Send form copy to applicant

tcalixte · January 19, 2011

I created a application for my client and I need to find a way to get the script that supports the form to send a copy to sender. So basically it will send the client an email and the applicant would also get a copy emailed.

this is what i have so far:

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org';

// Where to redirect after form is processed.
$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
$req = '0';

// --------------------------Do not edit below this line--------------------------
$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
?>

Right now it send the email to just the client... I dont know how to send it to the applicant... im a graphic designer and dont know much on php, just very basic php.. please help!!!!

TOA · January 19, 2011

You would need to capture the users email, most likely from the form, and then just add it to your $emailadd variable. The mail() function can send to multiple emails

http://php.net/manual/en/function.mail.php

You could also add a cc: header. There are multiple ways

tcalixte · January 19, 2011

i saw that link last night when i was searching... i see how i could use that information to send to an email i knew but i dont know how to i guess make it pull up the email the applicant placed in the form and send it to that email address...

im really bad with php... im sorry.. i hope i make sense...

TOA · January 19, 2011

The value they entered will be stored in the POST array (assuming your using post on your form method):

$_POST['name_of_input']

That value would be added to your $emailadd variable with a comma separating it like:

$emailadd = 'haiti@hacus.org,'.$_POST['name_of_input'];

Hope that helps

tcalixte · January 19, 2011

So at the top where is says to set parameters put this:

$_POST['email']

$emailadd = 'haiti@hacus.org,'.$_POST['email'];

i put the word email cuz i named the field email... is this correct? i really hope so...

TOA · January 19, 2011

Just change this:

$emailadd = 'haiti@hacus.org';

to this:

$emailadd = 'haiti@hacus.org,'.$_POST['email'];

and make sure your input is named "email" which you said you did, and you got it

tcalixte · January 19, 2011

still not working

heres the html:

<br />

Email Address:

<br />

and the php:

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org,'.$_POST['email'];

// Where to redirect after form is processed.
$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
$req = '0';

// --------------------------Do not edit below this line--------------------------
$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
?>

TOA · January 19, 2011

Just a note, you might want to verify that it's a valid email too.

$useremail = if (filter_var($_POST['email'], FILTER_VALIDATE_EMAIL)) { $useremail = $_POST['email'] };
$emailadd = "haiti@hacus.org".', '.$useremail;

TOA · January 19, 2011

still not working

heres the html:

<br />

Email Address:

<br />

and the php:

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org,'.$_POST['email'];

// Where to redirect after form is processed.
$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
$req = '0';

// --------------------------Do not edit below this line--------------------------
$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
?>

What's "not working" mean? What is it doing/not doing?

tcalixte · January 19, 2011

its sending the email to the webmaster but not to the applicant...

also i added the code to verify email and got this message:

Parse error: syntax error, unexpected T_IF in /home/hacusor1/public_html/Mailform2.php on line 8

TOA · January 19, 2011

its sending the email to the webmaster but not to the applicant...

also i added the code to verify email and got this message:

Parse error: syntax error, unexpected T_IF in /home/hacusor1/public_html/Mailform2.php on line 8

Forget the validating for now...let's fix the problem first

tcalixte · January 19, 2011

ok i took it out...

TOA · January 19, 2011

Echo the $emailadd variable after you've combined them to see if it's populating...like this:

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org,'.$_POST['email'];

echo $emailadd;
/*
// Where to redirect after form is processed.
$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
$req = '0';

// --------------------------Do not edit below this line--------------------------
$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
*/
?>

tcalixte · January 19, 2011

Warning: Unterminated comment starting line 11 in /home/hacusor1/public_html/Mailform2.php on line 11

Fatal error: fatal flex scanner internal error--end of buffer missed in /home/hacusor1/public_html/Mailform2.php on line 11

TOA · January 19, 2011

Warning: Unterminated comment starting line 11 in /home/hacusor1/public_html/Mailform2.php on line 11

Fatal error: fatal flex scanner internal error--end of buffer missed in /home/hacusor1/public_html/Mailform2.php on line 11

Oh yeah, a comment can't be nested, so you'll need to figure out a way to comment out the rest of the script so it doesn't execute when echoing the $emailadd variable for testing

The problem is the // comments inside the /**/ comment. Sorry about that

TOA · January 19, 2011

Try this:

Echo the $emailadd variable after you've combined them to see if it's populating...like this:

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org,'.$_POST['email'];

echo $emailadd;

// Where to redirect after form is processed.
//$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
//$req = '0';

// --------------------------Do not edit below this line--------------------------
/*$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
*/
?>

tcalixte · January 19, 2011

still not going to applicant email for some reason, only going to client email...

