The Mortgage Clinic - Apply Online

<% @LANGUAGE = "VBScript" %> <% OPTION EXPLICIT %> <% ' =================================================== ' Receives Form and uses SENDMAIL to email the result ' to an email address '==================================================== Dim StrTitle,StrMethod,StrUrl Dim StrBodyHtml,oMail,StrEmail,strFrom,strReply,strSubject,FormSubmitted 'strMethod=Ucase(Request.ServerVariables("Request_Method")) 'strTitle=Ucase(Request.ServerVariables("Server_Name")) & "InfoRequest" 'strUrl=Lcase(Request.ServerVariables("URL")) ' with Response End With doesn't work with the development server if Request("FormSubmitted") Then StrBodyHtml="" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" '========================= StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "

" StrBodyHtml=StrBodyHtml & "

How did you find this Web site?
" StrBodyHtml=StrBodyHtml & Request("SiteFound") & "

" StrBodyHtml=StrBodyHtml & "

General Information

" StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & " " StrBodyHtml=StrBodyHtml & "

	Borrower	Co-borrower (If" StrBodyHtml=StrBodyHtml & " different)
Full Name:	" & Request("BName") & "	" & Request("CName") & "
Address:	" & Request("BAdd") & "	" & Request("CAdd") & "
City, State, Zip	" & Request("BCity") & ", " & Request("Bstate") & " " & Request("Bzip") & "	" & Request("Ccity") & ", " & Request("Cstate") & " " & Request("Czip") & "
Home Phone:	" & Request("BHtel") & "	" & Request("CHtel") & "
Work Phone:	" & Request("Bwtel") & "	" & Request("Cwtel") & "
Best time to contact:	" & Request("Bcalltime") & "	" & Request("Ccalltime") & "
E-mail:	" & Request("Bemail") & "	" & Request("cEmail") & "
Social Security #:	" & Request("Bssn") & "	" & Request("Cssn") & "
Employers:	" & Request("Bemp") & "	" & Request("Cemp") & "

Are you self employed" StrBodyHtml=StrBodyHtml & " ?	" & Request("BselfEmp") & "	" & Request("CselfEmp") & "
Length of Employment:	" & Request("BempTime") & "	" & Request("CempTime") & "
Gross Monthly Income:	" & Request("Bsal") & "	" & Request("Csal") & "

My credit history" StrBodyHtml=StrBodyHtml & " is:	" & Request("BcreditHist") & "	" & Request("CcreditHist") & "

" StrBodyHtml=StrBodyHtml & "

Loan Request

Amount Requested:	" & Request("LoanAmt") & "
Type of loan:	" & Request("LoanType") & "

" StrBodyHtml=StrBodyHtml & "

Property Information

Street Address:	" & Request("PropAdd") & "
City, State, Zip Code:	" & Request("PropCityStateZip") & "
Estimated Present Value:	" & Request("PropVal") & "
Year Purchased:	" & Request("YrPurch") & "
Original Price:	" & Request("PropPrice") & "
Type of Property:	" & Request("PropType") & "
Purchase Amount:	" & Request("PropPurch") & "

" StrBodyHtml=StrBodyHtml & "

Loan Information

Outstanding Mortgages
First:	$" & Request("firstMort") & "
Second:	$" & Request("secondMort") & "
Other:	$" & Request("OtherMort") & "

Creditors	Amount Owed	Monthly Payment	Will you pay this off ?
creditor1	$" & Request("amount_owed_1") & "	$" & Request("monthly_payment_1") & "	" & Request("payoff_1") & "
creditor2	$" & Request("amount_owed_2") & "	$" & Request("monthly_payment_2") & "	" & Request("payoff_2") & "
creditor3	$" & Request("amount_owed_3") & "	$" & Request("monthly_payment_3") & "	" & Request("payoff_3") & "
creditor4	$" & Request("amount_owed_4") & "	$" & Request("monthly_payment_4") & "	" & Request("payoff_4") & "

" StrBodyHtml=StrBodyHtml & "

Other monthly debts and information - please describe

" StrBodyHtml=StrBodyHtml & "

" & Request("other_info") & "

" StrBodyHtml=StrBodyHtml & "

" '========================= StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" '********************************** DLL *************************************** strEmail = Request("Bemail") strFrom = Request("Bemail") strReply = Request("Bemail") strSubject = "On-Line Information Request" 'Set oMail = Server.CreateObject("CDONTS.Newmail") oMail.To = "Tim@TheMortgageClinic.com" oMail.From = strFrom 'oMail.Value("Reply-To") = strReply oMail.BodyFormat = 0 oMail.MailFormat = 0 oMail.Subject = strSubject oMail.Body = strBodyHTML oMail.Send Set oMail = Nothing response.redirect("./thankyou.htm") end if %> The Mortgage Clinic - Apply Online <% ' =================================================== ' Receives Form and uses SENDMAIL to email the result ' to an email address '==================================================== ''''Dim StrTitle,StrMethod,StrUrl ''''Dim StrBodyHtml,oMail,StrEmail,strFrom,strReply,strSubject,FormSubmitted 'strMethod=Ucase(Request.ServerVariables("Request_Method")) 'strTitle=Ucase(Request.ServerVariables("Server_Name")) & "InfoRequest" 'strUrl=Lcase(Request.ServerVariables("URL")) ' with Response End With doesn't work with the development server if Request("FormSubmitted") Then StrBodyHtml="" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" '========================= StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "

