<%@ Language="VBScript" %> <% Response.Buffer = True ' --- PROCESS FORM SUBMISSION --- If Request.Form("is_submitted") = "true" Then ' 1. Capture Form Data Dim AcctFirstName, AcctLastName, AcctEmail, AcctPhone1, AcctAddress, AcctCity, AcctState, AcctZip Dim LessonLocation, StudentFirstName, StudentLastName, Age, Instrument, Comments, Msg AcctFirstName = Request.Form("AcctFirstName") AcctLastName = Request.Form("AcctLastName") AcctEmail = Request.Form("AcctEmail") AcctPhone1 = Request.Form("AcctPhone1") AcctAddress = Request.Form("AcctAddress") AcctCity = Request.Form("AcctCity") AcctState = Request.Form("AcctState") AcctZip = Request.Form("AcctZip") LessonLocation = Request.Form("LessonLocation") StudentFirstName = Request.Form("StudentFirstName") StudentLastName = Request.Form("StudentLastName") Age = Request.Form("Age") Instrument = Request.Form("Instrument") Comments = Request.Form("Comments") ' 2. Construct Email Body Msg = "NEW STUDENT REGISTRATION" & vbCrLf & "==========================" & vbCrLf Msg = Msg & "PARENT/ACCOUNT INFO:" & vbCrLf Msg = Msg & "Name: " & AcctFirstName & " " & AcctLastName & vbCrLf Msg = Msg & "Email: " & AcctEmail & vbCrLf Msg = Msg & "Phone: " & AcctPhone1 & vbCrLf Msg = Msg & "Address: " & AcctAddress & ", " & AcctCity & ", " & AcctState & " " & AcctZip & vbCrLf & vbCrLf Msg = Msg & "STUDENT INFO:" & vbCrLf Msg = Msg & "Student: " & StudentFirstName & " " & StudentLastName & " (Age: " & Age & ")" & vbCrLf Msg = Msg & "Instrument: " & Instrument & vbCrLf Msg = Msg & "Location: " & LessonLocation & vbCrLf Msg = Msg & "Availability/Comments: " & Comments & vbCrLf ' 3. Send via CDOSYS On Error Resume Next Dim objMessage, objConfig, Flds Set objMessage = CreateObject("cdo.message") Set objConfig = CreateObject("cdo.configuration") Set Flds = objConfig.Fields Flds.Item("http://schemas.microsoft.com/cdo/configuration/sendusing") = 2 Flds.Item("http://schemas.microsoft.com/cdo/configuration/smtpserver") = "p1401.use1.mysecurecloudhost.com" Flds.Item("http://schemas.microsoft.com/cdo/configuration/smtpauthenticate") = 1 Flds.Item("http://schemas.microsoft.com/cdo/configuration/sendusername") = "info@melodymusicstudios.com" Flds.Item("http://schemas.microsoft.com/cdo/configuration/sendpassword") = "%y233lm3J" Flds.Update Set objMessage.Configuration = objConfig objMessage.To = "melodymusicstudios@gmail.com; lilah@melodymusicstudios.com" objMessage.From = "SignUp@melodymusicstudios.com" objMessage.Subject = "New Sign Up: " & AcctLastName objMessage.TextBody = Msg objMessage.Send If Err.Number = 0 Then Response.Redirect("Success.html") ' Create this page for a thank you message Else Response.Write("Mail Error: " & Err.Description) End If On Error GoTo 0 End If %> Student Registration | Melody Music Studios

Student Registration

Complete the form below to begin lessons.

Parent / Guardian Info

First Name

Last Name

Cell Phone

City

State

Zip

Lesson Location

Student Information

Student First Name

Student Last Name

Age

Instrument

Availability

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