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I have the following php form sending my info to an email address I have 2 problems

 

1. its not sending the correctly

 

Form details below.
 
Company Name: HigherPower
First Name: James
Last Name: Peters
Email:
Telephone: 7708961481
Address:
City:
State:
Zip Code:

 

2.  I have checkboxes where someone can check however many videos they would like to rent from the company video selection. how do I do that

 

 

<?php
if(isset($_POST['email'])) {
     
    // EDIT THE 2 LINES BELOW AS REQUIRED
    $email_to = "support@higherpowercomputers.com";
    $email_subject = "Video Rental Form";
     
     
    function died($error) {
        // your error code can go here
        echo "We are very sorry, but there were error(s) found with the form you submitted. ";
        echo "These errors appear below.<br /><br />";
        echo $error."<br /><br />";
        echo "Please go back and fix these errors.<br /><br />";
        die();
    }
     
    // validation expected data exists
    if( !isset($_POST['company_name']) ||
!isset($_POST['first_name']) ||
        !isset($_POST['last_name']) ||
!isset($_POST['telephone']) ||
        !isset($_POST['email'])) {
        died('We are sorry, but there appears to be a problem with the form you submitted.');       
    }
    $company_name = $_POST['company_name']; // required
    $first_name = $_POST['first_name']; // required
    $last_name = $_POST['last_name']; // required
$telephone = $_POST['telephone']; // required
    $email_from = $_POST['email']; // required
     
    $error_message = "";
    $email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/';
  if(!preg_match($email_exp,$email_from)) {
    $error_message .= 'The Email Address you entered does not appear to be valid.<br />';
  }
    $string_exp = "/^[A-Za-z .'-]+$/";
  if(!preg_match($string_exp,$first_name)) {
    $error_message .= 'The First Name you entered does not appear to be valid.<br />';
  }
  if(!preg_match($string_exp,$last_name)) {
    $error_message .= 'The Last Name you entered does not appear to be valid.<br />';
  }
  if(!preg_match($string_exp,$company_name)) {
    $error_message .= 'The Company Name you entered does not appear to be valid.<br />';
  }
  if(strlen($error_message) > 0) {
    died($error_message);
  }
    $email_message = "Form details below.\n\n";
     
    function clean_string($string) {
      $bad = array("content-type","bcc:","to:","cc:","href");
      return str_replace($bad,"",$string);
    }
     
 
    $email_message .= "Company Name: ".clean_string($company_name)."\n";
$email_message .= "First Name: ".clean_string($first_name)."\n";
    $email_message .= "Last Name: ".clean_string($last_name)."\n";
    $email_message .= "Email: ".clean_string($email)."\n";
    $email_message .= "Telephone: ".clean_string($telephone)."\n";
$email_message .= "Address: ".clean_string($address)."\n";
    $email_message .= "City: ".clean_string($city)."\n";
$email_message .= "State: ".clean_string($state)."\n";
$email_message .= "Zip Code: ".clean_string($zip_code)."\n";
     
     
// create email headers
$headers = 'From: '.$email_from."\r\n".
'Reply-To: '.$email_from."\r\n" .
'X-Mailer: PHP/' . phpversion();
@mail($email_to, $email_subject, $email_message, $headers);  
?>
 
<!-- include your own success html here -->
 
Thank you for contacting us. We will be in touch with you very soon.
 
