<%args> $control=>'mailForm' $Email => 'kelly@ccs-corporate.com' <%shared> my $IEmail; my %IARGS; <%init> $IEmail = $Email; %IARGS = %ARGS; <&$control&> <%def mailForm>


First name
Last name
Work Phone
Home Phone
E-mail
Location:
Be detailed, include block number, street, intersection, Hwy, etc.
If other, explain:
Be detailed, include block number, street, intersection, Hwy, etc.
Location Description
Type of traffic problem:
If other, explain
Please describe the problem
Do you wish to be contacted?
Method of contact:


The information contained in this site was valid at the time of posting. Dallas County assumes no liability for damages incurred directly or indirectly as a result of errors, omissions or discrepancies.
This site is sponsored by Cweb Communications. All rights reserved. This site was last edited on Wednesday, September 11, 2002 04:31:22 PM Central Time.
<%def email> <%init> use MIME::Lite; my $email = MIME::Lite->new( To => 'constable_pct_4@dallascounty.org', Subject => 'Citizens Traffic Complaint Form', From => '" Citizens Traffic Complaint Form" ', Type => 'TEXT', Data => " First Name: $IARGS{fname} Last Name: $IARGS{lname} Work Phone: $IARGS{wphone} Home Phone: $IARGS{hphone} Email: $IARGS{email} Location: $IARGS{location} Location Other: $IARGS{location_other} Location Description: $IARGS{location_description} Problem Type: $IARGS{problem_type} Problem Other: $IARGS{problem_other} Problem Description: $IARGS{problem_description} Contact Me: $IARGS{contact_me} Contact Method: $IARGS{contact_method}" ); $email->send; my $callPage=$IARGS{'callPage'}; $m->redirect("?control=done"); <%def done>

Thank you, your information has been sent.

Return to home page