiphosting.com', -from=$to, -subject='New Scheduling Institute order received', -body=$emailBody); email_send( -to=$email, -bcc='alex@flagshiphosting.com', -from=$to, -subject=$subject, -body=$emailCustBody); var('thankyou' = '/thank-you.htm'); redirect_url($thankyou); //*/ else; $displayForm = true; /if; /if; if($displayForm); ?>

800.518.9733

Worldwide Leader in New Patient Generation

Option #2: Basic Training
~~Regular Price $2,499~~ | $1,599 - Internet Special!
I'm Ready to Join! Train My Staff via Your Proven Distance Learning Program.

Option #3: On Site Training w/ Certified Training Specialist
~~Regular Price $6,100~~ | $5,995 - *Most Popular!*
I'm Ready to Join! Send Your Certified On-Site Trainer to My Office for a One Day Intensive Training Session with My Staff.

Option #4: On Site Training w/ Jay Geier
~~Regular Price $19,995~~ | $15,995 - Internet Special!
I'm Ready to Join...And I Want The Best! I Want Jay, Himself, to Come to My Office for a One Day Intensive Training Session with My Staff. [if($valError != map)]

ALERT
[iterate($valError, local('item'))][loop_count]) [#item->second]
[/iterate]

[/if]

*Required

*Name:

*Practice Name:

*Phone:

*Fax:

*Email:

*Address:

Address 2:

*City:

*State:

*Zip Code:

Card Type:

*Credit Card Number:

*Expiration Date:

*Credit Card Security ID:

Illegible

*How Did You Hear About Us?

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