<?php
}
?>
 
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https://forums.phpfreaks.com/topic/281731-form-not-sending-properly/
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 <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /><form id="video_rental_form" target="_self" enctype="multipart/form-data" method="post" action="send_form_email.php">

<table style="text-align:left;" cellpadding="2" cellspacing="0" border="1" bgcolor="#FFFFFF">

<tr>

<td style="" colspan="2" align="center">

<font face="Verdana" size="2" color="#000000"><b style="font-size:20px;">GUCA INDUSTRY VIDEOS</b><br /><label style="font-size:15px;">Choose the videos you wish to view.<br /></label><br /></font>

</td>

 

</tr>

<tr>

  <td width="379" align="left" valign="middle" id="td_element_label_0" style="font-size: 14px;"><input id="video_1" name="video_1" value="ALL ABOUT GUCA - A SHORT VIDEO EXPLAINING GUCA'S SERVICES IN SPANISH"

class="validate[optional]"  type="checkbox" />

  <font face="Verdana" size="2" color="#000000"><strong>ALL ABOUT GUCA</strong>: A SHORT VIDEO EXPLAINING GUCA'S SERVICES IN SPANISH </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_28" name="video_28" value="NATIONAL UTILITY CONTRACTORS ASSOCIATION - INDUSTRY RECRUITMENT VIDEO"

class="validate[optional]"  type="checkbox" />    

    <strong>NATIONAL UTILITY CONTRACTORS ASSOCIATION:</strong> INDUSTRY RECRUITMENT VIDEO </td>

</tr>

<tr>

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class="validate[optional]"  type="checkbox" />

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  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_29" name="video_29" value="NATIONAL UTILITY CONTRACTORS ASSOCIATION - INDUSTRY RECRUITMENT VIDEO"

class="validate[optional]"  type="checkbox" />

    <strong>NUTS AND BOLTS OF TRENCH PROTECTIVE SYSTEMS:</strong> PRODUCED BY NUCA TO PROVIDE EXAMPLES OF THE DIFFERENT PROTECTIVE SYSTEMS USED AND PROPER MEASURES TO MAINTAIN SAFE JOB SITES,  </td>

</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px;"><input id="video_3" name="video_3" value="AS EASY AS A PHONE CALL- 10 I\4IN. . A SHORTER VERSION OF THE JOINT CONRAIL/AT&T VIDEO RELATING TO FIBER OPTIC CABLE ALONG RAILROAD RIGHT OF WAY. WELL SUITED TO ANYONE WORKING NEAR RAILROADS."

class="validate[optional]"  type="checkbox" />

    <font face="Verdana" size="2" color="#000000"><strong> AS EASY AS A PHONE CALL: </strong>10 MIN. . A SHORTER VERSION OF THE JOINT CONRAIL/AT&T VIDEO RELATING TO FIBER OPTIC CABLE ALONG RAILROAD RIGHT OF WAY. WELL SUITED TO ANYONE WORKING NEAR RAILROADS. </font></td>

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class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

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class="validate[optional]"  type="checkbox" />

    <strong>AUGER BORING OPERATIONS: </strong>1o MIN,. NUCA- REVIEWS THE DANGERS OF AUGER BORING OPERATIONS AND TEACHES TEN GUIDELINES TO HELP PROTECT YOURSELF. </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px; font-weight: bold;"><input id="video_31" name="video_31" value="PIPE AND CABLE LOCATOR"

class="validate[optional]"  type="checkbox" />

    <span style="text-align: left; font-weight: bold; font-size: 14px;">PIPE HANDLING</span></td>

</tr>

<tr>

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class="validate[optional]"  type="checkbox" />    

    <strong>BUILD IT:</strong> 7 MIN-PRODUCED BY NAWIC TO EDUCATE AND INFORM CHILDREN ABOUT A POSSIBLE FUTURE IN THE FIELD OF CONSTRUCTION. </td>

  <td align="center" valign="middle" style="text-align: left; font-weight: bold; font-size: 14px;"><input id="video_32" name="video_32" value="PIPE HANDLING"

class="validate[optional]"  type="checkbox" />

    <span style="text-align: left; font-size: 14px; font-weight: normal;"><strong>POWERFUL FORCES: </strong>25 MIN. - ELECTRICAL SAFETY VIDEO PRODUCED BY GEORGIA POWER.</span></td>

</tr>

<tr>

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class="validate[optional]"  type="checkbox" />

