<%' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit. On Error Resume Next Session("FP_OldCodePage") = Session.CodePage Session("FP_OldLCID") = Session.LCID Session.CodePage = 1252 Err.Clear strErrorUrl = "" If Request.ServerVariables("REQUEST_METHOD") = "POST" Then If Request.Form("VTI-GROUP") = "0" Then Err.Clear Set fp_conn = Server.CreateObject("ADODB.Connection") FP_DumpError strErrorUrl, "Cannot create connection" Set fp_rs = Server.CreateObject("ADODB.Recordset") FP_DumpError strErrorUrl, "Cannot create record set" fp_conn.Open Application("lists_ConnectionString") FP_DumpError strErrorUrl, "Cannot open database" fp_rs.Open "Results", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable FP_DumpError strErrorUrl, "Cannot open record set" fp_rs.AddNew FP_DumpError strErrorUrl, "Cannot add new record set to the database" Dim arFormFields0(6) Dim arFormDBFields0(6) Dim arFormValues0(6) arFormFields0(0) = "First_Name" arFormDBFields0(0) = "T1" arFormValues0(0) = Request("First_Name") arFormFields0(1) = "Last_Name" arFormDBFields0(1) = "T2" arFormValues0(1) = Request("Last_Name") arFormFields0(2) = "City" arFormDBFields0(2) = "T7" arFormValues0(2) = Request("City") arFormFields0(3) = "State" arFormDBFields0(3) = "D1" arFormValues0(3) = Request("State") arFormFields0(4) = "Comments" arFormDBFields0(4) = "S1" arFormValues0(4) = Request("Comments") arFormFields0(5) = "Status" arFormDBFields0(5) = "D2" arFormValues0(5) = Request("Status") FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0 If Request.ServerVariables("HTTP_USER_AGENT") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("HTTP_USER_AGENT"), "Remote_computer_name" End If If Request.ServerVariables("REMOTE_HOST") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_HOST"), "Browser_type" End If FP_SaveFieldToDB fp_rs, Now, "Timestamp" If Request.ServerVariables("REMOTE_USER") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_USER"), "User_name" End If fp_rs.Update FP_DumpError strErrorUrl, "Cannot update the database" fp_rs.Close fp_conn.Close FP_FormConfirmation "text/html; charset=windows-1252",_ "Form Confirmation",_ "Thank you for submitting the following information:",_ "add.asp",_ "Return to the form." End If End If Session.CodePage = Session("FP_OldCodePage") Session.LCID = Session("FP_OldLCID") %> Add Record - WeCareTexas.com

Add a Person:


 

Name (name of victim):

City (prior to Hurricane Ike):

State (prior to Hurricane Ike):

Current Status: 

Other Information: 
You should include your current location, how to be reached, email address to be contacted or phone numbers and a personal message if you'd like.