PDA

Click to See Complete Forum and Search --> : Contact Form


Jamie_Garland
Nov 3rd, 2006, 05:13 AM
Can anyone help me code this i need the php end of it.

<form method="post" action ="" onsubmit="MM_validateForm('first','','R','second','','R','location','','R','email','','RisEmail','telephone',' ','RisNum');return document.MM_returnValue">
<table border="0" cellspacing="10">
<tr>
<td colspan="2" bgcolor="#003333"><b><span class="style33 style2"><b>About you </b></span></b></td>
</tr>
<tr>
<td>First Name</td>
<td><input name="first" type="text" id="first" size="15" /></td>
</tr>
<tr>
<td>Last Name </td>
<td><input name="second" type="text" id="second" size="15" /></td>
</tr>
<tr>
<td>Location (City) </td>
<td><input name="location" type="text" id="location" size="15" /></td>
</tr>
<tr>
<td>Business/Organisation</td>
<td><input name="company" type="text" id="company" size="15" /></td>
</tr>
<tr>
<td>Email</td>
<td><input name="email" type="text" id="email" size="15" /></td>
</tr>
<tr>
<td>Telephone</td>
<td><input name="telephone" type="text" id="telephone" size="15"/></td>
</tr>
<tr>
<td valign="top">Preferred contact method </td>
<td><p>
<label>
<input type="radio" name="conpref" value="email" />
Email</label>
<br />
<label>
<input name="conpref" type="radio" value="telephone" checked="checked" />
telephone</label>
<br />
</p></td>
</tr>
<tr>
<td height="5" colspan="2" bgcolor="#006699"><span class="style1 style32">Services</span></td>
</tr>
<tr>
<td>Service needs </td>
<td><select name="serneed" id="serneed">
<option value="5 page package">5 page package</option>
<option value="shopping system">Shopping system</option>
<option value="real estate package">Real Estate</option>
<option>----</option>
<option value="web site design">web site design</option>
<option value="web site re-design">site redesign</option>
<option value="site optimisation">site optimisation</option>
<option value="site validation">site validation</option>
<option value="web site consultation">advice</option>
<option value="other">other</option>
</select> </td>
</tr>
<tr>
<td valign="top">Comments</td>
<td><textarea name="comments" cols="15" rows="6" id="comments"></textarea></td>
</tr>
<tr>
<td>For our records please let us know how you found our services </td>
<td><select name="findus" id="findus">
<option value="newspaper">newspaper</option>
<option value="Google">Google</option>
<option value="Yahoo">Yahoo</option>
<option value="MSN">MSN</option>
<option value="Client">Recomended</option>
<option value="other">other</option>
</select>
<br />
If other please state<br />
<input name="other" type="text" id="other" size="15" /></td>
</tr>
<tr>
<td colspan="2"><img src="securimage_show.php" alt="Please enter the text from the image into the form field" /><br />
Please enter the letters in the field below </td>
</tr>
<tr>
<td>&nbsp;</td>
<td><input type="text" name="code" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><input name="submit" type="submit" value="Submit Form" /></td>
</tr>
</table>

<br />
<br />
</form>

penagate
Nov 3rd, 2006, 05:16 AM
rentacoder.com