      <font face="Verdana" size="2" color="#000000"><strong>CALL BEFORE YOU DIG:</strong>15 MIN.. PRODUCED BY NUCA ON THE IMPORTANCE OF CALLING BEFORE YOU DIG, </font></td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_33" name="video_33" value="POWERFUL FORCES. 25 I\,,|IN. - ELECTRICAL SAFEry VIDEO PRODUCED BY GEORGIA POWER."

class="validate[optional]"  type="checkbox" />    

     <strong>PRACTICAL BLASTING FUNDAMENTALS LEVEL I</strong>: 14 MIN PRODUCED BY THE ISEE CERTIFICATE PROGRAM ON BLASTING SAFETY </td>

</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px;"><input id="video_7" name="video_7" value="CNA INSURANCE "SEEING IS BELIEVING"-30 [/iN"

class="validate[optional]"  type="checkbox" />    

        <strong>CNA INSURANCE: </strong>"SEEING IS BELIEVING"- 30 MIN </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_34" name="video_34" value="PRACTICAL BLASTING FUNDAMENTALS.LEVEL I-14 MINPRODUCED BY THE ISEE CERTIFICATE PROGMI\,4 ON BLASTING SAFETY"

class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px;"><input id="video_8" name="video_8" value="COMMON GROUND IN DAMAGE PREVENTION. 30 MIN- A BEST PMCTICES STUDY ON DAMAGE PREVENTION PRODUCED BY THE GEORGIA D.O,T."

class="validate[optional]"  type="checkbox" />    

    <strong>COMMON GROUND IN DAMAGE PREVENTION:</strong> 30 MIN- A BEST PRACTICES STUDY ON DAMAGE PREVENTION PRODUCED BY THE GEORGIA D.O,T. </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_35" name="video_35" value="PROTECTIVE EQUIPMENT"

class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px;"><input id="video_9" name="video_9" value="CONFINED€PACE ENTRY- 1o MIN.. NUCA. REVIEWS THE DANGERS OF CONFINED SPACES AND TEACHES EIGHT GUIDELINES FOR ENTERING AND WORKING IN THEM."

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    <strong>CONFINED SPACE ENTRY:</strong> 10 MIN.. NUCA. REVIEWS THE DANGERS OF CONFINED SPACES AND TEACHES EIGHT GUIDELINES FOR ENTERING AND WORKING IN THEM. </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_36" name="video_36" value="PROTECTIVE SYSTEMS - BLOOED BORN PATHOGENS 2000- BBP NON-HEALTHCARE EMPLOYEES IN THE WORKPLACE"

class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px;"><input id="video_10" name="video_10" value="CONSOLIDATED INDUSTRY SAFETY PRODUCED BY JOHN DEERE ON SAFETY IN A CONSOLIDATED INDUSTRY"

class="validate[optional]"  type="checkbox" />

    <font face="Verdana" size="2" color="#000000"> <strong>CONSOLIDATED INDUSTRY SAFETY: </strong>PRODUCED BY JOHN DEERE ON SAFETY IN A CONSOLIDATED INDUSTRY </font></td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_37" name="video_37" value="REAL JOBS FOR REAL PEOPLE- PRODUCED BY HAMPTON ROADS UTILITY & HEAVY CONTRACTORS ASSOC. TO EDUCATE VIEWERS ON POSSIBLE CAREER OPTIONS IN THE HEAVY CONSTRUCTION INDUSTRY"

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    <span style="text-align: left; font-size: 14px; font-weight: bold;">SAFE & EFFICIENT OPERATION OF HAND HELD SAWS</span></td>

</tr>

<tr>

  <td align="left" valign="middle" style="font-size: 14px; font-weight: bold;"><input id="video_11" name="video_11" value="CONSTRUCTION DEMO"

class="validate[optional]"  type="checkbox" /> CONSTRUCTION DEMO</td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_38" name="video_38" value="SAFE & EFFICIENT OPERATION OF HAND HELD SAWS"

