Feedback Form

Enquiry received at Meerut Agro Chemical Industries Limited "; $msg .="Customer Details "; $msg .="Contact Person Name: $cname "; $msg .="Company Name: $com_name "; $msg .="Address: $address "; $msg .="Phone Number: $pcode-$phone "; if(strlen($fax)){ $msg .="Fax Number: $fax "; } $msg .="EmailID: $email "; if(strlen($website)){ $msg .="Website Address: $website "; } if(strlen($city)){ $msg .="City: $city "; } if(strlen($state)){ $msg .="State: $state "; } if(strlen($country)){ $country1=$country; } else{ $country1=$other; } $msg .="Country: $country1 "; if(strlen($product)){ $msg .="Products: $product "; } if(strlen($comment)){ $msg .="Comment: $comment "; } $headers = "From: $email\n"; $headers .= "cc: $CC\n"; $headers .= "X-Mailer: PHP/". phpversion(); $headers .= "X-Priority: 3 \n"; $headers .= "MIME-version: 1.0\n"; $headers .= "Content-Type: text/html; charset=iso-8859-1\n"; mail($To, $subject, $msg, $headers); //client... $to=$email; $from1="info@pdtmc.com"; $subject1="Thanks For Sending Enquiry"; $msg1="Dear $cname, "; $msg1 .="Thanks for sending us an enquiry. We have received your enquiry and we will get back to you soon, for further proceedings. "; $msg1 .="Thanks "; $msg1 .="Meerut Agro Chemical Industries Limited "; $msg1 .="A-1/105 Harsha House, Karampura Commercial Complex, "; $msg1 .="New Delhi-110015. (India) "; $msg1 .="Tel : +(91)-(11)-25920561/25920563 "; $msg1 .="Fax : +(91)-(11)-25920560. "; $headers1 = "From: info@meerutagro.com\n"; $headers1 .= "X-Mailer: PHP/". phpversion(); $headers1 .= "X-Priority: 3 \n"; $headers1 .= "MIME-version: 1.0\n"; $headers1 .= "Content-Type: text/html; charset=iso-8859-1\n"; mail($to, $subject1, $msg1, $headers1); echo"Your Enquiry has been sent successfully... "; } ?>
(*represents compulsory fields)
Name*	:
Address*	:
Company Name*	:
Phone No.*	:
Fax No.	:
E-mail Address*	:
Website Address	:
City	:
State	:
Country*	:	--Select Country-- India Australia Brazil China Canada New Zealand Sri Lanka Pakistan Bangladesh   If Other Please Specify
Product Name*	:	--Select Product-- Pesticides Bio Fertilizers Spray Adjuvants Bio Pesticides
Comments