<%@language="javascript" %> <% // checking if form was posted if(Request.Form("isPost")=="yes"){ var strLeadSite="debtpreventionandmanagement.co.uk"; var strData=Request.Form()+""; strData+="&leadsite="+strLeadSite; main(); }else{ var strFirstName = Session("firstname"); var strLastName = Session("lastname"); var strPostcode = Session("postcode"); var strTelephone = Session("telephone"); var strMobile = Session("mobile"); } // creating functions function echo(str){ Response.Write(str); } function main(){ postResultToOurService(strData); Response.Redirect("thankyou.html"); } function postResultToOurService(strLead){ try{ var objXMLHTTP_Log = Server.CreateObject("Msxml2.XMLHTTP"); var strServiceURL_Log = "http://94.136.39.80/loanhub/dm/main.php"; objXMLHTTP_Log.open("POST",strServiceURL_Log,false); objXMLHTTP_Log.setRequestHeader("Content-Type", "application/x-www-form-urlencoded"); var strData=strLead+""; objXMLHTTP_Log.send(strData); //echo(objXMLHTTP_Log.responseText); }catch(ex){ var strError = "/////// ERROR IN POSTING RESULT TO SERVICE /////\r\n"; strError += ex.description + "\r\n"; strError += "for " + Request.Form+""; logError(strError); } } %> Loan Application Form

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Salutation
First Name
LastName
Annual Income
Telephone(Home)
Telephone(Office)
Mobile
House name/Number
Postcode
Amount of Unsecured Debt
How many creditors
Are you struggling with your debts? Yes No
 
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THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME. YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON A MORTGAGE OR ANY OTHER DEBT SECURED ON IT.
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