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    <span style="text-align: left; font-size: 14px;"><strong>SAFETY IN FLAGGING: </strong>1O MIN,- NUCA- SHOWS FLAGGERS EIGHT GUIDELINES FOR CONTROLLING TRAFFIC SAFELY WHILE PROTECTING THEMSELVES AND THE CONSTRUCTION CREW FROM ONCOMING MOTORISTS, <br /><span class="redddd">"DOES NOT MEET GDOT FLAGGING REQUIREMENTS"</span></td>

</tr>

<tr>

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      <font face="Verdana" size="2" color="#000000"><strong>DIGGING DANGERS I</strong>: 15 MIN. - A GENERIC VIDEO REGARDING UNDERGROUND FACILITIES FROM A CONTRACTORS POINT OF VIEW</font></td>

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    <strong>SAFETY TRAINING FOR REPAIR TECHS</strong>: <br />

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</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_13" name="video_13" value="DIGGING DANGERS III - 16 I\,4IN. - AN IN DEPTH INVESTIGATION AND OVERVIEW OF A GAS EXPLOSION AS TOLD BY THE OWNER OF THE EXCAVATING COMPANY, HIGHLIGHTS THE IMPACT AN ACCIDENT HAS ON ALL PARTIES INVOLVED."

class="validate[optional]"  type="checkbox" />    

    <strong>DIGGING DANGERS III:</strong> 16 MIN. - AN IN DEPTH INVESTIGATION AND OVERVIEW OF A GAS EXPLOSION AS TOLD BY THE OWNER OF THE EXCAVATING COMPANY, HIGHLIGHTS THE IMPACT AN ACCIDENT HAS ON ALL PARTIES INVOLVED.</td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_40" name="video_40" value="SAFETY TRAINING FOR REPAIR TECHS- 21 MIN.- NUCA. EXAMINES COMMON REPAIR.RELATED ACCIDENTS AND ILLUSTRATES SAFEry PROCEDURES FOR SEVERAL DIFFERENT REPAIR SITUATIONS."

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</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_14" name="video_14" value="DIGGING DANGERS V - 12 I\,4IN. - A TRAINING VIDEo DETAILING THE PROCEDURES FOR SAFELY EXPOSING UNDERGROUND FACILITIES WHEN POTHOLING AND HAND DIGGING,"

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      <font face="Verdana" size="2" color="#000000"><strong>DIGGING DANGERS V</strong>: 12 MIN. - A TRAINING VIDEO DETAILING THE PROCEDURES FOR SAFELY EXPOSING UNDERGROUND FACILITIES WHEN POTHOLING AND HAND DIGGING, </font></td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_41" name="video_41" value="SEEING lS BELlEVlNG... Safelv Exposinq Buried Utilities"

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</tr>

<tr>

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class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

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class="validate[optional]"  type="checkbox" />    

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class="validate[optional]"  type="checkbox" />

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</tr>

<tr>

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</tr>

<tr>

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</tr>

<tr>

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</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-weight: bold; font-size: 14px;"><input id="video_20" name="video_20" value="HAND SIGNALS FOR CONSTRUCTION EQUIPMENT"

class="validate[optional]"  type="checkbox" />    HAND SIGNALS FOR CONSTRUCTION EQUIPMENT </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_47" name="video_47" value="THE FUTURE IS NOW- 8 MIN.- PRODUCED BY THE UNION PACIFIC RAILROAD EXPLAINS WHY PROTECTING FIBER OPTIC CABLE IS EVERYONE'S RESPONSIBILITY AND HOW EVERYONE CAN PARTICIPATE IN PROTECTING THE SYSTEM."

