<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> <% Dim MM_editAction MM_editAction = CStr(Request.ServerVariables("SCRIPT_NAME")) If (Request.QueryString <> "") Then MM_editAction = MM_editAction & "?" & Server.HTMLEncode(Request.QueryString) End If ' boolean to abort record edit Dim MM_abortEdit MM_abortEdit = false %> <% If (CStr(Request("MM_insert")) = "Registration_Form") Then If (Not MM_abortEdit) Then ' execute the insert Dim MM_editCmd Set MM_editCmd = Server.CreateObject ("ADODB.Command") MM_editCmd.ActiveConnection = MM_connMMCal_STRING MM_editCmd.CommandText = "INSERT INTO tblDonate (Lastname, FirstName, Home_Address, Home_City, Home_State, Home_ZipCode, Home_Phone, EmailAddress) VALUES (?, ?, ?, ?, ?, ?, ?, ?)" MM_editCmd.Prepared = true MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param2", 202, 1, 250, Request.Form("LastName")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param3", 202, 1, 250, Request.Form("FirstName")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param4", 203, 1, 536870910, Request.Form("home_Address")) ' adLongVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param5", 202, 1, 150, Request.Form("home_City")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param6", 202, 1, 5, Request.Form("home_state")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param7", 202, 1, 25, Request.Form("home_ZipCode")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param8", 202, 1, 50, Request.Form("home_Phone")) ' adVarWChar MM_editCmd.Parameters.Append MM_editCmd.CreateParameter("param9", 202, 1, 250, Request.Form("EmailAddress")) ' adVarWChar MM_editCmd.Execute MM_editCmd.ActiveConnection.Close End If End If %> <% If (CStr(Request("XYzy")) = "goaway") Then %> <% Const cdoSendUsingPickup = 1 Const cdoSendUsingPort = 2 Const cdoAnonymous = 0 Const cdoBasic = 1 Const cdoNTLM = 2 Set oMail = CreateObject("CDO.Message") oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/sendusing") = 2 oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpserver") = "mail.meckmed.org" oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpauthenticate") = cdoBasic oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/sendusername") = "webmaster@meckmed.org" oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/sendpassword") = "mario123!" oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpserverport") = 25 oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpusessl") = False oMail.Configuration.Fields.Item _ ("http://schemas.microsoft.com/cdo/configuration/smtpconnectiontimeout") = 60 oMail.Configuration.Fields.Update oMail.Sender = "webmaster@meckmed.org" oMail.From = "webmaster@meckmed.org" 'oMail.To = "ssmith@meckmed.org" oMail.To = "webwizard@carolina.rr.com" 'oMail.To = "leegthach@gmail.com" oMail.Subject = "Meck Med Donation" oMail.HTMLBody = "" oMail.HTMLBody = oMail.HTMLBody + "Date: "& Date() &"
" oMail.HTMLBody = oMail.HTMLBody + "Donating To: "& request.form("DonateTo")&"
" oMail.HTMLBody = oMail.HTMLBody + "Last Name: "& request.form("LastName")&"
" oMail.HTMLBody = oMail.HTMLBody + "First Name: "& request.form("FirstName")&"
" oMail.HTMLBody = oMail.HTMLBody + "Home Address: "& request.form("home_Address")&"
" oMail.HTMLBody = oMail.HTMLBody + "City: "& request.form("home_City")&"
" oMail.HTMLBody = oMail.HTMLBody + "State: "& request.form("home_state")&"
" oMail.HTMLBody = oMail.HTMLBody + "Zip: "& request.form("home_ZipCode")&"
" oMail.HTMLBody = oMail.HTMLBody + "Phone: "& request.form("home_Phone")&"
" oMail.HTMLBody = oMail.HTMLBody + "Email: "& request.form("EmailAddress")&"

" oMail.HTMLBody = oMail.HTMLBody + "
" oMail.Send Set oMail = Nothing Set oMailConfig = Nothing %> <% end if %> Mecklenburg County Medical Society
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Make a Donation

Thank you to all who support the Mecklenburg County Medical Society and Meck PAC.

<% if NOT request.form("qmcheck") = "True" then %>

If you would like to pay by check: 

Mail check to Mecklenburg County Medical Society at 1112 Harding Place, Suite 200, Charlotte, NC  28204. 
Make check payable to:

MCMS Foundation Make payable to MCMS Foundation
Scholarship Fund Make payable to MCMS Foundation, note at bottom “Scholarship Fund”
Meck PAC Make payable to Meck PAC

“North Carolina law requires political committees to report the name, mailing address, job title or profession, and name of employer or employer’s specific field, for each individual whose contributions' aggregate is in excess of $100 in an election cycle. ”



Donate to: MCMS Foundation
Scholarship Fund
Meck PAC (must be a personal credit card)
Last Name
First Name
Address
City
State
Zip Code
Phone
E-mail address to send receipt
   
 

 

<% else %>

THANK YOU!

You are being redirected to our payment processing system.

 

 

 

<% end if %>