Contact Us - Bio SB

Please fill out name, phone and email fields prior to submitting the form.
"; } else // check captcha { if ($_SESSION['security_code'] == stripslashes($_POST['phrase']) && !empty($_SESSION['security_code'])) { unset($_SESSION['security_code']); $goodCaptcha = true; } else { // invalid code entered unset($_SESSION['security_code']); $errorMsg = "You seem to have entered an incorrect spam prevention phrase. Please enter the letters you see in the image.
"; } } if ($goodCaptcha == true) // go ahead and process the form { $messageToSend = 'A visitor has sent email using the contact form on ' . $_SERVER["HTTP_HOST"] . ' Here is the information they submitted: --------------------------------------- Name: ' . stripslashes($fullName) . " "; if ($company != '') { $messageToSend .= "Company: " . stripslashes($company) . " "; } if ($address != '') { $messageToSend .= "Address: " . stripslashes($address) . " "; $messageToSend .= "City, State, Zip, Country: " . stripslashes($city) . ", " . stripslashes($state) . " " . stripslashes($zip) . " " . stripslashes($country) . " "; } if ($phone != '') { $messageToSend .= "Phone: " . stripslashes($phone) . " "; } if ($email != '') { $messageToSend .= "Email: " . stripslashes($email) . " "; } if ($message != '') { $messageToSend .= ' --------------------------------------- Message: '.stripslashes($message).' '; } $headers = "From: " . $fromAddress . " <" . $fromAddress . ">\r\n"; @mail($toAddress, $subject, $messageToSend, $headers); header("Location: contact-us-thanks.html"); } } ?> Contact Us - Bio SB

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Contact Us

Contact Bio SB at 805.692.2768 or at .

Name	:
Company	:
Address	:
City	:
State	:
Zip/Postal Code	:
Country	:
Phone	:
Email	:
Message	:	<?php echo $_POST['message'];?>

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