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Super Form
It allows to send by mail different information about the user.


					

					<?

					/////////////////////////////Name Your Form

					$name_form = "Contact Form";

					$Comp_Name = "10Tons";

					$email_address = "kmoo@10tons.com";

					$home_url = "http://www.10tons.com";

					$logo = "image/thanks.gif";

					/////////////////Table and Font Set Up///////////

					$table_width = "510";

					$font_face = "Arial";

					$size = "2";

					////////////////////////Input 1(yes=1, no=0)

					$add_input1 = "1";

					$check_input1 = "1";

					$input1_name = "Name";

					////////////////////////Input 2(yes=1, no=0)

					$add_input2 = "1";

					$check_input2 = "0";

					$input2_name = "Company Name";

					////////////////////////Input 3(yes=1, no=0)

					$add_input3 = "1";

					$check_input3 = "0";

					$input3_name = "Phone";

					/////////////////////////Input 4(yes=1, no=0)

					$add_input4 = "1";

					$check_input5 = "0";

					$input4_name = "Fax";

					/////////////////////////Input 5(yes=1, no=0)

					$add_input5 = "0";

					$check_input5 = "0";

					$input5_name = "Input5";

					////////Do you want radio Buttons(yes=1, no=0)

					$radio = "0";

					////////If yes Define Variables here///////////

					$radio1 = "Web Site";

					$radio2 = "Training";

					$radio3 = "Help";

					//////////////Do you want a select(yes=1, no=0)

					$select = "1";

					////////If yes Define Variables here///////////

					$opt1 = "Design";

					$opt2 = "Development";

					$opt3 = "Banners";

					$opt4 = "Logos";

					$opt5 = "Question On Site";

					$opt6 = "Help Please";

					$opt7 = "Hosting";

					$opt8 = "image/thanks.gif";

					///////////////////Do you want a comment box(yes=1, no=0)?///////////////////////

					$comment = "1";

					///////////////////////////Tracking Number///////////////////////////

					$unique = uniqid(1234567890);

					$id = substr("$unique", 18);

					////////////////////////////////Start the Form Building//////////////////////// 

					if ($add_input1 == "1"){ 

					    $form_input1 = "

					    <tr> 

					

					    <td align=\"right\"><font face=\"$font_face\" size=

					    \"$size\"><strong>$input1_name</strong></td>

					    <td align=\"left\">

					    <input type=\"text\" size=\"35\" maxlength=\"256\" name=\"input1\">

					    </font></td>

					    </tr>";

					}

					if ($add_input2 == "1"){ 

					    $form_input2 = "

					    <tr> 

					    <td align=\"right\"><font face=\"$font_face\" size=

					    \"$size\"><strong>$input2_name</strong></td>

					    <td align=\"left\">

					    <input type=\"text\" size=\"35\" maxlength=\"256\" name=\"input2\">

					    </font></td>

					    </tr>";

					}

					if ($add_input3 == "1"){ 

					    $form_input3 = "

					    <tr> 

					    <td align=\"right\"><font face=\"$font_face\" size=

					    \"$size\"><strong>$input3_name</strong></td>

					    <td align=\"left\">

					    <input type=\"text\" size=\"35\" maxlength=\"256\" name=\"input3\">

					    </font></td>

					    </tr>";

					}

					if ($add_input4 == "1"){ 

					    $form_input4 = "

					    <tr> 

					    <td align=\"right\"><font face=\"$font_face\" size=

					    \"$size\"><strong>$input4_name</strong></td>

					    <td align=\"left\">

					    <input type=\"text\" size=\"35\" maxlength=\"256\" name=\"input4\">

					    </font></td>

					    </tr>";

					}

					if ($add_input5 == "1"){ 

					    $form_input5 = "

					    <tr> 

					    <td align=\"right\"><font face=\"$font_face\"size=

					    \"$size\"><strong>$input5_name</strong></td>

					    <td align=\"left\"> 

					    <input type=\"text\" size=\"35\" maxlength=\"256\" name=\"input5\">

					    </font></td>

					    </tr>";

					}

					//THis is your Radio Buttons// 

					if ($radio == "0" && $select == "0"){ 

					    $radio_head = "";

					}else{ 

					    $radio_head = "

					    <tr> 

					    <td align=\"right\"><font face=\"$font_face\" size=\"$size\"></td>

					    <td align=\"left\"><strong>Info requested on?</strong></font></td>

					    </tr>"; 

					}

					if ($radio == "1"){ 

					    $form_radio = "<br>

					    <td align=\"right\"><font face=\"$font_face\" size=\"$size\"></td>

					    <td align=\"left\"><input type=\"radio\" name=\"MessageType\" value=\"$radio1\" checked>

					    $radio1 

					    <input type=\"radio\" name=\"MessageType\" value=\"$radio2\">

					    $radio2</font>

					    <input type=\"radio\" name=\"MessageType\" value=\"$radio2\">

					    $radio3</font></td>

					    </tr>";

					}

					if ($select == "1"){ 

					    $form_select = "

					    <td align=\"right\"><font face=\"$font_face\" size=\"$size\"></td>

					    <td align=\"left\">

					    <select name=\"Subject\" size=\"1\">

					    <option selected value=\"General\">General</option>

					    <option value=\"$opt1\">$opt1</option>

					    <option value=\"$opt2\">$opt2</option>

					    <option value=\"$opt3\">$opt3</option>

					    <option value=\"$opt4\">$opt4</option>

					    <option value=\"$opt5\">$opt5</option>

					    <option value=\"$opt6\">$opt6</option>

					    <option value=\"$opt7\">$opt7</option>

					    <option value=\"$opt7\">$opt7</option>

					    </select>

					    Other: 

