<?

function my_get_post($name,$escape=false)
{
  $var_read = '';
  if (isset($_POST[$name]))
  {
    $var_read = $_POST[$name];
    if (get_magic_quotes_gpc()) $var_read=stripslashes($var_read);
	if ($escape) $var_read=htmlspecialchars($var_read,ENT_QUOTES);
  }
  return $var_read;
}


function form_5_count_spam($str)
{
$nb=0;
$word='http:';
if (stristr($str,$word)) $nb++;
$word='<';
if (stristr($str,$word)) $nb++;
$word='>';
if (stristr($str,$word)) $nb++;

return $nb;
}

function isEmail($str) 
{
  if(eregi("^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,4})$", $str)) 
    return true;
  else
    return false;
}
  $form_5_class='form_5_error';
$form_5_error='';
  $form_5_spam=0;
  
$form_5_td_28_class='form_5_info';
$form_5_td_28_error='&nbsp;';
$form_5_td_28_value='';

$form_5_td_29_class='form_5_info';
$form_5_td_29_error='&nbsp;';
$form_5_td_29_value='';

$form_5_td_30_class='form_5_info';
$form_5_td_30_error='&nbsp;';
$form_5_td_30_value='';

$form_5_td_31_class='form_5_info';
$form_5_td_31_error='&nbsp;';
$form_5_td_31_value='';

$form_5_td_32_class='form_5_info';
$form_5_td_32_error='&nbsp;';
$form_5_td_32_value='';


if ('dauuzqnw'==my_get_post('form_5_submit'))
{
$form_5_error_string='There are errors which need correction.';
$form_5_td_28_error_class='form_5_error';
$form_5_td_28_error_must='Error: This field is required!';
$form_5_td_28_error_spam='Error: http: < > are not allowed!';


$form_5_td_28_value=my_get_post('Name' ,true);
$form_5_body.='Name : '.my_get_post('Name')."\r\n";


if (''==trim(my_get_post('Name'))) {$form_5_td_28_class=$form_5_td_28_error_class; $form_5_td_28_error=$form_5_td_28_error_must; $form_5_error=$form_5_error_string;}
  

$form_5_td_28_spam=form_5_count_spam(my_get_post('Name'));
if ($form_5_td_28_spam>0)
{
  if ($form_5_td_28_class!=$form_5_td_28_error_class) {$form_5_td_28_class=$form_5_td_28_error_class; $form_5_td_28_error=$form_5_td_28_error_spam; $form_5_error=$form_5_error_string;}
  $form_5_spam += $form_5_td_28_spam;
}
  
$form_5_td_29_error_class='form_5_error';
$form_5_td_29_error_must='Error: This field is required!';
$form_5_td_29_error_validation='Error: This field must be an email!';
$form_5_td_29_error_spam='Error: http: < > are not allowed!';


$form_5_td_29_value=my_get_post('Email' ,true);
$form_5_body.='Email : '.my_get_post('Email')."\r\n";


if (''==trim(my_get_post('Email'))) {$form_5_td_29_class=$form_5_td_29_error_class; $form_5_td_29_error=$form_5_td_29_error_must; $form_5_error=$form_5_error_string;}
  

if ($form_5_td_29_class!=$form_5_td_29_error_class && ''!=trim(my_get_post('Email')) && !isEmail(my_get_post('Email'))) {$form_5_td_29_class=$form_5_td_29_error_class; $form_5_td_29_error=$form_5_td_29_error_validation; $form_5_error=$form_5_error_string;}
  

$form_5_td_29_spam=form_5_count_spam(my_get_post('Email'));
if ($form_5_td_29_spam>0)
{
  if ($form_5_td_29_class!=$form_5_td_29_error_class) {$form_5_td_29_class=$form_5_td_29_error_class; $form_5_td_29_error=$form_5_td_29_error_spam; $form_5_error=$form_5_error_string;}
  $form_5_spam += $form_5_td_29_spam;
}
  
$form_5_td_30_error_class='form_5_error';
$form_5_td_30_error_spam='Error: http: < > are not allowed!';


$form_5_td_30_value=my_get_post('Address' ,true);
$form_5_body.='Address : '.my_get_post('Address')."\r\n";


$form_5_td_30_spam=form_5_count_spam(my_get_post('Address'));
if ($form_5_td_30_spam>0)
{
  if ($form_5_td_30_class!=$form_5_td_30_error_class) {$form_5_td_30_class=$form_5_td_30_error_class; $form_5_td_30_error=$form_5_td_30_error_spam; $form_5_error=$form_5_error_string;}
  $form_5_spam += $form_5_td_30_spam;
}
  
