Send form copy to applicant

TOA · January 19, 2011

Ok, I didn't really find anything wrong. It captured all the post data and sent me emails at two different accounts.

Here's Mailform2.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';
$emailList = $emailadd.', '.$_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($emailList, $subject, $text, 'From: '.$emailadd);
echo '<META HTTP-EQUIV=Refresh CONTENT="0; URL='.$url.'">';

And here's the form :

<form action="Mailform2.php" method="post" enctype="multipart/form-data">
  <label>
  <div align="center"><strong>Dates and length of time of trip for which you are applying:
    <input name="Dates" type="text" id="Dates" size="50" />
    <br />
    <br />
    Name (Official name that appears on passport): 
    <input name="Name" type="text" id="Name" size="40" />
    <br />
    <br />
    First: 
    <input type="text" name="First Name" id="First Name" />
    Middle: 
    <input type="text" name="Middle Name" id="Middle Name" />
    Last: 
    <input type="text" name="Last Name" id="Last Name" />
    <br />
    <br />
    Name you would like to be called: 
    <input type="text" name="Nick Name" id="Nick Name" />
    <br />
    <br />
    Date of Birth: 
    <input type="text" name="Date of Birth" id="Date of Birth" />
    <br />
    <br />
    Gender:  
    <input type="radio" name="radio" id="Female" value="Female" />
    Female 
    <input type="radio" name="radio" id="Male" value="Male" />
    Male<br />
    Nationality: 
    <input type="text" name="Nationality" id="Nationality" />
    <br />
    <br />
    Address:<br /> 
    <textarea name="Address" id="Address" cols="45" rows="3"></textarea>
    <br />
    <br />
    City: 
    <input type="text" name="City" id="City" /> 
    State/Prov.: 
    <input type="text" name="State" id="State" />
    <br />
    <br />
    Zip/Postal Code: 
    <input type="text" name="Zip Code" id="Zip Code" />
    <br />
    <br />
    Home Phone: (
    <input name="Area Code" type="text" id="Area Code" size="6" maxlength="3" />
    ) 
    <input type="text" name="Home Number" id="Home Number" />
    <br />
    <br />
    Work Phone: (
    <input name="Area Code 2" type="text" id="Area Code 2" size="6" maxlength="3" />
    ) 
    <input type="text" name="Work Phone" id="Work Phone" />
    <br />
    <br />
    Email Address: 
    <input type="text" name="email" id="email" />
    <br />
    <br />
    Cell Phone (
    <input name="Area Code 3" type="text" id="Area Code 3" size="6" maxlength="3" />
    ) 
    <input type="text" name="Cell Phone" id="Cell Phone" />
    <br />
    <br />
    Traveling with Friend or Relative? If so, who? 
    <input name="Friend Info" type="text" id="Friend Info" size="50" />
    <br />
    <br />
    Highest qualification (i.e. high school graduate, undergraduate): 
    <input type="text" name="Education" id="Education" />
    <br />
    <br />
    Work experience:<br />
    <textarea name="Work Experience" id="Work Experience" cols="45" rows="5"></textarea>
    <br />
    <br />
    Travel Experience:<br />
    <textarea name="Travel Experience" id="Travel Experience" cols="45" rows="5"></textarea>
    <br />
    <br />
    Do you speak any other languages: 
    <input name="Languages" type="text" id="Languages" size="55" />
    <br />
    <br />
    T-Shirt Size:<br />
    <input type="radio" name="radio" id="S" value="S" /> 
    S 
    <input type="radio" name="radio" id="M" value="M" />
    M
    <input type="radio" name="radio" id="L" value="L" /> 
    L 
    <input type="radio" name="radio" id="XL" value="XL" />
    XL 
    <input type="radio" name="radio" id="XXL" value="XXL" />
    XXL<br />
    <br />
    <input type="checkbox" name="Passport" id="Passport" />
    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: 
    <input name="Passport Number" type="text" id="Passport Number" size="55" />
    <br />
    <br />
    Expiration: 
    <input type="text" name="Expiration" id="Expiration" />
    <br />
    <br />
    Country of Citizenship:
    <select name="country"  id="country">
      <!-- CACHE countries -->
      <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="41">CHAD</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="52">CUBA</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="69">FIJI</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="84">GUAM</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="91">HONG KONG</option>
      <option  value="92">HUNGARY</option>
      <option  value="93">ICELAND</option>
