<html>
<head>
<title>Untitled Document</title>
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
</head>
<body>
<?php
if ($submit) {
// process form
$db = mysql_connect("localhost", "moda", "recall");
mysql_select_db("basil",$db);
$sql= "
INSERT INTO addressbook
(f,l,g,d,n,e,mo,t,c,sc,p) /when i add more fields here it doesnt work... it doesnt give an error it just doesnt add any records to the database/
VALUES ('$f','$l','$g','$d/$m/$y','$n','$e','$mo','$t','$c-$s-$b-$fl','$sc','$p')";
$result = mysql_query($sql);
echo "Thank you for your time! We will be contacting you soon\n";
} else{
// display form
?>
<form method="post" action="<?php echo $PHP_SELF?>">
<TABLE align=center>
<TBODY>
<TR>
<TD colSpan=2> </TD>
</TR>
<TR>
<TD>First Name:</TD>
<TD><INPUT class=lined maxLength=50 name="f"></TD>
</TR>
<TR>
<TD>Last Name:</TD>
<TD><INPUT class=lined maxLength=50 name="l"></TD>
</TR>
<TR>
<TD>Gender:</TD>
<TD><select name="g" id="gender">
<option value="Male" selected>Male</option>
<option value="Female">Female</option>
</select></TD>
<TR>
<TD>Birthday:</TD>
<TD><select name="d" id="day">
<option value="1" selected>1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select> <select name="m" id="month">
<option value="1" selected>1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select> <select name="y" id="year">
<option value="2002" selected>2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
</select> </TD>
</TR>
<TR>
<TD>Nationality:*</TD>
<TD><INPUT class=lined maxLength=50 size=30 name="n"></TD>
</TR>
<TR>
<TD>E-mail:*</TD>
<TD><INPUT class=lined maxLength=50 size=30 name="e"></TD>
</TR>
<TR>
<TD>Mobile:*</TD>
<TD><INPUT class=lined maxLength=50 name="mo"></TD>
</TR>
<TR>
<TD>Telephone:*</TD>
<TD><INPUT class=lined maxLength=50 name="t"></TD>
</TR>
<TR>
<TD>City:*</TD>
<TD><input name="c" type="text" id="city"></TD>
</TR>
<TR>
<TD>Street:*</TD>
<TD><input name="s" type="text" id="street"></TD>
</TR>
<TR>
<TD>Building:*</TD>
<TD><input name="b" type="text" id="building"></TD>
</TR>
<TR>
<TD>Floor:*</TD>
<TD><input name="fl" type="text" id="floor"></TD>
</TR>
<TR>
<TD>School / University:*</TD>
<TD><INPUT class=lined maxLength=50 size=30 name="sc"></TD>
</TR>
<TR>
<TD>Profession:*</TD>
<TD><INPUT class=lined maxLength=50 size=30 name="p"></TD>
</TR>
<TR>
<TD>Size top:</TD>
<TD><select name="top" id="to">
<option value="small" selected>small</option>
<option value="medium">medium</option>
<option value="large">large</option>
</select></TD>
</TR>
<TR>
<TD>Size bottom:*</TD>
<TD><INPUT class=lined maxLength=50 size=30 name="bo"></TD>
</TR>
<TR>
<TD>Shoe size:*</TD>
<TD><input name="sh" type="text" id="shoe" size="30" maxlength="50"></TD>
</TR>
<TR>
<TD>4 Favorite colours:*</TD>
<TD><input class=lined maxlength=50 size=30 name="co"></TD>
</TR>
<TR>
<TD>Style:</TD>
<TD><INPUT id=a type=checkbox value=Formalwear name="s1"> <LABEL
for=a>Formalwear</LABEL> <INPUT id=b type=checkbox value=Casualwear
name="s2"> <LABEL for=b>Casualwear</LABEL> <INPUT id=c type=checkbox
value=Fashionwear name="s3"> <LABEL for=c>Fashionwear</LABEL> <INPUT id=d
type=checkbox value=Streetwear name="s4"> <LABEL for=d>Streetwear</LABEL>
</TD>
</TR>
<TR>
<TD> </TD>
<TD>Others:
<INPUT class=lined maxLength=50 size=30 name="o"></TD>
</TR>
<TR>
<TD colSpan=2>* Must be filled in</TD>
</TR>
<TR>
<TD align=middle colSpan=2><div align="center">
<INPUT type=submit value="Join Club" name="submit">
</div></TD>
</TR>
</TBODY>
</TABLE>
<TABLE cellSpacing=0 cellPadding=0 width=689 align=center border=0>
<TBODY>
<TR>
<TD><FONT size=2>We beleive that business is all about knowing people and
sharing with them the special moments.<BR>We would like to stay in touch
with all of our clients by informing them of the arrivals of our latest
collections.</FONT></TD></TR></TBODY></TABLE>
<TABLE cellSpacing=0 cellPadding=0 width=500 align=center border=0>
<TBODY>
<TR>
<TD>
<DIV align=center>For More Information Please Call : 01989300/02<BR>email:
<A
href="mailto:VM-Beirut@Bestseller.dk">VM-Beirut@Bestseller.dk</A></DIV></TD></TR></TBODY></TABLE><BR>
<TABLE cellSpacing=0 cellPadding=0 width="102%" align=center border=0>
<TBODY>
<TR bgColor=#9999cc>
<TD height=43>
<P align=center><FONT face="Arial, Helvetica, sans-serif" color=#000066
size=2><B><FONT size=1>You subscribed to receive this information at e-ad</FONT></B></FONT><FONT face="Arial Black" color=#000066 size=1><FONT
face="Arial, Helvetica, sans-serif"><B> Int.</B></FONT></FONT><FONT
face="Arial, Helvetica, sans-serif" color=#000066 size=1><B> -Should you
no longer wish to receive similar messages, please notify us through
e-mail at the following address: <A
href="mailto:removeme@eadmail-lb.com">REMOVEME</A>.</B></FONT></P>
</TD></TR></TBODY></TABLE></FORM> <?php
} // end if
?>
</body>
</html>