" StrBodyHtml=StrBodyHtml & "

How did you find this Web site?
" StrBodyHtml=StrBodyHtml & Request("SiteFound") & "

" StrBodyHtml=StrBodyHtml & "

General Information

	Borrower	Co-borrower (If" StrBodyHtml=StrBodyHtml & " different)
Full Name:	" & Request("BName") & "	" & Request("CName") & "
Address:	" & Request("BAdd") & "	" & Request("CAdd") & "
City, State, Zip	" & Request("BCity") & ", " & Request("Bstate") & " " & Request("Bzip") & "	" & Request("Ccity") & ", " & Request("Cstate") & " " & Request("Czip") & "
Home Phone:	" & Request("BHtel") & "	" & Request("CHtel") & "
Work Phone:	" & Request("Bwtel") & "	" & Request("Cwtel") & "
Best time to contact:	" & Request("Bcalltime") & "	" & Request("Ccalltime") & "
E-mail:	" & Request("Bemail") & "	" & Request("cEmail") & "
Social Security #:	" & Request("Bssn") & "	" & Request("Cssn") & "
Employers:	" & Request("Bemp") & "	" & Request("Cemp") & "

Are you self employed" StrBodyHtml=StrBodyHtml & " ?	" & Request("BselfEmp") & "	" & Request("CselfEmp") & "
Length of Employment:	" & Request("BempTime") & "	" & Request("CempTime") & "
Gross Monthly Income:	" & Request("Bsal") & "	" & Request("Csal") & "

My credit history" StrBodyHtml=StrBodyHtml & " is:	" & Request("BcreditHist") & "	" & Request("CcreditHist") & "

" StrBodyHtml=StrBodyHtml & "

Loan Request

Amount Requested:	" & Request("LoanAmt") & "
Type of loan:	" & Request("LoanType") & "

" StrBodyHtml=StrBodyHtml & "

Property Information

Street Address:	" & Request("PropAdd") & "
City, State, Zip Code:	" & Request("PropCityStateZip") & "
Estimated Present Value:	" & Request("PropVal") & "
Year Purchased:	" & Request("YrPurch") & "
Original Price:	" & Request("PropPrice") & "
Type of Property:	" & Request("PropType") & "
Purchase Amount:	" & Request("PropPurch") & "

" StrBodyHtml=StrBodyHtml & "

Loan Information

Outstanding Mortgages
First:	$" & Request("firstMort") & "
Second:	$" & Request("secondMort") & "
Other:	$" & Request("OtherMort") & "

Creditors	Amount Owed	Monthly Payment	Will you pay this off ?
creditor1	$" & Request("amount_owed_1") & "	$" & Request("monthly_payment_1") & "	" & Request("payoff_1") & "
creditor2	$" & Request("amount_owed_2") & "	$" & Request("monthly_payment_2") & "	" & Request("payoff_2") & "
creditor3	$" & Request("amount_owed_3") & "	$" & Request("monthly_payment_3") & "	" & Request("payoff_3") & "
creditor4	$" & Request("amount_owed_4") & "	$" & Request("monthly_payment_4") & "	" & Request("payoff_4") & "

" StrBodyHtml=StrBodyHtml & "

Other monthly debts and information - please describe

" StrBodyHtml=StrBodyHtml & "

" & Request("other_info") & "

" StrBodyHtml=StrBodyHtml & "

" '========================= StrBodyHtml=StrBodyHtml & "" StrBodyHtml=StrBodyHtml & "" strEmail = Request("Bemail") strFrom = Request("Bemail") strReply = Request("Bemail") strSubject = "On-Line Information Request" Set oMail = Server.CreateObject("CDONTS.Newmail") oMail.To = "Tim@TheMortgageClinic.com" oMail.From = strFrom 'oMail.Value("Reply-To") = strReply oMail.BodyFormat = 0 oMail.MailFormat = 0 oMail.Subject = strSubject oMail.Body = strBodyHTML oMail.Send Set oMail = Nothing response.redirect("./thankyou.htm") end if %>


PRE-QUALIFY LOAN APPLICATION

How did you find this Web site?

General Information

	Borrower	Co-borrower (If different)
Full Name:
Address:
City, State, Zip
Home Phone:
Work Phone:
Best time to contact:
E-mail:
Social Security #:
Employers:

Are you self employed ?	Yes No	Yes No
Length of Employment:
Gross Monthly Income:

My credit history is:	excellent good, but some lates some credit problems major credit problems don't know	excellent good, but some lates some credit problems major credit problems don't know

Loan Request

Amount Requested:
Type of loan:

Property Information

(This information needs to be filled out for property that is collateral for the loan)

Street Address:
City, State, Zip Code:
Estimated Present Value:
Year Purchased:
Original Price:
Type of Property:	Primary Second/Vacation Investment
Purchase Amount:

Loan Information

Mortgage Balances	Amount:
First:
Second:
Other:

Creditors	Amount Owed	Monthly Payment	Will you pay this off ?
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No

Other monthly debts and information - please describe

HOME ] REFINANCE ] HOME IMPROVEMENT ] NEW HOME ] SECOND MORTGAGE ] DEBT CONSOLIDATION ]

PRE APPROVAL APPLICATION ] GLOSSARY ] CALCULATORS ] ABOUT US ] CONTACT US