TOA · January 19, 2011

still not going to applicant email for some reason, only going to client email...

It shouldn't be going to either if you did what I posted in my last post. We're trying to tell if $emailadd is holding what we expect it to by echoing it. Then we check if something is resetting this variable later in the script (which is my guess)

tcalixte · January 19, 2011

i did what you said and it went to the clients email... i think my code is messing it up somewhere... just not sure where in the code its messing up...

TOA · January 19, 2011

i did what you said and it went to the clients email... i think my code is messing it up somewhere... just not sure where in the code its messing up...

And you have this as your php file?

<?php
//--------------------------Set these paramaters--------------------------

// Subject of email sent to you.
$subject = 'Haiti Operation Application';

// Your email address. This is where the form information will be sent.
$emailadd = 'haiti@hacus.org,'.$_POST['email'];

echo $emailadd;

// Where to redirect after form is processed.
//$url = 'https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TVWP3VVDZAXJWl';

// Makes all fields required. If set to '1' no field can not be empty. If set to '0' any or all fields can be empty.
//$req = '0';

// --------------------------Do not edit below this line--------------------------
/*$text = "Results from form:\n\n";
$space = ' ';
$line = '
';
foreach ($_POST as $key => $value)
{
if ($req == '1')
{
if ($value == '')
{echo "$key is empty";die;}
}
$j = strlen($key);
if ($j >= 20)
{echo "Name of form element $key cannot be longer than 20 characters";die;}
$j = 20 - $j;
for ($i = 1; $i <= $j; $i++)
{$space .= ' ';}
$value = str_replace('\n', "$line", $value);
$conc = "{$key}:$space{$value}$line";
$text .= $conc;
$space = ' ';
}
mail($emailadd, $subject, $text, 'From: '.$emailadd.'');
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';
*/
?>

That shouldn't be sending anything anywhere because we have everything commented out

tcalixte · January 19, 2011

you are right, i didnt do it correctly.. i copied, pasted and now its not sending... its on a white page and says haiti@hacus.org

TOA · January 19, 2011

you are right, i didnt do it correctly.. i copied, pasted and now its not sending... its on a white page and says haiti@hacus.org

Ok, that tells us the value the user posted on the form isn't getting to the variable.

Can you post your form?

tcalixte · January 19, 2011

<label>

<div align="center"><strong>Dates and length of time of trip for which you are applying:

<br />

Name (Official name that appears on passport):

<br />

First:

Middle:

Last:

<br />

Name you would like to be called:

<br />

Date of Birth:

<br />

Gender:

Female

Male<br />

Nationality:

<br />

Address:<br />

<br />

City:

State/Prov.:

<br />

Zip/Postal Code:

<br />

Home Phone: (

)

<br />

Work Phone: (

)

<br />

Email Address:

<br />

Cell Phone (

)

<br />

Traveling with Friend or Relative? If so, who?

<br />

Highest qualification (i.e. high school graduate, undergraduate):

<br />

Work experience:<br />

<br />

Travel Experience:<br />

<br />

Do you speak any other languages:

<br />

T-Shirt Size:<br />

S

M

L

XL

XXL<br />

<br />

I do not have a passport yet. (Please call the Haitian American Caucus or email<br />

passport information as soon as you get it).<br />

<br />

Passport Number:

<br />

Expiration:

<br />

Country of Citizenship:

<option value="" selected="selected">Please select an option...</option>

<option value="1">UNITED STATES</option>

<option value="4">AFGHANISTAN</option>

<option value="5">ALBANIA</option>

<option value="6">ALGERIA</option>

<option value="7">AMERICAN SAMOA</option>

<option value="8">ANDORRA</option>

<option value="9">ANGOLA</option>

<option value="10">ANGUILLA</option>

<option value="11">ANTARCTICA</option>

<option value="12">ANTIGUA AND BARBUDA</option>

<option value="13">ARGENTINA</option>

<option value="14">ARMENIA</option>

<option value="15">ARUBA</option>

<option value="16">AUSTRALIA</option>

<option value="17">AUSTRIA</option>

<option value="18">AZERBAIJAN</option>

<option value="19">BAHAMAS</option>

<option value="20">BAHRAIN</option>

<option value="21">BANGLADESH</option>

<option value="22">BARBADOS</option>

<option value="23">BELARUS</option>

<option value="24">BELGIUM</option>

<option value="25">BELIZE</option>

<option value="26">BENIN</option>

<option value="27">BERMUDA</option>

<option value="28">BHUTAN</option>

<option value="29">BOLIVIA</option>

<option value="30">BOTSWANA</option>

<option value="31">BOUVET ISLAND</option>

<option value="32">BRAZIL</option>

<option value="33">BRUNEI DARUSSALAM</option>

<option value="34">BULGARIA</option>

<option value="35">BURKINA FASO</option>

<option value="36">BURUNDI</option>

<option value="37">CAMBODIA</option>

<option value="38">CAMEROON</option>

<option value="2">CANADA</option>

<option value="39">CAPE VERDE</option>

<option value="40">CAYMAN ISLANDS</option>

<option value="42">CHILE</option>

<option value="43">CHINA</option>

<option value="44">CHRISTMAS ISLAND</option>

<option value="45">COLOMBIA</option>

<option value="46">COMOROS</option>

<option value="47">CONGO</option>

<option value="48">COOK ISLANDS</option>

<option value="49">COSTA RICA</option>

<option value="50">COTE D'IVOIRE</option>

<option value="51">CROATIA</option>

<option value="53">CYPRUS</option>

<option value="54">CZECH REPUBLIC</option>

<option value="55">DENMARK</option>

<option value="56">DJIBOUTI</option>

<option value="57">DOMINICA</option>

<option value="58">DOMINICAN REPUBLIC</option>

<option value="59">EAST TIMOR</option>

<option value="60">ECUADOR</option>

<option value="61">EGYPT</option>

<option value="62">EL SALVADOR</option>

<option value="63">EQUATORIAL GUINEA</option>

<option value="64">ERITREA</option>

<option value="65">ESTONIA</option>

<option value="66">ETHIOPIA</option>

<option value="67">FALKLAND ISLANDS</option>

<option value="68">FAROE ISLANDS</option>

<option value="70">FINLAND</option>

<option value="71">FRANCE</option>

<option value="72">FRENCH GUIANA</option>

<option value="73">FRENCH POLYNESIA</option>

<option value="74">GABON</option>

<option value="75">GAMBIA</option>

<option value="76">GEORGIA</option>

<option value="77">GERMANY</option>

<option value="78">GHANA</option>

<option value="79">GIBRALTAR</option>

<option value="80">GREECE</option>

<option value="81">GREENLAND</option>

<option value="82">GRENADA</option>

<option value="83">GUADELOUPE</option>

<option value="85">GUATEMALA</option>

<option value="86">GUINEA</option>

<option value="87">GUINEA-BISSAU</option>

<option value="88">GUYANA</option>

<option value="89">HAITI</option>

<option value="90">HONDURAS</option>

<option value="92">HUNGARY</option>

<option value="93">ICELAND</option>

<option value="94">INDIA</option>

<option value="95">INDONESIA</option>

<option value="98">IRELAND</option>

<option value="99">ISRAEL</option>

<option value="100">ITALY</option>

<option value="101">JAMAICA</option>

<option value="102">JAPAN</option>

<option value="103">JORDAN</option>

<option value="104">KAZAKSTAN</option>

<option value="105">KENYA</option>

<option value="106">KIRIBATI</option>