$form_5_td_31_error_class='form_5_error';
$form_5_td_31_error_spam='Error: http: < > are not allowed!';


$form_5_td_31_value=my_get_post('Telephone' ,true);
$form_5_body.='Telephone : '.my_get_post('Telephone')."\r\n";


$form_5_td_31_spam=form_5_count_spam(my_get_post('Telephone'));
if ($form_5_td_31_spam>0)
{
  if ($form_5_td_31_class!=$form_5_td_31_error_class) {$form_5_td_31_class=$form_5_td_31_error_class; $form_5_td_31_error=$form_5_td_31_error_spam; $form_5_error=$form_5_error_string;}
  $form_5_spam += $form_5_td_31_spam;
}
  
$form_5_td_32_error_class='form_5_error';
$form_5_td_32_error_spam='Error: http: < > are not allowed!';


$form_5_td_32_value=my_get_post('Comments' ,true);
$form_5_body.='Comments : '.my_get_post('Comments')."\r\n";


$form_5_td_32_spam=form_5_count_spam(my_get_post('Comments'));
if ($form_5_td_32_spam>0)
{
  if ($form_5_td_32_class!=$form_5_td_32_error_class) {$form_5_td_32_class=$form_5_td_32_error_class; $form_5_td_32_error=$form_5_td_32_error_spam; $form_5_error=$form_5_error_string;}
  $form_5_spam += $form_5_td_32_spam;
}
  

if (''==trim($form_5_error) && 0==$form_5_spam)
{
$receiver='aeht@sbcglobal.net';
$subject='Form Result -- Contact';
$subject.=$form_5_td_2_value;

  $subject= substr($subject, 0, 255);
  $subject=str_replace("\n", " ", $subject);
  $subject=str_replace("\r", " ", $subject);

  $body=str_replace("\n.", "\n..", $form_5_body);


  if ($body!="")
  {
    $result=mail($receiver,$subject,$body,$header);
    if (!result)
    {
       echo 'ERROR: The PHP mail function mail($receiver,$subject,$body,$header); does not work properly on your server, please contact your web hosting.';
       exit;
    }
  }

  if ($result)
  {
    $url='http://myweb/internal_link/8';
    if (!headers_sent()){    
        header('Location: '.$url); exit;
    }else{                    
        echo '<script type="text/javascript">';
        echo 'window.location.href="'.$url.'";';
        echo '</script>';
        echo '<noscript>';
        echo '<meta http-equiv="refresh" content="0;url='.$url.'" />';
        echo '</noscript>'; exit;
    }	
    exit;
  }
}

  if (trim($form_5_error)) $form_5_error="<tr><td colspan=3 class='$form_5_class'>$form_5_error</td></tr>";
}
if ($form_5_spam >= 3)  sleep(20);
if ($form_5_spam >= 3) $form_5_td_28_value='';

if ($form_5_spam >= 3) $form_5_td_29_value='';

if ($form_5_spam >= 3) $form_5_td_30_value='';

if ($form_5_spam >= 3) $form_5_td_31_value='';

if ($form_5_spam >= 3) $form_5_td_32_value='';