      <option  value="94">INDIA</option>
      <option  value="95">INDONESIA</option>
      <option  value="96">IRAN</option>
      <option  value="97">IRAQ</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="122">MALI</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="148">NIUE</option>
      <option  value="149">NORFOLK ISLAND</option>
      <option  value="150">NORTHERN MARIANA ISLANDS</option>
      <option  value="151">NORWAY</option>
      <option  value="152">OMAN</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="158">PERU</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="200">TOGO</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>
  <p align="center"><strong><br />
    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>
  <p align="center"><strong><br />
    1. Name: 
      <label>
      <input type="text" name="Name Med" id="Name Med" />
        </label> 
      Age: 
      <label>
      <input type="text" name="Age" id="Age" />
      </label>
    </strong></p>
  <p align="center"><strong><br />
    2. Do you have a history of any of the following medical conditions?<br />
    <label>
    <input type="checkbox" name="Epilepsy" id="Epilepsy" />
    </label>
    Epilepsy 
    <label>
    <input type="checkbox" name="Emphysema" id="Emphysema" />
    </label> 
    Emphysema<br />
    <input type="checkbox" name="Allergies" id="Allergies" />
    <label for="Allergies"></label>
    Allergies (including allergies to any medicines) 
    <input type="checkbox" name="High Blood Pressure" id="High Blood Pressure" />
    <label for="High Blood Pressure"></label> 
    High blood pressure<br />
    <input type="checkbox" name="Heart Condition" id="Heart Condition" />
    <label for="Heart Condition"></label>
    Heart condition  
    <input type="checkbox" name="Eating Disorder" id="Eating Disorder" />
    <label for="Eating Disorder"></label>
    Eating disorders<br />
    <input type="checkbox" name="Back Problems" id="Back Problems" />
    <label for="Back Problems"></label>
    Back problems or other injuries 
    <input type="checkbox" name="Diabetes" id="Diabetes" />
    <label for="Diabetes"></label> 
    Diabetes<br />
    <input type="checkbox" name="Substance Abuse" id="Substance Abuse" />
    <label for="Substance Abuse"></label>
    other substance abuse or chemical dependencies 
    <input type="checkbox" name="Asthma" id="Asthma" />
    <label for="Asthma"></label> 
    Asthma<br />
    <input type="checkbox" name="Other" id="Other" />
    <label for="Other"></label>
    other medical conditions – please list:<br />
    <label for="Other med"></label>
    <textarea name="Other med" id="Other med" cols="55" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
  How might any of the conditions you listed affect your travels?</strong></p>
  <p align="center"><strong> 
    <label for="Travel Conditions"></label>
    <textarea name="Travel Conditions" id="Travel Conditions" cols="45" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    3. Are you currently or have you been under a doctor’s care during the past six months?<br />
    <input type="radio" name="radio" id="Yes" value="Yes" />
    <label for="Yes">Yes</label>
    <input type="radio" name="radio" id="No" value="No" />
    <label for="No">No</label>
  </strong></p>
  <p align="center"><strong><br />
    If yes, what conditions(s) are being treated?</strong></p>
  <p align="center"><strong>
    <label for="Treatment"></label>
    <textarea name="Treatment" id="Treatment" cols="55" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    How might these conditions affect your travels?</strong></p>
  <p align="center"><strong>
    <label for="more"></label>
    <textarea name="more" id="more" cols="55" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    4. Do you carry any medication? If so, please specify names, conditions which they treat,<br />
    and possible side effects.</strong></p>
  <p align="center"><strong>
    <label for="Medications"></label>
    <textarea name="Medications" id="Medications" cols="55" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    5. Are you currently on any special diet (even if voluntary, such as vegetarian)?</strong></p>
  <p align="center"><strong>
    <label for="Diet"></label>
    <textarea name="Diet" id="Diet" cols="45" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    6. I understand that I assume all medical costs incurred while participating on this trip to 
    Haiti: 
    
