<head>
<title>Moderator Application</title>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1" />
</head>
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<h1><MARQUEE bgcolor="#6699FF" loop="100" scrollamount="10" width="150%">Moderation Application on ChatChaos, please fill in as much as you can.Any false input and The form will be VOID.</MARQUEE></h1>
<form method="email" action="sendmail.php">
<EMBED src="http://www.chatchaos.org/danjpg.jpe" width="100%" height="110" align="center">
NickName:<input name="sub" type="text" <br />
Age:<input name="messages" type="text" <br />
Gender:<INPUT type="radio" name="option"> Male<INPUT type="radio" name="option"> Female <br />
Emails:<input name="email" type="text" <br />
How long you Been on ChatChaos:<input name="message" type="text" <br />
Why Do You Want To Become Moderator:<input name="message" type="text" <br />
Do you Think you will be good a this job:<input name="message" type="text" <br />
Do You Work on any other Chat-Sites:<input name="message" type="text" <br />
How Many Times a week do you think you will be on:<input name="message" type="text" /><br />
<input type="submit" />
</form><div id="footer">
All contents of this site © 2008-2009 ChatChaos
<font face="Arial Unicode MS" size="4"><a href="http://chatchaos.org">Home</a> <a href="http://chatchaos.org/chat">Java-Chat</a></font></div>
</body>
</html>
*********sendmail.php***************
<?php
$email = $_REQUEST['email'];
$message = $_REQUEST['message'];
$option = $_REQUEST['option'];
$sub = $_REQUEST['sub'];
$Age = $_REQUEST['messages'];
mail( "Staff@ChatChaos.Org", "Moderator Application",
$message, "From: $email" );
header( "Location: http://ChatChaos.Org" );
?>