<!-- Copyright ยฉ 2002 Kali (http://www.xentrik.net) -->
<html><head>
<title>Bum Records - Advertisement Form</title>
<?php
// COPYRIGHT/LIABILITY NOTICE
// Copyright ยฉ 2002 Kali (http://www.xentrik.net)
// Last modified 04/05/2004
// Kali's Contact Form may be used and modified free of charge as long as this
// copyright notice and the comments above remain intact. By using this code
// you agree to indemnify Kali from any liability that might arise from its use.
// Selling the code for this program without prior written consent is not permitted.
// Permission must be obtained before redistributing this software. In all cases the
// copyright and header information must remain intact.
// MODIFY THE FOLLOWING SECTION
// your name
$recipientname = "Def 1";
// your email
$recipientemail = "[email protected]";
// subject of the email sent to you
$subject = "Online-Form Response for $recipientname";
// send an autoresponse to the user?
$autoresponse = "yes";
// subject of autoresponse
$autosubject = "Thank you for your mail!";
// autoresponse message
$automessage = "This is an auto response to let you know that we've successfully received your email sent through our email form. Thanks! We'll get back to you shortly.";
// thankyou displayed after the user clicks "submit"
$thanks = "Thank you for contacting us.<br>We will get back to you as soon as possible.<br>";
// END OF NECESSARY MODIFICATIONS
?>
<style type="text/css"><!--
td,body,input,textarea {
font-size:12px;
font-family:Verdana,Arial,Helvetica,sans-serif;
color:#000000}
--></style>
</head>
<body>
<table width="100%" height="100%"><tr>
<td valign="top"><font face="Verdana,Arial,Helvetica" size="2">
<?php
if($_POST['submitform']) {
$Name = $HTTP_POST_VARS['Name'];
$Email = $HTTP_POST_VARS['Email'];
$Comments = $HTTP_POST_VARS['Comments'];
// check required fields
$dcheck = explode(",",$require);
while(list($check) = each($dcheck)) {
if(!$$dcheck[$check]) {
$error .= "Missing $dcheck[$check]<br>";
}
}
// check email address
if ((!ereg(".+\@.+\..+", $Email)) || (!ereg("^[[email protected]]+$", $Email))){
$error .= "Invalid email address<br>";}
// display errors
if($error) {
?>
<b>Error</b><br>
<?php echo $error; ?><br>
<a href="#" onClick="history.go(-1)">try again</a>
<?php
}
else
{
$browser = $HTTP_USER_AGENT;
$ip = $REMOTE_ADDR;
// format message
$message = "Online-Form Response for $recipientname:
Name: $Name
Email: $Email
Comments: $Comments
-----------------------------
Browser: $browser
User IP: $ip";
// send mail and print success message
mail($recipientemail,"$subject","$message","From: $Name <$Email>");
if($autoresponse == "yes") {
$autosubject = stripslashes($autosubject);
$automessage = stripslashes($automessage);
mail($Email,"$autosubject","$automessage","From: $recipientname <$recipientemail>");
}
echo "$thanks";
}
}
else {
?>
<form name="contactform" action="<?php echo $PHP_SELF; ?>" method="post">
<input type="hidden" name="require" value="Name,Email,Comments">
<table><tr>
<td colspan="2" align="center"><b>Contact Me!</b><p></td>
</tr><tr>
<td valign="top" align="right">Name:</td>
<td valign="top"><input name="Name" size="25"></td>
</tr><tr>
<td valign="top" align="right">E-mail:</td>
<td valign="top"><input name="Email" size="25"></td>
</tr><tr>
<td valign="top" align="right">Comments:</td>
<td valign="top"><textarea name="Comments" rows="5" cols="35"></textarea></td>
</tr><tr>
<td colspan="2" align="center"><input type="submit" value="Submit" name="submitform">
<input type="reset" value="Reset" name="reset"></td>
</tr></table>
<br>
</form>
<?php } ?>
</font><p></td>
</tr><tr>
<td valign="bottom"><font face="Verdana" size="1">Mailform Copyright ยฉ 2002 <a href="http://www.xentrik.net/">Kali's Web Shoppe</a>.</font></td>
</tr></table>
</body>
</html>
