This is a form and a processing PHP page that will send you an email then present the data retrieved from the user as well as their browser and IP address.
The Form (in html but with a php extension) call it mailtest.php
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Email Form </title>
</head>
<body>
<form method="post" action="sendemail.php">
<!-- DO NOT change ANY of the php sections -->
<?php
$ipi = getenv("REMOTE_ADDR");
$httprefi = getenv ("HTTP_REFERER");
$httpagenti = getenv ("HTTP_USER_AGENT");
?>
<input type="hidden" name="ip" value="<?php echo $ipi ?>" />
<input type="hidden" name="httpref" value="<?php echo $httprefi ?>" />
<input type="hidden" name="httpagent" value="<?php echo $httpagenti ?>" />
Your Name: <br />
<input type="text" name="visitor" size="35" />
<br />
Your Email:<br />
<input type="text" name="visitormail" size="35" />
<br /> <br />
<br />
Attention:<br />
<select name="attn" size="1">
<option value=" Sales n Billing ">Sales n Billing </option>
<option value=" General Support ">General Support </option>
<option value=" Technical Support ">Technical Support </option>
<option value=" Webmaster ">Webmaster </option>
</select>
<br /><br />
Mail Message:
<br />
<textarea name="notes" rows="4" cols="40"></textarea>
<br />
<input type="submit" value="Send Mail" />
<br />
Free Code at: <a href="http://www.ibdhost.com/contact/">ibdhost.com/contact/</a>
</form>
</body>
</html>
The processing script call it sendemail.php
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Sendemail Script</title>
</head>
<body>
<!-- Reminder: Add the link for the 'next page' (at the bottom) -->
<!-- Reminder: Change 'YourEmail' to Your real email -->
<?php
$ip = $_POST['ip'];
$httpref = $_POST['httpref'];
$httpagent = $_POST['httpagent'];
$visitor = $_POST['visitor'];
$visitormail = $_POST['visitormail'];
$notes = $_POST['notes'];
$attn = $_POST['attn'];
?>
<?php
if(!$visitormail == "" && (!strstr($visitormail,"@") || !strstr($visitormail,".")))
{
echo "<h2>Use Back - Enter valid e-mail</h2>\n";
$badinput = "<h2>Feedback was NOT submitted</h2>\n";
}
if(empty($visitor) || empty($visitormail) || empty($notes )) {
echo "<h2>Use Back - fill in all fields</h2>\n";
}
echo $badinput;
$todayis = date("l, F j, Y, g:i a") ;
$attn = $attn ;
$subject = $attn;
$notes = stripcslashes($notes);
$message = " $todayis [EST] \n
Attention: $attn \n
Message: $notes \n
From: $visitor ($visitormail)\n
Additional Info : IP = $ip \n
Browser Info: $httpagent \n
Referral : $httpref \n
";
$from = "From: $visitormail\r\n";
mail("youremail@yours.com", $subject, $message, $from);
?>
<p align="center">
Date: <?php echo $todayis ?>
<br />
Thank You : <?php echo $visitor ?> ( <?php echo $visitormail ?> )
<br />
Attention: <?php echo $attn ?>
<br />
Message:<br />
<?php $notesout = str_replace("\r", "<br/>", $notes);
echo $notesout; ?>
<br />
<?php echo $ip ?>
<br /><br />
<a href="contact.php"> Next Page </a><!--Now all you need is a contact.php or contact HTML...Whatever-->
</p>
</body>
</html>
