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Please help send enquiry form by email and store details

vikaspa

By vikaspa
in PHP Coding Help

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vikaspa Regular Member

vikaspa

Posted
Posted

Dear All

 

I want to send following form by email....

 

Can i send it ....

 

Further Can I send auto response (to the person who fills up the form)

 

and in case we need to store the information entered in database what changes I need to make vis-a-vis norm form on web site

 

I am asking this because the form wil be sent via email and will be filled us online and not on my web site

 

Please please please help

 

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">

<?

$MODULE="enquirys.php";

$SITENAME="sealretailworld.com";

$SITEMAIL="[email protected], [email protected], [email protected]";

include("includes/config.inc.php");

include("includes/getsqlvaluestring.inc.php");

include("includes/class.phpmailer.php");

$FormAction = $_SERVER['PHP_SELF'];

  if (isset($_SERVER['QUERY_STRING'])) {

  $FormAction .= "?" . htmlentities($_SERVER['QUERY_STRING']);

}

 

$showform='Y';

 

if(isset($_POST['Submit'])){

 

$showform='N';

echo $showform;

 

$subject="New enquiry has been received on $SITENAME";

$message="Enquiry  received on $SITENAME <br><br>

The details are given below<br>

Name: ".$_POST['name']."<br>

Address: ".$_POST['address']."<br>

City: ".$_POST['city']."<br>

State: ".$_POST['state']."<br>

Zip: ".$_POST['zip']."<br>

Phone No: ".$_POST['isdt']."-".$_POST['stdt']."-".$_POST['tel']."<br>

Mobile : ".$_POST['mobile']."<br>

Email Id: ".$_POST['email']."<br>

Location Details: ".$_POST['locationdetail']."<br>

Franchisee City: ".$_POST['franchiseeforcity']."<br>

Carpet Area:      ".$_POST['carpetarea']."<br>

Experience of retail Shift: ".$_POST['experience']."<br>

";

 

$to = $SITEEMAIL;

 

        mail($to, $subject, $message, "From: $email\nReply-To: $email\nContent-Type: text/html;");

 

 

$alert="<table cellspacing='0' cellpadding='0'>

  <tr>

<td colspan='3'>Dear ".ucwords($_POST['name']).",  </td>

  </tr>

  <tr>

<td colspan='3'><br>

Thank you for visiting our site.<br>

Your enquiry has been received, one of our customer support officers will get back to you shortly. <p><br>

With Best Regards,<br>

Team - ".$SITENAME." <br>

</p>

</td>

  </tr>

</table>";

 

  $to=$email;

mail($to, $subject, $message, "From: $email\nReply-To: $email\nContent-Type: text/html;");

$subject = "You had sent following enquiry on  $SITENAME";

 

$to="[email protected], [email protected], [email protected]";

mail($to, $subject, $message, "From: $email\nReply-To: $email\nContent-Type: text/html;");

}

?>

<html xmlns="http://www.w3.org/1999/xhtml">

<head>

<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />

<title>Untitled Document</title>

</head>

 

<body>

<?php echo $alert; if($showform=='Y'){?>

<form method="post" name="contactus" id="contactus"  onsubmit="return formCheck(this)">

<table width="90%"  border="0" align="center" cellpadding="2" cellspacing="2" id="formtable">

  <tr>

    <td colspan="3" bgcolor="#F1F1ED" id="toptable"><div align="center">

      <p class="normalb12"><strong>Franchisee Details Form </strong></p>

    </div></td>

  </tr>

  <tr>

    <td colspan="3" align="center" bgcolor="#F1F1ED" id="toptable"></td>

  </tr>

  <tr id="row">

    <td width="28%" bgcolor="#F1F1ED" class="normalb12" id="formcellinfo"><div align="left"><span class="text">Name:<span class="quicklist">*</span></span></div></td>

    <td width="72%" colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><input name="name" type="text" class="input" id="name" value="" /></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Address</td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <textarea name="address" id="address"></textarea>

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">City</td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="city" type="text" id="city" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">State</td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="state" type="text" id="state" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Zip</td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="zip" type="text" id="zip" size="15" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Tel Phone No. </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><input name="isdt" type="text" value="" size="4"/>

      -

      <input name="stdt" type="text" id="stdt" value="" size="7"/>

      -

      <input name="tel" type="text" value="" size="14"/></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Mobile</td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="mobile" type="text" id="mobile" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Email Id </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="email" type="text" id="email" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Location Details </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <textarea name="locationdetail" id="locationdetail"></textarea>

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Franchisee for which city </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="franchiseeforcity" type="text" id="franchiseeforcity" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Carpet area (Sq. Ft.) </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="carpetarea" type="text" id="carpetarea" size="12" />

    </label></td>

  </tr>

  <tr id="row">

    <td bgcolor="#F1F1ED" class="normalb12" id="formcellinfo">Experience of Retail Shift(No.of Years). </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><label>

      <input name="experience" type="text" id="experience" size="8" />

    </label></td>

  </tr>

  <tr id="row">

    <td height="50" bgcolor="#F1F1ED" class="normalb12" id="formcellinfo"> </td>

    <td colspan="2" bgcolor="#F1F1ED" class="text12bb" id="inputcell"><span class="normalb11"> </span></td>

  </tr>

  <tr id="row">

    <td height="64" colspan="3" align="center" bgcolor="#F1F1ED" class="text12bb" id="formcellinfo"><label>

      <input name="Submit" type="submit" id="submit" value="Submit" align="middle" />

    </label></td>

  </tr>

  <!--

        <tr id="row">

          <td id="formcellinfo"><span class="text">Best time to call: </span></td>

          <td colspan="2" id="inputcell"><select name="time" id="time">

            <option value="Morning" >Morning</option>

            <option value="Afternoon" selected>Afternoon</option>

            <option value="Weekend" >Weekend</option>

          </select></td>

        </tr>

-->

</table>

</form>

<?php } ?>

 

 

</body>

</html>

 

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