<?php
$totalcomments.="Company:".$company. "\n\n";
$totalcomments.="New_or_existing:".$new_or_existing."\n\n";
$totalcomments.="Allocated_or_pooled:".$allocated_or_pooled."\n\n";
$totalcomments.="Profit_sharing:".$profit_sharing."\n\n";
$totalcomments.="Employer:".$employer."\n\n";
$totalcomments.="Number_of_employers:".$number_of_employers."\n\n";
$totalcomments.="Name:".$name."\n\n";
$totalcomments.="Email:".$email."\n\n";
$totalcomments.="Phone:".$phone."\n\n";
$notify_email = "dayna@sozopivotal.com";
//$notify_email = "dayna@sozopivotal.com";
$notify_subject = "Thank you!";
$notifyadmin_subject = "Request for Quote";
$notify_user = "Thanks for the submission ";
//$from = "dayna@sozopivotal.com";
$from = "dayna@sozopivotal.com";
$notify_message = "There is feedback";
$visitor_message = "Thank you for requesting a quote. At Applied Plan Administrators we look forward to serving you. If you have any questions, please do not hesitate to contact us at 248.645.6145 or via email at info@appliedplan.com.
";
mail( "$email", "$notify_subject", "$visitor_message", "From: $from");
mail( "$notify_email", "$notifyadmin_subject", "$totalcomments", "From: $email");
//mail( "$mailto", "$subject", "$message", "From: $from");
header("Location:http://www.appliedplan.com/new_site/thankyou.html");
exit();
?>
and the meat of the form:
tr>
<td align="left" bgcolor="white">
<form action="http://www.sozopivotal.com/apa/form.php" method="post" name="FormName">
<p><strong>Company Name:</strong> <input type="text" name="company" size="24" /></p>
<p><strong>Please describe your plan</strong><br />
<input type="radio" name="new_or_existing" value="new" /> New<br />
<input type="radio" name="new_or_existing" value="existing" /> Existing</p>
<p><strong>Number of participants with balances: </strong><input type="text" name="number_of_participants" size="5" /></p>
<p><input type="radio" name="allocated_or_pooled" value="allocated" /> Allocated Account<br />
<input type="radio" name="allocated_or_pooled" value="pooled" /> Pooled Account</p>
<p><input type="radio" name="profit_sharing:" value="only" /> Profit Sharing only<br />
<input type="radio" name="profit_sharing:" value="with_401k" /> Profit Sharing with 401(k)</p>
<p><strong>Profit Sharing Allocation Method:</strong><br />
<input type="radio" name="profit_share_allocation_method" value="integrated" /> Integrated with Social Security<br />
<input type="radio" name="profit_share_allocation_method" value="new_comp" /> New Comparability<br />
<input type="radio" name="profit_share_allocation_method" value="age_weighted" /> Age Weighted</p>
<p><input type="radio" name="employer" value="multiple" /> Multiple Employer<br />
<input type="radio" name="employer" value="single" /> Single Employer</p>
<p><strong>If multiple employer, number of participating employers: </strong><input type="text" name="number_of_employers" size="5" /></p>
<p><strong>Send quote to:</strong></p>
<p>Name: <input type="text" name="name" size="24" /></p>
<p>Email: <input type="text" name="email" size="24" /></p>
<p>Phone: <input type="text" name="phone" size="24" /></p>
<input type="submit" name="submitButtonName" value="Submit">
</form>