Eco-$mart Contacts

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New Contact for ~ ~

*Required
*First Name:		Title:
*Last Name:		*Business Type:
Company:		*Phone:
*Address:		FAX:
City:		*Email:
State:	*Zip:	Referred by:	" . ""); } while($row2 = mysql_fetch_array($ok2)){ $name_1 = $row2['name_1']; $name_2 = $row2['name_2']; $name = $name_1.' '.$name_2; if($name != $usrn){ echo(""); } } mysql_select_db('ecosmar_contacts', $dbcnx); $ok3 = @mysql_query("SELECT name_1,name_2 FROM refcon ORDER BY name_2"); if (!$ok3) { echo ' Could not get Referrer List: ' . mysql_error(); }else{ while($row3 = mysql_fetch_array($ok3)){ $name_1 = $row3['name_1']; $name_2 = $row3['name_2']; $name = $name_1.' '.$name_2; echo(""); } } ?>
Alternate Contact: Title:
Notes:	Notes are dated automatically.	List for Email Marketing Program Activity Report First Contact Date: Type: Visit Phone Email Mail Response: +Pos ~NC -Neg Set RE-Contact Date (OPT) Date:
Upon successful submission of this Contact, you will be able to Register this Contact to a Manufacturer, Add this Contact to the Dealers List, Set up Referral Payments to this Contact, or Start a New Project with this Contact. Look for "Contact Options" on the Successful Submission Page.