vickytanghm

Hi Guys, i need help on this, html contact form php mailer. <form name="contact_form" method="post" action="mailer1.php" onSubmit="return evalid()"> <fieldset> <table> <tr> <td><b>Personal Information</b></td> <tr> <td>Title</td> <td colspan="2"><select name="title[]"> <option selected="selected">Mr</option> <option>Mrs <option>Ms <option>Mdm </select> </td> </tr><tr> <td>Name </td> <td colspan="2"><input name="name" type="text" /></td> </tr><tr> <td>NRIC </td> <td colspan="2"><input name="nric" type="text" /></td> </tr><tr> <td>Date Of Birth </td> <td colspan="2"><input name="dob" type="text" /></td> </tr><tr> <td>Nationality </td> <td colspan="2"><input name="nationality" type="text" /></td> </tr><tr> <td>Race </td> <td colspan="2"><input name="race" type="text" /></td> </tr><tr> <td>Occupation </td> <td colspan="2"><input name="occupation" type="text" /></td> </tr><tr> <td>Your E-mail </td> <td colspan="2"><input type="text" name="email" /></td> </tr><tr> <td>Mobile </td> <td colspan="2"><input type="text" name="mobile" /></td> </tr><tr> <td>Home </td> <td colspan="2"><input type="text" name="home" /></td> </tr><tr> <td>Highest Qualification Attained </td> <td colspan="2"><input type="text" name="hqa" /></td> </tr><tr> <td>Number Of Years Of Tutoring </td> <td colspan="2"><input type="text" name="noyot" /></td> </tr><tr> <td>Secondary </td> <td colspan="2"><input type="text" name="sec" /></td> </tr><tr> <td>JC/POLY </td> <td colspan="2"><input type="text" name="jcpoly" /></td> </tr><tr> <td>University </td> <td colspan="2"><input type="text" name="uni" /></td> </tr><tr> <td>Results or Grades attained for all school attended </td> <td colspan="2"><textarea name="rmessage" style="width: 250px; height: 100px"></textarea></td> </tr><tr> <td>Self Introduction </td> <td colspan="2"><textarea name="smessage" style="width: 250px; height: 100px"></textarea></td> </tr><tr> <td>Minimal Expected Rate </td> <td colspan="2"><input type="text" name="mer" /></td> </tr><tr> <td>Teach IP Student</td> <td colspan="2"><select name="title"> <option selected="selected">Yes</option> <option>No </tr><tr> <td>Tutoring Location In </td> <td style="vertical-align"> <input type="checkbox" name="location[0]" value="East"> Central<br> <input type="checkbox" name="location[1]" value="East"> East<br> <input type="checkbox" name="location[2]" value="North"> North<br> <input type="checkbox" name="Others,Please Specify" value="Others,Please Specify"> Others,Please Specify<br> <textarea id="text_7" name="Others,Please Specify" rows="2" cols="24"></textarea> <td style="vertical-align"> <input type="checkbox" name="location[3]" value="NorthEast"> NorthEast<br> <input type="checkbox" name="location[4]" value="NorthWest"> NorthWest<br> <input type="checkbox" name="location[5]" value="West"> West<br> </tr><tr> <td>Pre-school </td> <td> <input type="checkbox" name="Preschool" value="Preschool"> <br> </tr><tr> <td>Primary School </td> <td style="vertical-align"> <input type="checkbox" name="English" value="English"> English<br> <input type="checkbox" name="Mathematics" value="Mathematics"> Mathematics<br> <input type="checkbox" name="Science" value="Science"> Science<br> <td style="vertical-align right"> <input type="checkbox" name="Chinese" value="Chinese"> Chinese<br> <input type="checkbox" name="Malay" value="Malay"> Malay<br> <input type="checkbox" name="Tamil" value="Tamil"> Tamil<br> </tr><tr> <td>'O' Level </td> <td style="vertical-align"> <input type="checkbox" name="Amath" value="Amath"> Amath<br> <input type="checkbox" name="Biology" value="Biology"> Biology<br> <input type="checkbox" name="Bio/Chem" value="Bio/Chem"> Bio/Chem<br> <input type="checkbox" name="Bio/Physics" value="Bio/Physics"> Bio/Physics<br> <input type="checkbox" name="Biz Studies" value="Biz Studies"> Biz Studies<br> <input type="checkbox" name="Chemistry" value="Chemistry"> Chemistry<br> <input type="checkbox" name="Chinese" value="Chinese"> Chinese<br> <input type="checkbox" name="Emath" value="Emath"> Emath<br> <input type="checkbox" name="English" value="English"> English<br> <input type="checkbox" name="Geography" value="Geography"> Geography<br> <input type="checkbox" name="Higher Chinese" value="Higher Chinese"> Higher Chinese<br> <input type="checkbox" name="History" value="History"> History<br> <input type="checkbox" name="Others,Please Specify" value="Others,Please