<option value="107">KUWAIT</option>

<option value="108">KYRGYZSTAN</option>

<option value="109">LATVIA</option>

<option value="110">LEBANON</option>

<option value="111">LESOTHO</option>

<option value="112">LIBERIA</option>

<option value="113">LIECHTENSTEIN</option>

<option value="114">LITHUANIA</option>

<option value="115">LUXEMBOURG</option>

<option value="116">MACAU</option>

<option value="117">MACEDONIA</option>

<option value="118">MADAGASCAR</option>

<option value="119">MALAWI</option>

<option value="120">MALAYSIA</option>

<option value="121">MALDIVES</option>

<option value="123">MALTA</option>

<option value="124">MARSHALL ISLANDS</option>

<option value="125">MARTINIQUE</option>

<option value="126">MAURITANIA</option>

<option value="127">MAURITIUS</option>

<option value="128">MAYOTTE</option>

<option value="129">MEXICO</option>

<option value="130">MICRONESIA</option>

<option value="131">MOLDOVA</option>

<option value="132">MONACO</option>

<option value="133">MONGOLIA</option>

<option value="134">MONTSERRAT</option>

<option value="135">MOROCCO</option>

<option value="136">MOZAMBIQUE</option>

<option value="137">MYANMAR</option>

<option value="138">NAMIBIA</option>

<option value="139">NAURU</option>

<option value="140">NEPAL</option>

<option value="141">NETHERLANDS</option>

<option value="142">NETHERLANDS ANTILLES</option>

<option value="143">NEW CALEDONIA</option>

<option value="144">NEW ZEALAND</option>

<option value="145">NICARAGUA</option>

<option value="146">NIGER</option>

<option value="147">NIGERIA</option>

<option value="149">NORFOLK ISLAND</option>

<option value="150">NORTHERN MARIANA ISLANDS</option>

<option value="151">NORWAY</option>

<option value="153">PAKISTAN</option>

<option value="154">PALAU</option>

<option value="155">PANAMA</option>

<option value="156">PAPUA NEW GUINEA</option>

<option value="157">PARAGUAY</option>

<option value="159">PHILIPPINES</option>

<option value="160">PITCAIRN</option>

<option value="161">POLAND</option>

<option value="162">PORTUGAL</option>

<option value="163">PUERTO RICO</option>

<option value="164">QATAR</option>

<option value="165">REUNION</option>

<option value="166">ROMANIA</option>

<option value="167">RUSSIAN FEDERATION</option>

<option value="168">RWANDA</option>

<option value="169">SAINT HELENA</option>

<option value="170">SAINT KITTS AND NEVIS</option>

<option value="171">SAINT LUCIA</option>

<option value="172">SAINT PIERRE AND MIQUELON</option>

<option value="173">SAINT VINCENT</option>

<option value="174">SAMOA</option>

<option value="175">SAN MARINO</option>

<option value="176">SAO TOME AND PRINCIPE</option>

<option value="177">SAUDI ARABIA</option>

<option value="178">SENEGAL</option>

<option value="179">SEYCHELLES</option>

<option value="180">SIERRA LEONE</option>

<option value="181">SINGAPORE</option>

<option value="182">SLOVAKIA</option>

<option value="183">SLOVENIA</option>

<option value="184">SOLOMON ISLANDS</option>

<option value="185">SOMALIA</option>

<option value="186">SOUTH AFRICA</option>

<option value="225">SOUTH KOREA</option>

<option value="187">SPAIN</option>

<option value="188">SRI LANKA</option>

<option value="189">SUDAN</option>

<option value="190">SURINAME</option>

<option value="191">SVALBARD AND JAN MAYEN</option>

<option value="192">SWAZILAND</option>

<option value="193">SWEDEN</option>

<option value="194">SWITZERLAND</option>

<option value="195">SYRIAN ARAB REPUBLIC</option>

<option value="196">TAIWAN</option>

<option value="197">TAJIKISTAN</option>

<option value="198">TANZANIA</option>

<option value="199">THAILAND</option>

<option value="201">TOKELAU</option>

<option value="202">TONGA</option>

<option value="203">TRINIDAD AND TOBAGO</option>

<option value="204">TUNISIA</option>

<option value="205">TURKEY</option>

<option value="206">TURKMENISTAN</option>