    <input type="radio" name="radio" id="Yes2" value="Yes" />
    <label for="Yes2">Yes</label>
    <input type="radio" name="radio" id="No2" value="No" />
    <label for="No2">No</label>
  </strong></p>
  <p align="center"><strong>    <br />
    7. Any other comments about your health?</strong></p>
  <p align="center"><strong>
    <label for="Health Comments"></label>
    <textarea name="Health Comments" id="Health Comments" cols="55" rows="5"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    8. In case of illness or emergency, please notify:</strong></p>
  <p align="center"><strong><br />
    Name/Relationship:
    <label for="Emergency Name"></label>
    <input name="Emergency Name" type="text" id="Emergency Name" size="55" />
    </strong></p>
  <p align="center"><strong><br />
    Address:</strong></p>
  <p align="center"><strong> 
    <label for="label"></label>
    <textarea name="Address2" id="label" cols="45" rows="3"></textarea>
  </strong></p>
  <p align="center"><strong><br />
    City: 
      <label for="label2"></label>
      <input type="text" name="City2" id="label2" />
    State: 
    <label for="label3"></label>
    <input type="text" name="State2" id="label3" />
  </strong></p>
  <p align="center"><strong><br />
    Zip/Postal Code: 
      <label for="label4"></label>
      <input type="text" name="Zip Code2" id="label4" />
  </strong></p>
  <p align="center"><strong><br />
    Phone: (Day): 
      <label for="Day Phone"></label>
      <input type="text" name="Day Phone" id="Day Phone" />
    (Evening): 
    <label for="Evening Phone"></label>
    <input type="text" name="Evening Phone" id="Evening Phone" />
  </strong></p>
  <p align="center"> </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>
  <p><br />
    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>
  <p><br />
    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>
  <p><br />
    2. <span class="style2">Refund Policy</span></p>
  <p><br />
    <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>
  <p><br />
    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>
  <p><br />
    3. <span class="style2">Communication</span></p>
  <p><br />
    <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>
  <p><br />
    <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>
  <p><br />
    <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>
  <p><br />
    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>
  <p><br />
    Online payments are processed through a secure third party site, and HAC does not 
    receive sensitive information such as credit card information.</p>
  <p><br />
    <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>
  <p><br />
    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>
  <p><br />
    <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>
  <p><br />
    <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>
  <p><br />
    You may not use any HAC logo or other HAC trademark without explicit permission<br />
    from HAC.</p>
  <p><br />
    <strong>
    <input type="checkbox" name="Accept" id="Accept" />
    <span class="style12">
    <label for="Accept"></label>
    I accept the Legal Terms of Service.<br />
    <input type="checkbox" name="Don't Accept" id="Don't Accept" />
    <label for="Don't Accept"></label>
    I do not accept the Legal Terms of Service.</span></strong></p>
  <p><br />
    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>
  <p><br />
    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>
  <p><br />
    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>
  <p><br />
    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>
  <p><br />
    Please note that HAC reserves the right to accept and cancel reservations for travelers 
    who join escorted groups at our discretion.</p>
  <p><strong><br />
    Electronic Signature: 
    <label for="Sign"></label>
      <input type="text" name="Sign" id="Sign" />
    Date: 
    <label for="Date"></label>
    <input type="text" name="Date" id="Date" />
  </strong></p>
  <p>
    <label for="Submit"></label>
    <input type="submit" name="Submit" id="Submit" value="Submit" />
    <label for="Reset"></label>
    <input type="reset" name="Reset" id="Reset" value="Reset" />
  </p>
</form>

So if you still have the issue, I'm not sure what to tell you, cause it's working for me :shrug:

tcalixte · January 19, 2011

OMG.... IT WORKS!!!!!!!!!!! YAY!!!!!!!!

I dont know what you did, but you did it! Thank you soo much... I've been at this since 9 last night, thank you thank you thank you!

TOA · January 19, 2011

OMG.... IT WORKS!!!!!!!!!!! YAY!!!!!!!!

I dont know what you did, but you did it! Thank you soo much... I've been at this since 9 last night, thank you thank you thank you!

LMAO :shrug:

Glad it worked

TOA · January 19, 2011

Just so you know, what I did was:

line 5 and 6 add the emails together, with a comma and space separating.

Then, instead of adding both emails to the From header (which might have been the issue) I used $emailList as the list of addresses so $emailadd could remain singular.

Peek through the code and see where they are different. Thats the best way to learn.

Mark it solved too please

tcalixte · January 19, 2011

I see what you did... I would have never thought of that... Once again, thank you! I can feel my headache going away now lol

I'll make this as solved

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