Specify"> Others,Please Specify<br> <textarea id="text_7" name="Others,Please Specify" rows="2" cols="24"></textarea> <td style="vertical-align middle"> <input type="checkbox" name="Literature" value="Literature"> Literature<br> <input type="checkbox" name="Malay" value="Mala"> Mala<br> <input type="checkbox" name="Phy/Chem" value="Phy/Chem"> Phy/Chem<br> <input type="checkbox" name="Physics" value="Physics"> Physics<br> <input type="checkbox" name="POA" value="POA"> POA<br> <input type="checkbox" name="Science" value="Science"> Science<br> <input type="checkbox" name="Tamil" value="Tamil"> Tamil<br> <input type="checkbox" name="Hindi" value="Hindi"> Hindi<br> <input type="checkbox" name="Economics" value="Economics"> Economics<br> <input type="checkbox" name="Business English" value="Business English"> Business English<br> <input type="checkbox" name="Business Chinese" value="Business Chinese"> Business Chinese<br> </tr><tr> <td>'A' Level </td> <td style="vertical-align"> <input type="checkbox" name="Accounting" value="Accounting"> Accounting<br> <input type="checkbox" name="AO Chinese" value="AO Chinese"> AO Chinese<br> <input type="checkbox" name="Biology" value="Biology"> Biology<br> <input type="checkbox" name="Chemistry" value="Chemistry"> Chemistry<br> <input type="checkbox" name="Computing" value="Computing"> Computing<br> <input type="checkbox" name="Economics" value="Economics"> Economics<br> <input type="checkbox" name="General Paper" value="General Paper"> General Paper<br> <input type="checkbox" name="Others,Please Specify" value="Others,Please Specify"> Others,Please Specify<br> <textarea id="text_7" name="Others,Please Specify" rows="2" cols="24"></textarea> <td style="vertical-align"> <input type="checkbox" name="Higher Chinese" value="Higher Chinese"> Higher Chinese<br> <input type="checkbox" name="History" value="History"> History<br> <input type="checkbox" name="Literature" value="Literature"> Literature<br> <input type="checkbox" name="Mathematics" value="Mathematics"> Mathematics<br> <input type="checkbox" name="Physics" value="Physics"> Physics<br> <input type="checkbox" name="Project Work" value="Project Work"> Project Work<br> <input type="checkbox" name="Mgmt of Biz" value="Mgmt of Biz"> Mgmt of Biz<br> <input type="checkbox" name="Georgraphy" value="Georgraphy"> Georgraphy<br> </tr><tr> <td>Diploma </td> <td style="vertical-align"> <input type="checkbox" name="Accounting" value="Accounting"> Accounting<br> <input type="checkbox" name="Business" value="Business"> Business<br> <input type="checkbox" name="Computing" value="Computing"> Computing<br> <input type="checkbox" name="Engineering Maths" value="Engineering Maths"> Engineering Maths<br> <input type="checkbox" name="Others, Please Specify" value="Others, Please Specify"> Others, Please Specify<br> <textarea id="text_7" name="Others,Please Specify" rows="2" cols="24"></textarea> <td style="vertical-align"> <input type="checkbox" name="Management" value="Management"> Management<br> <input type="checkbox" name="Fine Arts" value="Fine Arts"> Fine Arts<br> <input type="checkbox" name="HR" value="HR"> HR<br> </tr><tr> <td>Foreign Language </td> <td style="vertical-align"> <input type="checkbox" name="Bahasa" value="Bahasa"> Bahasa<br> <input type="checkbox" name="French" value="French"> French<br> <input type="checkbox" name="German" value="German"> German<br> <input type="checkbox" name="Japanese" value="Japanese"> Japanese<br> <input type="checkbox" name="Korean" value="Korean"> Korean<br> <input type="checkbox" name="Spanish" value="Spanish"> Spanish<br> <input type="checkbox" name="Others, Please Specify" value="Others, Please Specify"> Others, Please Specify<br> <textarea id="text_7" name="Others,Please Specify" rows="2" cols="24"></textarea> <td style="vertical-align"> <input type="checkbox" name="Thai" value="Thai"> Thai<br> <input type="checkbox" name="Vietnamese" value="Vietnamese"> Vietnamese<br> <input type="checkbox" name="English" value="English"> English<br> <input type="checkbox" name="Mandarin" value="Mandarin"> Mandarin<br> <input type="checkbox" name="Malay" value="Malay"> Malay<br> </tr><tr> <td>Piano </td> <td> <input type="checkbox" name="Preschool" value="Preschool"> <br> </tr><tr> <tr> <td style="vertical-align"> <td><input type="submit" name="Submit" value="Submit"> <input type="reset" name="reset" value="Reset"></td> </tr> </table> </form>