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HELP!! I'm new to PHP and need some help with this contact form...


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Everything seems to work except my "select" list that I tried to add....and I don't know if it is capturing all the data once you hit the send button...

 

<?php

class maxContact {

    var $subjectText = "This message has been sent from the web site";

    var $targetEmail = "mail@mail.com";

    var $mailFormat  = "text/plain";

    var $fieldList;

    var $errorList;

    var $email = '';

    var $name  = '';

    var $phone= '';

    var $additionalText = '';

 

    function maxContact(){

        //Extend the list as you want here

        $this->fieldList[0]['caption'] = "City";

        $this->fieldList[0]['fieldName'] = "city";

        $this->fieldList[0]['value'] = "";

        $this->fieldList[1]['caption'] = "State";

        $this->fieldList[1]['fieldName'] = "state";

        $this->fieldList[1]['value'] = "";

      $this->fieldList[2]['caption'] = "Zip";

        $this->fieldList[2]['fieldName'] = "zip";

        $this->fieldList[2]['value'] = "";

    }

 

    function showForm(){

      $message = '';

      echo '<form action="'.$_SERVER['PHP_SELF'].'" method="post">';

      echo '  <table>';

      echo '  <tr><td>Name:</td>'

          .'  <td><input type="text" name="name" value="'.$this->name.'" /></td></tr>';

      echo '  <tr><td>Email:</td>'

          .'  <td><input type="text" name="email" value="'.$this->email.'"/></td></tr>';

       

      // Now display additional elements 

      foreach ($this->fieldList as $value) {

          echo '  <tr><td>'.$value['caption'].':</td>'

              .'  <td><input type="text" name="'.$value['fieldName'].'" value="'.$value['value'].'" /></td></tr>';

      }         

   

      echo '    <tr><td>Phone:</td>'

          .'    <td ><input type="text" name="phone">'.$this->phone.'</textarea></td></tr>'

      echo '    <tr><td>Reason for contact:</td>'

          .'    <td ><select name="reason" id="reason">

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

                <option value="Life  Insurance">Life  Insurance</option>

                <option value="Long Term Care">Long Term Care</option>

                <option value="Medicare Supplement  Insurance">Medicare Supplement  Insurance</option>

                <option value="Health  Insurance">Health  Insurance</option>

            </select></td></tr>'

          .'<tr><td><input type="submit" name="submitBtn" class="sbtn" value="Send" /></td></tr>';

      echo '  </table>';

      echo '</form>';

    }

 

    function sendMail() {

        $subject = $this->subjectText;

        $from    = "From: $this->name <$this->email>\r\nReply-To: $this->email\r\n";

        $header  = "MIME-Version: 1.0\r\n"."Content-type: $this->mailFormat; charset=iso-8859-1\r\n";

        $content = $this->message;

        if ($this->additionalText != ''){

            $content .= "\r\n\r\nAdditional information:\r\n\r\n"

                    .$this->additionalText;

        }

     

        $content = wordwrap($content,70);

        @mail($this->targetEmail,$subject,$content,$from.$header);

 

    }

 

    function isValidEmail($email){

        $pattern = "^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,3})$";

   

        if (eregi($pattern, $email)){

            return true;

        }

        else {

            return false;

        } 

    }

 

    function processForm(){

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

            $email  = isset($_POST['email']) ? trim($_POST['email']) : '';

            $name    = isset($_POST['name']) ? trim($_POST['name']) : '';

            //$message = isset($_POST['message']) ? trim($_POST['message']) : '';

         

            if (!$this->isValidEmail($email)) $this->errorList[] = "Invalid email address!";

            if (strlen($name)<2) $this->errorList[] = "Invalid name! It must be at least 2 characters long.";

            //if (strlen($message)<5) $this->errorList[] = "Invalid message! It must be at least 10 characters long.";

 

            $this->email = $email;

            $this->name  = $name;

            //$this->message = htmlspecialchars($message);

            foreach ($this->fieldList as $key=>$value) {

                if (isset($_POST[$value['fieldName']])) {

                      $this->fieldList[$key]['value'] = $_POST[$value['fieldName']];

                      $this->additionalText .= $value['caption'] . " : " . $_POST[$value['fieldName']]."\r\n";

                }

            }

 

         

            if (sizeof($this->errorList) > 0){

                $this->showErrors();

                $this->showForm();

            } else {

                $this->sendMail();

                $this->showInfo();

            }

         

        } else {

            $this->showForm();

        }

    }

 

    function showErrors(){

        echo '<ul class="error">';

        foreach ($this->errorList as $value) {

            echo " <li>$value</li>";

        }         

        echo "</ul>";

    }

 

    function showInfo(){

        echo "<p>Thanks for your message!</p>";

    }

 

 

}

?>

well first of all the more important problem is that once I added this code, the page went blank...

 

echo '    <tr><td>Reason for contact:</td>'

          .'    <td ><select name="reason" id="reason">

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

                <option value="Life  Insurance">Life  Insurance</option>

                <option value="Long Term Care">Long Term Care</option>

                <option value="Medicare Supplement  Insurance">Medicare Supplement  Insurance</option>

                <option value="Health  Insurance">Health  Insurance</option>

            </select></td></tr>'

 

 

And I KNOW NOTHING ABOUT PHP....I found this contact form and I am simply trying to piece my own contact form together from it. Thanks.

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