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Simple form issues


rik72

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<?php

    $firstname = $_REQUEST['firstname'] ;
    $surname = $_REQUEST['surname'] ;
    $servicerequired = $_REQUEST['servicerequired'] ;
$housenumber = $_REQUEST['housenumber'] ;
$streetadress = $_REQUEST['streetaddress'] ;
$towncity = $_REQUEST['towncity'] ;
$county = $_REQUEST['county'] ;
$postcode = $_REQUEST['postcode'] ;
$mobilenumber = $_REQUEST['mobilenumber'] ;
$homenumber = $_REQUEST['homenumber'] ;
$worknumber = $_REQUEST['worknumber'] ;
$emailaddress = $_REQUEST['emailaddress'] ;
    $agentdetails = $_REQUEST['agentdetails'] ;
$propertyage = $_REQUEST['propertyage'] ;
$propertytype = $_REQUEST['propertytype'] ;
$bedrooms = $_REQUEST['bedrooms'] ;
$extensions = $_REQUEST['extensions'] ;
$heatingtype = $_REQUEST['heatingtype'] ;
$inspectiondaytime = $_REQUEST['inspectiondaytime'] ;
$notes = $_REQUEST['notes'] ;

$to = "[email protected]";
$subject = "EPC/HIP Request Form Submission";
$message = "Service Required: $servicerequired

Firstname: $firstname
Surname: $surname

House Number: $housenumber
Street Address: $streetaddress
Town/City: $towncity
County: $county
Postcode: $postcode

Mobile Number: $mobilenumber
Home Number: $homenumber
Work Number: $worknumber
Email Address: $emailaddress

Agent Details: $agentdetails
Property Age: $propertyage
Property Type: $propertytype
Bedrooms: $bedrooms
Extensions: $extensions
Heating Type: $heatingtype
Inspection Day/Time: $inspectiondaytime

Notes: $notes";
$headers = "From: $emailaddress";

mail($to, $subject, $message, $headers);

?>

<h1>Thank you</h1>

<p>Thank you for your contact form submission, someone will be in touch shortly.</p>

 

I can't see a single issue in the above code, but i'm sure there is one as i'm getting server misconfiguration error 500.

 

Any help?

 

appreciated

thanks

Rik

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