<option value="207">TURKS AND CAICOS ISLANDS</option>

<option value="208">TUVALU</option>

<option value="209">UGANDA</option>

<option value="210">UKRAINE</option>

<option value="211">UNITED ARAB EMIRATES</option>

<option value="3">UNITED KINGDOM</option>

<option value="1">UNITED STATES</option>

<option value="212">URUGUAY</option>

<option value="213">UZBEKISTAN</option>

<option value="214">VANUATU</option>

<option value="215">VENEZUELA</option>

<option value="216">VIETNAM</option>

<option value="217">VIRGIN ISLANDS, BRITISH</option>

<option value="218">VIRGIN ISLANDS, U.S.</option>

<option value="219">WALLIS AND FUTUNA</option>

<option value="220">WESTERN SAHARA</option>

<option value="221">YEMEN</option>

<option value="222">YUGOSLAVIA</option>

<option value="223">ZAMBIA</option>

<option value="224">ZIMBABWE</option>

</select>

</strong></div>

</label>

<p align="center"><strong><span class="style12">Medical Information:</span><br />

Travel in Haiti can be physically and emotionally demanding. Please thoughtfully assess<br />

your health in light of the potential rigors of the trip. Example: long days and physical<br />

work, travel on very poor roads in the back of a pick up truck, some travel on foot,<br />

limited availability of some medical equipment.</strong></p>

We ask that you assess your physical and mental condition carefully and encourage you<br />

to consult with your doctor. We require that you provide us with the following<br />

information so that our staff can make any possible accommodations to meet your health<br />

needs.</strong></p>

1. Name:

<label>

</label>

Age:

<label>

</label>

</strong></p>

2. Do you have a history of any of the following medical conditions?<br />

<label>

</label>

Epilepsy

<label>

</label>

Emphysema<br />

Allergies (including allergies to any medicines)

High blood pressure<br />

Heart condition

Eating disorders<br />

Back problems or other injuries

Diabetes<br />

other substance abuse or chemical dependencies

Asthma<br />

other medical conditions – please list:<br />

</strong></p>

How might any of the conditions you listed affect your travels?</strong></p>

</strong></p>

3. Are you currently or have you been under a doctor’s care during the past six months?<br />

</strong></p>

If yes, what conditions(s) are being treated?</strong></p>

</strong></p>

How might these conditions affect your travels?</strong></p>

</strong></p>

4. Do you carry any medication? If so, please specify names, conditions which they treat,<br />

and possible side effects.</strong></p>

</strong></p>

5. Are you currently on any special diet (even if voluntary, such as vegetarian)?</strong></p>

</strong></p>

6. I understand that I assume all medical costs incurred while participating on this trip to

Haiti:

</strong></p>

7. Any other comments about your health?</strong></p>

</strong></p>

8. In case of illness or emergency, please notify:</strong></p>

Name/Relationship:

</strong></p>

Address:</strong></p>

</strong></p>

City:

State:

</strong></p>

Zip/Postal Code:

</strong></p>

Phone: (Day):

(Evening):

</strong></p>

<p><span class="style2">LEGAL TERMS OF SERVICE</span><br />

1. <strong>Terms of Use</strong><br />

Please read this legal information carefully before signing below.

By filling out this form, you signify you have read and accepted these terms of use. If you

do not agree to these terms of use, do not sign the application.

The materials in this application are provided "as is" and without warranties of any kind

either expressed or implied. To the fullest extent permissible and subject and pursuant to

applicable law, HAC disclaims all warranties, express or implied, including, but not

limited to, implied warranties of merchantability and fitness for a particular purpose.

