I have being trying to create a customer data form which I can send with PHP mailer, but it giving some hard time, I don't no if you could be a good help
to me, if you require money I will pay.
Code:
User Name:............
Chose Password:....
Email Address:.......
Confirm Email:.......
Payment Name:.....
Payment Date:.......
Amount Paid:.......
GSM Phone:.........
Holiday Maker: ......... (e.g. BBT Plc, woodpic Plc, jonds Plc, UBA Plc)
Deposit Teller No:.......
Detail:.........
HTML Code:
<form name="form1" method="post" action="send_contact.php">
<table width="100%" border="0" cellspacing="1" cellpadding="3">
<!--DWLayoutTable-->
<tr>
<td width="16%" height="28">Username</td>
<td width="2%">:</td>
<td width="300" valign="top"><input name="subject" type="text" id="subject" size="50"></td>
<td width="218"> </td>
</tr>
<tr>
<td height="28">Password</td>
<td>:</td>
<td valign="top"><input name="password" type="text" id="password" size="50"></td>
<td> </td>
</tr>
<tr>
<td height="28">Contact Name</td>
<td>:</td>
<td valign="top"><input name="name" type="text" id="name" size="50"></td>
<td> </td>
</tr>
<tr>
<td height="28">Amount Paid</td>
<td>:</td>
<td valign="top"><input name="Paid_amount" type="text" id="Paid_amount" size="50"></td>
<td> </td>
</tr>
<tr>
<td height="28">Payment Date</td>
<td>:</td>
<td valign="top"><input name="payment_date" type="text" id="payment_date" size="23">
Example: dd/mm/yyyy </td>
<td> </td>
</tr>
<tr>
<td height="28">GSM Number</td>
<td>:</td>
<td valign="top"><input name="gsm_number" type="text" id="gsm_number" size="23" maxlength="14">
Example: 0802 897 0909 </td>
<td> </td>
</tr>
<tr>
<td height="28">Bank Name</td>
<td>:</td>
<td valign="top"><span class="style4"></span>
<select name="bankname" id="bankname">
<option>UBA Plc</option>
<option>Zenith Bank Plc</option>
<option selected="selected">Skye bank Plc</option>
<option>Diamond Bank Plc</option>
<option>GTBank Plc</option>
</select>
<td> </td>
</tr>
<tr>
<td height="28">Email Address</td>
<td>:</td>
<td valign="top"><input name="customer_mail" type="text" id="customer_mail" size="50"></td>
<td> </td>
</tr>
<tr>
<td height="73">Other Detail</td>
<td>:</td>
<td valign="top"><textarea name="detail" cols="47" rows="4" id="detail"></textarea></td>
<td> </td>
</tr>
<tr>
<td height="30"> </td>
<td> </td>
<td valign="top"><input type="submit" name="Submit" value="Submit"> <input type="reset" name="Submit2" value="Reset"></td>
<td> </td>
</tr>
</table>
</form>
send_contact.php
-------------------------------------------------------
PHP Code:
<?php
// Contact subject
$subject ="$subject";
// Details
$message="The following data submitted:\n"
$Subject: "$subject"n
$password: "$password"n
$name: "$name"n
$paid_amount: "$paid_amount"n
$payment_date: "$payment_date"n
$gsm_number: "$gsm_number"n
$bankname: "$bankname"n
$detail: "$detail"nn Thank You;
// Mail of sender
$mail_from="$customer_mail";
// From
$header="from: $name <$mail_from>";
// Enter your email address
$to ='developer@nijahost.com';
$send_contact=mail($to,$subject,$message,$header);
// Check, if message sent to your email
// display message "We've recived your information"
if($send_contact){
echo "We've recived your contact information";
}
else {
echo "ERROR";
}
?>
The big thing is that am having a lot of problem with this, please I need some figure it out for me, I will appreciate.
thanks
Thank you
My Best regards,
11-Sep-2009, 10:33
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