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

[jagreen78]

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 = "[email protected]";

    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>";

    }

 

 

}

?>

[BlueSkyIS]

"I don't know if it is capturing all the data once you hit the send button"

 

can you expand on the problem? what do you mean by you don't know? what have you done to check? thx

[jagreen78]

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.