International travel is inherently risky. By becoming a volunteer, you acknowledge and

accept these risks and those associated with living and working in developing countries.</p>

As a volunteer you must appreciate and understand that some of these activities may be

outside of your personal insurance cover. HAC is not liable (to the maximum extent of

the law) for any loss or harm you may suffer, including but not limited to loss caused by:<br />

 delay;<br />

 bodily injury or death;<br />

 emotional upset;<br />

 damage to or loss of property;<br />

 war or terrorism;<br />

 natural disasters.</p>

HAC reserves the right to use feedback from volunteers for website material.

HAC is not liable for any errors or mistakes made by partner organizations. All disputes

are governed by the law of the United States of America.</p>

2. <span class="style2">Refund Policy</span></p>

<strong>Application Fee</strong><br />

The US$100 application fee, which secures your placement, is fully transferable. This allows the volunteer the flexibility to switch, transfer, or postpone your placement within a five-year period from date of payment. The application fee is non-refundable.</p>

HAC reserves the right to revise the application fee. All application fee revisions will be

announced at least seven days in advance via email. Please note that the application fee

may not be the same as when you applied.

A full refund of your US$100 pre-paid application fee will be issued only under the

following circumstance:<br />

When a pre-paid application fee is paid at the time the application was submitted (i.e.

prior to HAC processing your application form and emailing your letter of acceptance),

and HAC is unable to place you into the program you have applied for, at the dates of

your choice (as per your application form).</p>

3. <span class="style2">Communication</span></p>

<strong>Email</strong><br />

Emails from HAC staff contain information intended solely for the addressee, which is

confidential or private in nature. If you are not the intended recipient, you may not

peruse, use, disseminate, distribute or copy this message or any file attached to this

message. Any such unauthorized use, is prohibited and may be unlawful. If you have

received an email from HAC in error, please notify the sender immediately by e-mail and

thereafter delete the original message from your machine. Furthermore, the information

contained in the email, and any attachments thereto, is for information purposes only and

may contain the personal views and opinions of the author, which are not necessarily the

views and opinions of the Haitian American Caucus, or any of its associated entities.

Haitian American Caucus therefore does not accept liability for any claims, loss or

damages of whatsoever nature, arising as a result of the reliance on such information by<br />

anyone. Whilst all reasonable steps are taken to ensure the accuracy and integrity of

information transmitted electronically and to preserve the confidentiality thereof, Haitian

American Caucus accepts no liability or responsibility whatsoever if information or data

is, for whatsoever reason, incorrect, corrupted or does not reach its intended destination.</p>

<strong>Voice Broadcasts, Text Messaging, Phone Calls</strong><br />

In applying to volunteer you agree to our terms of service which include receiving

automated emails, text messages, and phone calls from HAC.</p>

<strong>Required Documentation</strong><br />

HAC requires certain information from volunteers throughout the process leading up to

program arrival. This may include details about the volunteer's skills and experience, etc.

If this information is not submitted or reveals a volunteer's lack of suitability for the

program, HAC reserves the right to halt the placement process until satisfactory changes<br />

are made. If the necessary changes cannot be made, this may result in loss of placement.</p>

4. <span class="style2">Privacy Policy</span><br />

Information on HAC's application forms is collected solely for internal use within HAC

and its partner organizations. Your e-mail and other details will be passed onto other

volunteers who are in the same group as you, so that you can make contact before you

meet; if you would prefer that this did not happen, please let us know.</p>

Online payments are processed through a secure third party site, and HAC does not

receive sensitive information such as credit card information.</p>

<strong>Communication From Volunteers</strong><br />

You warrant to us that all information provided, in electronic, written or oral

communication to HAC, is true and correct. HAC will not be liable or responsible from

any consequences that result if false information is provided.</p>

5. <span class="style2">Website Multimedia and Content</span><br />

You acknowledge that Hac and HAC Haiti may utilize photographs, video and other

media that may be taken of you, statements that you may make during your time on the

program, or words that you write. You consent to this use and waive all rights to

compensation.</p>

<strong>Excluded Websites</strong><br />

You may not display any HAC Content on any Site that is a web site that is excluded by

HAC. Web sites excluded by HAC are any sites that contain material which is libellous,

defamatory, pornographic, misleading, or obscene, any site which brings HAC into

disrepute, or any site which promotes discrimination, violence, or illegal activity.</p>

