The letters you entered for the security image did not match the letters on the image. Please go back and correct it.'); } } $newid = insert($salesPerson,$businessName,$address,$city,$state,$zip,$liame,$phone,$taxID,$busType,$busYears,$officer1,$officer2,$officer3,$position1,$position2,$position3,$otherLoan1,$otherLoan2,$otherLoan3,$loanPhone1,$loanPhone2,$loanPhone3,$bank,$bankAddress,$bankPhone,$comments,$http_referrer,$ip); sendEMail($sitename,$siteemail,$emailto,$subject,$salesPerson,$businessName,$address,$city,$state,$zip,$liame,$phone,$taxID,$busType,$busYears,$officer1,$officer2,$officer3,$position1,$position2,$position3,$otherLoan1,$otherLoan2,$otherLoan3,$loanPhone1,$loanPhone2,$loanPhone3,$bank,$bankAddress,$bankPhone,$comments,$http_referrer); message('Thank you for contacting us.

A representative will get
back to you shortly.'); break; default : showFrm($CaptchaImage,$affiliate,$CaptchaPubKey); } function showFrm($CaptchaImage,$affiliate,$CaptchaPubKey) { ?>

Business Application

Business Credit Information
Sales Person:
 
Business Name:
Address: City:
State: Zip:
Phone: Email Address:
Tax ID: Type of Business:
Years in Business:    
Company Officers
Names: Position:
Trade Credit References (other loans or leases and their suppliers)
Phone:
Bank Information
Bank Name:
Address: Phone:
Comments:
\r\nReply-to: ".$liame,"-f$siteemail"); if(!$SentSuccess) { die('There was an error submitting your form. Please contact our office and provide the error #EM-1'); } return; } function message($message) { echo "

$message

"; } ?>