					    <input type=\"text\" size=\"10\" maxlength=\"256\" name=\"SubjectOther\"></td>

					    </tr>";

					} 

					if ($comment == "1"){ 

					    $form_comment = "<td align=\"right\"><font face=\"$font_face\" size=\"$size\"></td>

					    <td align=\"left\"><strong>Post comments in the space provided
					below:</strong><br>

					    <textarea name=\"Comments\" rows=\"5\" cols=\"35\"></textarea>

					    </font></td>

					    </tr>";

					}

					///////////////////////////Form Build///////////////////////////// 

					$form_block = "

					<FORM method=\"POST\" action=\"$PHP_SELF\">

					<table width=\"$table_width\">

					$form_input1

					<tr> 

					<td align=\"right\"><font face=\"$font_face\" size=\"$size\"><strong>Email</strong></td>

					<td align=\"left\">

					<input type=\"text\" size=\"35\" maxlength=\"256\" name=\"email\">

					</font></td>

					</tr>

					$form_email

					$form_input2

					$form_input3

					$form_input4

					$form_input5

					$radio_head

					$form_radio

					$form_select

					$form_comment

					<tr> 

					<td align=\"right\"></td><td align=\"left\">

					<font face=\"$font_face\" size=\"$size\"> 

					<input type=\"checkbox\" name=\"mailing_list\" value=\"YES\" checked>

					Yes&nbsp;&nbsp;add to mailing list.<br>

					<input type=\"checkbox\" name=\"mailing_list\" value=\"NO\">

					No don't add to mailing list.<br>

					<input type=\"checkbox\" name=\"ContactRequested\" value=\"ASAP\">

					Please contact me as soon as possible regarding this matter.</font>

					</td></tr><td align=\"right\"></td><td align=\"left\">

					<font face=\"$font_face\" size=\"$size\"> 

					<INPUT type=\"hidden\" name=\"op\" value=\"ds\">

					<INPUT type=\"submit\" value=\"Submit\">

					<input type=\"reset\">

					</font><center>Super Form V2.4 By <a href=\"http://www.10tons.com\">10tons</a><center>

					</td></tr></form>

					</table>";

					/////////////////////////////Begin Checking the form/////////////////////////////

					if ($op != "ds") {

					        echo "$form_block";

					} else if ($op == "ds") {

					    $send = "yes";

					    if ($check_input1=="1" && $input1=="")
					{

					        $input1_err = "

					        <font color=red>$input1_name Is blank.</font><br>

					        ";

					        $send = "no"; 

					    } 

					    if(!ereg("^([0-9,a-z,A-Z]+)([.,_]([0-9,a-z,A-Z]+))*[@]([0-9,a-z,A-Z]+)([.,_,-]([0-9,a-z,A-Z]+))*[ 

					.]([0-9,a-z,A-Z]){2}([0-9,a-z,A-Z])?$",$email)) { 

					        $email_err = "

					        <font color=red>Please enter your Email Address(Example:jim@jack.com)!</font><br>

					        ";

					        $send = "no";

					    }

					if ($check_input2=="1" && $input2=="") {

					    $input2_err = "

					    <font color=red>$input2_name Is blank.</font><br>

					    ";

					    $send = "no"; 

					} 

					if ($check_input3=="1" && $input3=="") {

					    $input3_err = "

					    <font color=red>$input3_name Is blank.</font><br>

					    ";

					    $send = "no"; 

					} 

					if ($check_input4=="1" && $input4=="") {

					    $input4_err = "

					    <font color=red>$input4_name Is blank.</font><br>

					    ";

					    $send = "no"; 

					} 

					if ($check_input5=="1" && $input5== "") {

					    $input5_err = "

					    <font color=red>$input5_name Is blank.</font><br>

					    ";

					    $send = "no"; 

					}

					$mail_body = "($email)\n";

					$mail_body .= "Tracking Number = $id \n";

					$mail_body .= "===============Personal Info===================== \n";

					$mail_body .= "$input1_name = $input1 \n";

					$mail_body .= "$input2_name = $input2 \n";

					$mail_body .= "$input3_name = $input3 \n";

					$mail_body .= "$input4_name = $input4 \n";

					$mail_body .= "$input5_name = $input5 \n";

					$mail_body .= "Comments\n";

					$mail_body .= "------------\n";

					$mail_body .= "$Comments\n";

					$mail_body .= "Mailing List = $mailing_list, Contact Me = $ContactRequested\n";

					$mail_body .= "===============Personal Info===================== \n";

					$mail_body .= "ip is ($REMOTE_ADDR)";

					if ($send == "yes") {

					    $headers = "From: \"$Name\" <$email>\n";

					    mail("$email_address", "$name_form", $mail_body, $headers);

					    $headers = "From: \"$Comp_Name\" <$Comp_email>\n";

					    echo "<center><img src=\"$logo\"></center><br>";

					    echo "<center><font face=\"Arial, Helvetica, sans-serif\" size=\"3\">Your
					Email Tracking Number is = ";

					    echo "(<b><font size=3 color=red>$Comp_Name-$id</font></b>)";

					    echo "</font><br>";

					    echo "<font face=\"Arial, Helvetica, sans-serif\" size=\"3\">Form
					Sent and...";

					    echo "We Got It</font><br>";

					    echo "Again thanks. ";

					    echo "<a href=\"$home_url\">$Comp_Name Home</a></font></center>";

					} else if ($send == "no") {

					    echo "<blockquote><blockquote>$input1_err";

					    echo "$email_err";

					    echo "$input2_err";

					    echo "$input3_err";

					    echo "$input4_err";

					    echo "$input5_err";

					    echo "Please Click <a href=\"javascript:history.back(1)\">Back</a></blockquote></blockquote>"; 

					}

					}

					?>
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