?><!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
<title>Academy of Exceptional Healthcare Training</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" >
<meta name="description" content="CNA, Certified Nurse Aide, Medication Aide, Medication Aide Refresher, CPR, First Aide, EKG Seminar" >
<meta name="keywords" content="CNA, Certified Nurse Aide, Medication Aide, Medication Aide Refresher, CPR, First Aide, EKG Seminar" >
<meta name="GENERATOR" content="Ewisoft Website Builder eCommerce Software from http://www.ewisoft.com/" >
<link href="./usertpl/1corporate1/stylesheet.css" rel=stylesheet type="text/css" ><link rel=stylesheet type="text/css" href="./user/g-css-js/form-5.css" />
<script language=javascript type="text/javascript" src="./user/g-css-js/form-5.js" ></script><script language="javascript" type="text/javascript" src="./user/g-css-js/common-form.js" ></script> </head>
<body leftmargin=0 topmargin=0 >
<table width="100%" border=0 cellspacing=0 cellpadding=0 >
<tr valign=top >
<td colspan=2 class=bannerbackground ><table width="100%" border=0 cellpadding=10 cellspacing=0 >
<tr>
<td><img src="./usertpl/1corporate1/pushing-a-wc.jpg" ></td>
<td height="100%" ><span class=slogan >Academy of Exceptional Healthcare Training. We offer Nurse Aide, Medication Aide, 7 Hour Refresher for Medication Aide, AHA courses for CPR, ACLS, PALS, and First Aid. We also offer Dialysis Tech, IV Therapy Seminar and EKG Seminar. The school is located in Houston, TX</span></td>
<td><img src="./user/cimage/EKG-Moving.gif" width=600 height=68 ></td></tr></table></td></tr>
<tr valign=top background="./usertpl/1corporate1/1.jpg" >
<td height=5 colspan=2 background="./usertpl/1corporate1/1.jpg" ><img src="./usertpl/1corporate1/1.jpg" width=6 height=5 ></td></tr>
<tr valign=top >
<td colspan=2 ><table width="100%" border=0 cellspacing=0 cellpadding=0 >
<tr>
<td width=10 valign=top ><img src="./usertpl/1corporate1/2.jpg" width=10 height=19 ></td>
<td class=nav1background >
<a href="p1.htm" target="_self" class=nav1 >Home</a></td>
<td valign=top ><img src="./usertpl/1corporate1/4.jpg" width=27 height=19 ></td></tr></table></td></tr>
<tr valign=top >
<td width=160 class=border ><table width=160 border=0 cellspacing=0 cellpadding=5 >
<tr>
<td height=20 class=nav2border ><a href="products.htm" target="_self" class=nav2 >Courses</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="services.htm" target="_self" class=nav2 >Links</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="american-heart-association-courses.htm" target="_self" class=nav2 >American Heart Association Courses</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="news.htm" target="_self" class=nav2 >Complaint Policy</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="map-to-the-school.htm" target="_self" class=nav2 >Map to the School</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="directions.htm" target="_self" class=nav2 >Directions</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="nurse-aide-skills.htm" target="_self" class=nav2 >Nurse Aide Skills</a></td></tr>
<tr>
<td height=20 class=nav2border ><a href="new-page-4.php" target="_self" class=nav2active >Contact Us</a></td></tr></table>
<table width="100%" border=0 cellpadding=5 cellspacing=0 >
<tr>
<td class=contentleftbk >. </td></tr></table>
<p>&nbsp;</p></td>
<td width="84%" class=borderbottom ><table width="100%" border=0 cellspacing=0 cellpadding=10 >
<tr>
<td valign=top class=contentbackground ><H1>We enjoy hearing from you. Please send us an e-mail with any questions you may have about our programs. </H1>
<P>
<form id="ewisoft_form-5" name=form5 method=post action="#" onsubmit="return onsubmit_form_5();" >
<input type=hidden name="form_5_submit" value=dauuzqnw >
<table cellpadding=2 cellspacing=0 border=0 >
<? echo $form_5_error ?>
<tr><td class="form_5_td_28" >Name:</td><td class="form_5_td" ><input type=text name=Name value="<? echo $form_5_td_28_value ?>" onchange="validate_form_5_input_28(false);" /></td><td id="form_5_info_td_28" class="<? echo $form_5_td_28_class ?>" ><? echo $form_5_td_28_error ?></td></tr>
<tr><td class="form_5_td_29" >Email:</td><td class="form_5_td" ><input type=text name=Email value="<? echo $form_5_td_29_value ?>" onchange="validate_form_5_input_29(false);" /></td><td id="form_5_info_td_29" class="<? echo $form_5_td_29_class ?>" ><? echo $form_5_td_29_error ?></td></tr>
<tr><td class="form_5_td" >Address:</td><td class="form_5_td" ><textarea name=Address ><? echo $form_5_td_30_value ?></textarea></td><td id="form_5_info_td_30" class="<? echo $form_5_td_30_class ?>" ><? echo $form_5_td_30_error ?></td></tr>
<tr><td class="form_5_td" >Telephone:</td><td class="form_5_td" ><input type=text name=Telephone value="<? echo $form_5_td_31_value ?>" onchange="validate_form_5_input_31(false);" /></td><td id="form_5_info_td_31" class="<? echo $form_5_td_31_class ?>" ><? echo $form_5_td_31_error ?></td></tr>
<tr><td class="form_5_td" >Comments:</td><td class="form_5_td" ><textarea name=Comments ><? echo $form_5_td_32_value ?></textarea></td><td id="form_5_info_td_32" class="<? echo $form_5_td_32_class ?>" ><? echo $form_5_td_32_error ?></td></tr>
<tr><td align=center class="form_5_td" colspan=2 ><input type=submit value=Submit /></td><td id="form_5_info_td_33" class="form_5_info" >&nbsp;</td></tr></table></form></P></td></tr></table></td></tr>
<tr valign=top >
<td colspan=2 ><div align=center ><P>&nbsp;</P></div></td></tr>
<tr valign=top >
<td colspan=2 ><div align=center ><span class=copyright >Copyright &copy; Academy of Exceptional Healthcare Training. All rights reserved.</span></div></td></tr></table></body></html>