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</tr>

<tr>

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class="validate[optional]"  type="checkbox" />    

    <strong>HEADACHES FOR VANDALS:</strong> INFORMS VIEWERS ABOUT WAYS TO DISCOURAGE JOB SITE ENTRY, PREVENT DAMAGE AND HOW TO REDUCE LIABILITY AND COST. PRODUCED BY NUCA. </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_48" name="video_48" value="TRAILER TRANSPORT SAFETY-24-MIN -PRODUCED BY VISTA TO SHOW SAFE LOADING AND UNLOADING TECHNIQUES, TIE-DOWN TECHNIQUES, TIPS FOR SAFE TRANSPORT, ADVICE ON HOW TO SAFELY HANDLE AND SECURE UNUSUAL EOUIPMENT. AND THE OPPORTUNITY TO LEARN FROIV THE EXPERI"

class="validate[optional]"  type="checkbox" />

    <strong>TRENCH SHIELDS</strong>: 1O MIN.- NUCA- HIGHLIGHTS TEN GUIDELINES FOR THE SAFE USE OF TRENCH SHIELDS - ,1997</td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_22" name="video_22" value="HEAVY EQUIPMENT OPERATIONS. 1O MIN.- NUCA- HIGHLIGHTS SEVERAL CONCERNS FOR HEAVY.EQUIPMENT OPERATORS AND TEACHES TWELVE GUIDELINES FOR SAFE HEAVY EQUIPI\4ENT OPERATION."

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      <font face="Verdana" size="2" color="#000000"><strong>HEAVY EQUIPMENT OPERATIONS</strong>:<br />

       1O MIN.- NUCA- HIGHLIGHTS SEVERAL CONCERNS FOR HEAVY.EQUIPMENT OPERATORS AND TEACHES TWELVE GUIDELINES FOR SAFE HEAVY EQUIPMENT OPERATION. </font></td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_49" name="video_49" value="TRENCH SHIELDS- 1O MIN.- NUCA- HIGHLIGHTS TEN GUIDELINES FOR THE SAFE USE OF TRENCH SHIELDS - ,1997"

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    <strong>TRENCH SHORING:</strong> 10 MIN,- NUCA- PROVIDES TEN GUIDELINES FOR CORRECT INSTALLATION, USE, AND REMOVAL OF TRENCH SHORING.</td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_23" name="video_23" value="HORIZONTAL DIRECTIONAL DRILLING-GOOD PRACTICES GUIDELINES"

class="validate[optional]"  type="checkbox" />    

    <strong>HORIZONTAL DIRECTIONAL DRILLING</strong>:<br />

    GOOD PRACTICES GUIDELINES </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_50" name="video_50" value="TRENCH SHORING- 1o MIN,- NUCA- PROVIDES TEN GUIDELINES FOR CORRECT INSTALLATION, USE, AND REI\4OVAL OF TRENCH SHORING."

class="validate[optional]"  type="checkbox" />      <strong>TRENCHING SAFETY I:</strong> 5 MIN-BASIC GUIDELINES TO ENSURE A SAFE TRENCHING JOB </td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_24" name="video_24" value="HOW FAR DO YOU WANT TO GO?-PRODUCED BY THE NC INDUSTRIES FOR TECHNICAL EDUCATION TO EDUCATE STUDENTS ABOUT REWARDING CAREERS IN THE CONSTRUCTION INDUSTRY,"

class="validate[optional]"  type="checkbox" />    

    <strong>HOW FAR DO YOU WANT TO GO?</strong>:<br />

    PRODUCED BY THE NC INDUSTRIES FOR TECHNICAL EDUCATION TO EDUCATE STUDENTS ABOUT REWARDING CAREERS IN THE CONSTRUCTION INDUSTRY.</td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_51" name="video_51" value="TRENCHING SAFETY I-5 I\,IIN-BASIC GUIDELINES TO ENSURE A SAFE TRENCHING JOB"

class="validate[optional]"  type="checkbox" />

    <strong>TRENCHING SAFETY II</strong>: 5 MIN-BASIC GUIDELINES TO ENSURE A SAFE TRENCHING JOB </td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_25" name="video_25" value="INSTALLING: PRESTRESSED CONCRETE CYLINDER PIPE - 15:20 NIIN. - PRESENTED BY PRICE BROTHERS"