<strong>Accreditation</strong><br />

You must ensure that all HAC content on your site has an accreditation to the HAC

website. Where possible you must create a functional link back to the HAC website; if

this is not possible, you must display on-screen the URL from which the HAC content

can be obtained. You may not directly or indirectly change, edit, add to or produce

summaries of the HAC Content or any content on the HAC website nor place any fullstory

HAC content in an HTML frame-set.</p>

You may not use any HAC logo or other HAC trademark without explicit permission<br />

from HAC.</p>

I accept the Legal Terms of Service.<br />

I do not accept the Legal Terms of Service.</span></strong></p>

I am fully informed and understand that all domestic and foreign travel involves some

risk to person and property. On behalf of my spouse, family, heirs, and personal

representative(s), I voluntarily agree to assume all of the risks and responsibilities

surrounding my participation in volunteering with HAC Haiti, the transportation, and in

any independent or unsupervised activities undertaken as an adjunct thereto, expected or

unexpected, including, but not limited to, travel cancellation or delays, property damage

and loss, bodily injuries, sickness, disease and death. I acknowledge and agree that I am

aware of or have been warned of such risks, and I have been advised to take appropriate

action and to govern myself accordingly. </p>

<p> Knowing the dangers, hazards, and risks of foreign travel and in consideration of being

permitted to participate in “Alternative Break Haiti”, on behalf of myself, my family,

heirs, and personal representative(s), I agree to forever discharge, hold harmless, release

and covenant not to sue the HAC, the staff in Haiti and the United States of America, and

its respective trustees, agents, officers and employees (referred to collectively as "HAC")

from any and all claims, demands, or causes of action for any injury, death, damage, cost,

expense or loss of any kind sustained by me while participating in “Alternative Break

Haiti”. I, on behalf of myself, my spouse, family, heirs, and personal representative(s),<br />

also hold harmless, release, and agree to indemnify the HAC and its respective trustees,

agents, officers and employees with regard to any financial obligations or liabilities of

any kind that I may incur personally or any loss or damage resulting from my

participation in “Alternative Break Haiti”.</p>

I shall comply with all applicable laws of any jurisdiction in which I may travel, and all

policies of HAC. I acknowledge and understand that should I have or develop legal

problems with any foreign nationals or government of any location in Haiti, I will attend

to the matter personally with my own personal funds. HAC will not be responsible for

providing any assistance under such circumstances.</p>

It is my express intent that this Agreement shall bind myself, the members of my family

and spouse, if I am alive, and my spouse, family, estate, heirs, administrators, personal

representatives or assigns, if I am deceased, and shall be deemed as a “Release, Waiver,

Discharge and Covenant" not to sue HAC. I agree to save and hold harmless, indemnify,<br />

and defend HAC from any claim demand, or cause of action by myself, my spouse,

family, estate, heirs, administrators, personal representatives or assigns, arising out of my

participation in “Alternative Break Haiti”.</p>

I hereby certify that HAC shall not be held responsible for any injuries, damages, or

losses caused to any traveler in connection with any terrorist activities, social or labor

unrest, mechanical or construction failures or difficulties, diseases, local laws, climatic

conditions, criminal acts or abnormal conditions or developments, or any other actions,

omissions, or conditions outside of HAC’s control. Travelers assume complete and full

responsibility for, and hereby release HAC from any duty of, checking and verifying any

and all passport, visa, vaccination, or other entry requirements of each destination, and all

safety or security conditions at such destinations, during the length of the proposed travel.</p>

Please note that HAC reserves the right to accept and cancel reservations for travelers

who join escorted groups at our discretion.</p>

Electronic Signature:

Date:

</strong></p>

<p>

</p>

</form>

TOA · January 19, 2011

Well, you're form looks fine. Let me look at your php again. Give me a few minutes and let me see what I can find out, not sure why the value isn't going to the POST array, but that seems to be our problem

tcalixte · January 19, 2011

thank you soo much, i appreciate you taking the time to help me b/c i am completely unfamiliar with php...

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