Custom Quotes and Samples Requests

We offer a full array of promotional products from the leading manufacturers across the USA including bags, packs, lighters, backpacks, note pads, jotters and portfolios as well as seasonal items like calendars. If you can't find exactly what you are looking for in our store, please contact one of our product specialists, or use this form, and someone will work with you to find the perfect item for your project.

This service is provided as a means for qualified customers to receive samples of our products for review prior to purchase decisions. Because of the potential for abuse, we reserve the right to determine, based solely upon our discretion, whether a submitted request will be honored.

Samples are not available for Waterman or other fine pen brands.

Click Here if you are you interested in purchasing a Deluxe PENSRUS sampler kit for only $24.95, featuring 12 of our best selling items - please contact our Sales Consultants after placing your order so that we may put together the perfect sample package for your needs.

Purchase price is completely refunded with initial $250.00 or more purchase. NY state residents will also be charged sales tax.

add('label', 'label_urgency', 'urgency', 'What should we do:'); $obj = & $form->add('select', 'urgency', ''); $obj->add_options(array( 'Contact me immediately', 'Contact someone in my organization', 'Please send me more info', 'Please Email me more info', )); $obj->set_rule(array( 'required' => array('error', 'This is required!') )); // "message" $form->add('label', 'label_message', 'message', 'How can we help:'); $obj = & $form->add('textarea', 'message'); $obj->set_rule(array( 'required' => array('error', 'Message is required!'), 'length' => array(0, 220, 'error', 'Maximum length is 220 characters!', true) )); // the label for the "quantity" element $form->add('label', 'label_quantity', 'quantity', 'Quantity needed:'); // add the "name" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'quantity'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'Quantity is required!') )); $form->add('note', 'note_quantity', 'quantity', 'This is important for planning'); // the label for the "event" element $form->add('label', 'label_event', 'event', 'Event type:'); // add the "name" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'event'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'Event type is required!') )); $form->add('note', 'note_event', 'event', 'This can help us provide product recommendations'); // "date needed" $form->add('label', 'label_date_needed', 'date_needed', 'Needed in-hand date'); $date = & $form->add('date', 'date_needed'); $date->set_rule(array( 'date' => array('error', 'Date is invalid!'), )); // date format // don't forget to use $date->get_date() if the form is valid to get the date in YYYY-MM-DD format ready to be used // in a database or with PHP's strtotime function! $date->format('M d, Y'); // selectable dates are starting with the current day $date->direction(1); $form->add('note', 'note_date_needed', 'date_needed', 'Use date picker by clicking icon or in box'); // the label for the "name" element $form->add('label', 'label_name', 'name', 'Your name:'); // add the "name" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'name'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'Name is required!') )); $form->add('note', 'note_name', 'name', 'Your name or name of person we should contact'); // the label for the "company name" element $form->add('label', 'label_company', 'company', 'Company:'); // add the "company" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'company'); // "email" $form->add('label', 'label_email', 'email', 'Your email address:'); $obj = & $form->add('text', 'email'); $obj->set_rule(array( 'required' => array('error', 'Email is required!'), 'email' => array('error', 'Email address seems to be invalid!'), )); // the label for the "phone" element $form->add('label', 'label_phone', 'phone', 'Phone number:'); // add the "phone" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'phone'); $obj->set_rule(array( 'required' => array('error', 'Phone is required!'), )); $form->add('note', 'note_phone', 'phone', 'Include extension number if needed'); // the label for the "altphone" element $form->add('label', 'label_altphone', 'altphone', 'Alternate phone number:'); // add the "phone" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'altphone'); // the label for the "fax" element $form->add('label', 'label_fax', 'fax', 'Fax number:'); // add the "phone" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'fax'); // the label for the "address" element $form->add('label', 'label_address1', 'address', 'Address:'); // add the "address1" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'address'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'Address is required!') )); // the label for the "address2" element $form->add('label', 'label_address2', 'address2', 'Addl Address:'); // add the "address2" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'address2'); // the label for the "city" element $form->add('label', 'label_city', 'city', 'City:'); // add the "city" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'city'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'City is required!') )); // the label for the "state" element $form->add('label', 'label_state', 'state', 'State/Province:'); // add the "state" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'state'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'State/Province is required!') )); // the label for the "zipcode" element $form->add('label', 'label_zip', 'zip', 'Zip/Postal Code:'); // add the "zipcode" element // the "&" symbol is there so that $obj will be a reference to the object in PHP 4 // for PHP 5+ there is no need for it $obj = & $form->add('text', 'zip'); // set rules $obj->set_rule(array( // error messages will be sent to a variable called "error", usable in custom templates 'required' => array('error', 'Zip/Postal Code is required!') )); // "captcha" $form->add('captcha', 'captcha_image', 'captcha_code'); $form->add('label', 'label_captcha_code', 'captcha_code', 'Are you human?'); $obj = & $form->add('text', 'captcha_code'); $form->add('note', 'note_captcha', 'captcha_code', 'You must enter the characters with black color that stand out from the other characters', array('style'=>'width: 200px')); $obj->set_rule(array( 'required' => array('error', 'Captcha is required!'), 'captcha' => array('error', 'Characters from image entered incorrectly!') )); // "submit" $form->add('submit', 'btnsubmit', 'Submit'); // if the form is valid if ($form->validate()) { // show results // Turn on error reporting. Handy for debugging. error_reporting(E_ALL ^ E_NOTICE); // I find including the time/date useful for record-keeping. // Note that it is the web server's time/date, not yours // or the sender's. $date = date("l jS F Y, g:i A"); // Get the form fields. $name = $_POST['name']; $company = $_POST['company']; $urgency = $_POST['urgency']; $email = $_POST['email']; $phone = $_POST['phone']; $fax = $_POST['fax']; $altphone = $_POST['altphone']; $message = $_POST['message']; $quantity = $_POST['quantity']; $event = $_POST['event']; $date_needed = $_POST['date_needed']; $address = $_POST['address']; $address2 = $_POST['address2']; $city = $_POST['city']; $state = $_POST['state']; $zip = $_POST['zip']; // The following parameters are pretty much all that you // need to change except for the format of the email message // below. Note that your mail server may require the mailTo // address be in the host domain. $mailTo = "quotes@pensrus.com"; // The address that will receive form submissions $mailSubject = "$name" ; // Whatever you want $mailHost = "mail.pensrus.com"; // Usually looks like mail.yourhost.com $mailPort = "25"; // Usually 25 $mailAuth = true; // "true" if your mail server requires authentication, "false" if not $mailPassword = "!r@@W_.JVE{}"; // The mail password associated with $mailTo // Note that for security reasons it is HIGHLY recommended // that you set the above in this PHP file and NOT pass // them as form parameters. If you want to send to different // email addresses depending upon form field values, pass a // parameter that doesn't contain login info with // conditional statements in this file. // If you want to get cookies values... // $myCookie = $_COOKIE["cookiename"]; if ($urgency == '0') { // PHP If Statement $urgent_2 = "Contact me immediately"; } elseif ($urgency == '1') { // PHP Elseif Statement $urgent_2 = "Contact someone in my organization"; } elseif ($urgency == '2') { // PHP Elseif Statement $urgent_2 = "Please send me more info - snailmail"; } else { $urgent_2 = "Please Email me more info"; // PHP Else } // Build the email. $body = " Date: $date Name: $name Company: $company Email: $email Phone: $phone Alt Phone: $altphone Fax: $fax Urgency: $urgent_2 Event: $event Date Needed: $date_needed Quantity: $quantity Address: $address Address2: $address2 City: $city State: $state Zip: $zip ----- Comments ----- $message --------------------"; include("Mail.php"); $headers["From"] = $mailTo; $headers["Reply-To"] = $email; $headers["To"] = $mailTo; $headers["Subject"] = $mailSubject; $params["host"] = $mailHost; $params["port"] = $mailPort; $params["auth"] = $mailAuth; $params["username"] = $mailTo; $params["password"] = $mailPassword; @$mail_object =& Mail::factory("smtp", $params); $mail_object->send($mailTo, $headers, $body); ?>

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