class="validate[optional]"  type="checkbox" />    

    <strong>INSTALLING: PRESTRESSED CONCRETE CYLINDER PIPE:</strong> 15:20 MIN. - PRESENTED BY PRICE BROTHERS </td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_52" name="video_52" value="TRENCHING SAFETY II-5 MIN-BASIC GUIDELINES To ENSURE A SAFE TRENCHING JOB"

class="validate[optional]"  type="checkbox" />

    T<strong>RYING TO MAKE SENSE OF YOUR FUTURE</strong>: GUCA RECRUITING VIDEO </td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;">

      <input id="video_26" name="video_26" value="IT'S WHERE SAFE DIGGING STARTS. IN THIS SHORT VIDEO, THE PSC EXPLAINS THE ONE CALL SYSTEM AND OTHER METHODS OF DAMAGE PREVENTION"

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      <strong>IT'S WHERE SAFE DIGGING STARTS:</strong> IN THIS SHORT VIDEO, THE PSC EXPLAINS THE ONE CALL SYSTEM AND OTHER METHODS OF DAMAGE PREVENTION</td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_53" name="video_53" value="TRYING TO MAKE SENSE OF YOUR FUTURE - GUCA RECRUITING VIDEO"

class="validate[optional]"  type="checkbox" />

    <font face="Verdana" size="2" color="#000000"><strong>TUNNELING SAFETY:</strong> 12 MIN,- NUCA- REVIEWS THE BASIC SAFETY CONCERNS IN A TUNNEL AND TEACHES TEN GUIDELINES FOR SAFELY WORKING IN TUNNELS, </font></td>

</tr>

<tr>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_27" name="video_27" value="MANUFACTURING: PRESTRESSED CONCRETE CYLINDER PIPE -'15:30 N.4IN.. PRESENTED BY PRICE BROTHERS"

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    <strong>MANUFACTURING:</strong> PRESTRESSED CONCRETE CYLINDER PIPE -'15:30 MIN.. PRESENTED BY PRICE BROTHERS</td>

  <td align="center" valign="middle" style="text-align: left; font-size: 14px;"><input id="video_54" name="video_54" value="WE DIG SAFETY- PRODUCED BY SOUTHWEST FLORIDA UTILITY CONTRACTORS ASSOCIATION ON TRENCH SAFETY."

class="validate[optional]"  type="checkbox" />    

    <strong>WE DIG SAFETY:</strong> PRODUCED BY SOUTHWEST FLORIDA UTILITY CONTRACTORS ASSOCIATION ON TRENCH SAFETY. </td>

</tr>

<tr valign="top" ><td colspan="2" style="" align="center"><h3 style="font-size: 14px; padding: 10px 0 6px 0; border-top: 1px dotted #CCCCCC; margin: 14px 0; position: static; text-align: center;" id="information" name="information">

<font face="Verdana" size="2" color="#000000">

Please fill in information below to have the selected videos sent to you!

</font>

</h3><div style="padding-bottom:8px;color:#000000;"><small><font face="Verdana"></font></small></div>

</td>

 

</tr><tr valign="top" >

  <td colspan="2" align="center" id="td_element_label_2" style=""><font face="Verdana" size="2" color="#000000"><b>Company and Name Information</b></font>

 

</td>

</tr><tr valign="top" >

<td width="379" align="left" id="td_element_label_3" style=""><font face="Verdana" size="2" color="#000000"><b>Company</b></font>

<span style="color:red;">*<small></small></span>

</td><td width="382" id="td_element_field_3" style=""><input id="company_name" name="company_name" value="" size="30"

class="validate[required]" type="text" /></td>

</tr><tr valign="top" >

<td id="td_element_label_4" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>First Name</b></font>

<span style="color:red;">*<small></small></span> 

</td><td id="td_element_field_4" style=""><input id="first_name" name="first_name" value="" size="30"

class="validate[required]" type="text" /></td>

</tr><tr valign="top" >

<td id="td_element_label_5" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Last Name</b></font>

