.net CLR Version: 4.0.30319.42000 Robert Betz, RobertWBetz.com

Adopt & Bowls

Adopt Dogs

Adopt Cats

Volunteer

Donate

Donate Vehicles

Donate Online

Behavior Help



A dog in goggles sticks his head out the window of a yellow volkswagon bug

This webpage form exhibits some past work I have done with Asp.Net programming with VB.Net.
This page has been retired and replaced as part of a complete new Wordpress website for the
Penninsula Humane Society

This is a working webpage that can be filled out and submitted. The original production page returned
an acknowledgement web page and a thank you email to the submitter with an attached .PDF of
the information they submitted.

The PHS donation staff was sent an email alerting them to the new donation. That email had 3 attachments:
(1) the same .PDF document that was sent to the submitter
(2) a .VCF file to allow easy transfer of the donor contact information into Outlook
(3) a .TXT file to be used like a .CSV file to allow easy addition of donor information to Excel

For demonstration purposes, if you submit the form with a valid email, the thank you email will include
the same files as attached to the PHS donation staff.
The donor information was also saved in a MS Access database. There were various forms and reports
available to manage donor information.

We accept vehicle donations (cars, trucks, motorcycles, boats, etc.) regardless of their ability to run
and/or pass smog, and whether or not you still have the title. We handle all the paperwork and take
pride in making the whole process safe, quick and easy for you.

To get started, simply fill in the form below. Clicking the submit button will send your information to us
on our secure web server, with a copy going to the email address you provide. After we receive your
information you'll receive a call to coordinate the pick up or drop off. Towing can typically be scheduled
for a window of time within a few days after we receive your information, or a date of your choosing.

yellow shading = this information is required for your form to be submitted

REGISTERED OWNER INFORMATION
  Last Name     
  Address-2     
 State  Zip  

Person to contact (if different) Relationship to owner 

Address where vehicle is located (if different)
  Address-2     
 State  Zip  

Please enter the best phone number for contact in Phone-1
     Phone-2 
Confirm Email

VEHICLE INFORMATION
Year     Make     Model     Body Style
Delivery preference?    Do you have the title? 
Is vehicle drivable? 
  Is the registration current?     If no, how much is due? 
?? Check all that apply:


License Plate    Mileage(can be approximate)    VIN
Overall condition (100)

Anything else we should know? (quirks, work needed, past history, condition specifics, etc.) (750)