<span style="color:red;"><small>*</small></span>

</td><td id="td_element_field_5" style=""><input id="last_name" name="last_name" value="" size="30"

class="validate[required]" type="text" /></td>

 

</tr>

</tr><tr valign="top" >

<td id="td_element_label_15" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Phone</b></font>

<span style="color:red;"><small>*</small></span>

</td><td id="td_element_field_15" style=""><table cellpadding='0' cellspacing='0' border='0'><tr><td style='padding-left:0px;'><input maxlength='3' style='width:30px;' value='' id='element_15_1' name='element_15[]' type='text' class='validate[required]' /><br /><font face="Verdana" size="2" color="#000000">###</font></td><td style='padding-top:5px;padding-left:3px;' valign='top'><font face="Verdana" size="2" color="#000000">-</font></td><td style='padding-left:3px;'><input maxlength='3' style='width:30px;' value='' id='element_15_2' name='element_15[]' type='text' class='validate[required,custom[onlyNumber],length[3,3]]' /><br /><font face="Verdana" size="2" color="#000000">###</font></td><td style='padding-top:5px;padding-left:3px;' valign='top'><font face="Verdana" size="2" color="#000000">-</font></td><td style='padding-left:3px;'><input maxlength='4' style='width:40px;' value='' id='element_15_3' name='element_15[]' type='text' class='validate[required],length[4,4]]' /><br /><font face="Verdana" size="2" color="#000000">####</font></td></tr></table></td>

 

</tr>

<tr valign="top" ><td colspan="2" align="center" id="td_element_label_7" style="font-weight: bold; font-size: 18px;"><font face="Verdana" size="2" color="#000000"><b>Address</b></font>

<span style="color:red;"><small></small></span></td>

</tr><tr valign="top" ><td id="td_element_label_8" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Street Address</b></font>

<span style="color:red;"><small></small></span>

</td><td id="td_element_field_8" style=""><input id="address" name="address" value="" size="30"

class="validate[optional]" type="text" /></td>

</tr><tr valign="top" ><td id="td_element_label_10" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>City</b></font>

<span style="color:red;"><small></small></span>

</td><td id="td_element_field_10" style=""><input id="city" name="city" value="" size="30"

class="validate[optional]" type="text" /></td>

</tr><tr valign="top" ><td id="td_element_label_11" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>State / Province / Region</b></font>

<span style="color:red;"><small></small></span>

</td><td id="td_element_field_11" style=""><input id="state" name="state" value="" size="30"

class="validate[optional]" type="text" /></td>

</tr><tr valign="top" ><td id="td_element_label_12" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Postal / Zip Code</b></font>

<span style="color:red;"><small></small></span>

</td><td id="td_element_field_12" style=""><input id="zip_code" name="zip_code" value="" size="30"

class="validate[optional]" type="text" /></td>

</tr><tr valign="top" ><td id="td_element_label_14" style="" align="left"><font face="Verdana" size="2" color="#000000"><b>Email</b></font>

<span style="color:red;"><small></small></span>

</td><td id="td_element_field_14" style=""><input id="email" name="email"

class="validate[optional,custom]"






In the future when you're posting your samples, please use code tags! 

 

So, fill and submit the form and give me the output string of $email_message.

 

Add next line of code before to call a mail php function.

.........................................................................................

// create email headers
$headers = 'From: '.$email_from."\r\n".
'Reply-To: '.$email_from."\r\n" .
'X-Mailer: PHP/' . phpversion();

// add this
echo '<pre>'.print_r($email_message, true).'</pre>'; exit; 

// use this instead yours
if(mail($email_to, $email_subject, $email_message, $headers)) {
 echo 'Ok......message sent';   
} else {
 echo 'Ok......message failed';   
  }
}

Also, turn on error_reporting on the top of the send_mail_form file.

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