<?php
$editFormAction = $_SERVER['PHP_SELF'];
if (isset($_SERVER['QUERY_STRING'])) {
$editFormAction .= "?" . htmlentities($_SERVER['QUERY_STRING']);
}
if ((isset($_POST["MM_insert"])) && ($_POST["MM_insert"] == "form1")) {
$mybound = "----=_NextPart_000_0074_01C44E26.3D8C5FB0";
$MailTo = "[email protected]"; //recipient of the form results
$MailSubject = "Form Submission"; //text in the Subject field of the mail
$MailHeader = "From: [email protected]\r\n" . "MIME-Version: 1.0\r\n" . "Content-Type: text/html"; //text in the From field of the mail
$MailBody = "<!DOCTYPE HTML PUBLIC '-//W3C//DTD HTML 4.0 Transitional//EN'> <HTML><HEAD> <META http-equiv=Content-Type content='text/html; charset=iso-8859-1'></HEAD><BODY>";
ob_start();
foreach ( $_POST as $key => $value ) {
print $key . " " . "=" . " " . $value;
print "<BR/>";
}
$thestuff = ob_get_contents();
ob_end_clean();
$MailBody .= $thestuff . "</BODY></HTML>";
mail($MailTo, $MailSubject, $MailBody, $MailHeader); //message send
$insertGoTo = "https://dazlovers.com/thankyou.htm";
if (isset($_SERVER['QUERY_STRING'])) {
$insertGoTo .= (strpos($insertGoTo, '?')) ? "&" : "?";
$insertGoTo .= $_SERVER['QUERY_STRING'];
}
header(sprintf("Location: %s", $insertGoTo));
}
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Dazeal's Form</title>
</head>
<body>
<form id="form1" name="form1" method="post" action="<?php echo $editFormAction; ?>">
<div id="Layer1" style="position: absolute; left: 15px; top: 56px; width: 207px; height: 26px; z-index: 1; vertical-align: middle">
First Name
</div>
<div id="Layer2" style="position: absolute; left: 228px; top: 56px; width: 144px; height: 26px; z-index: 2; vertical-align: middle">
<input name="firstName" type="text" id="firstName" />
</div>
<div id="Layer3" style="position: absolute; left: 15px; top: 84px; width: 207px; height: 26px; z-index: 3; vertical-align: middle">
Last Name
</div>
<div id="Layer4" style="position: absolute; left: 228px; top: 84px; width: 144px; height: 26px; z-index: 4; vertical-align: middle">
<input name="lastName" type="text" id="lastName" />
</div>
<div id="Layer5" style="position: absolute; left: 15px; top: 112px; width: 207px; height: 26px; z-index: 5; vertical-align: middle">
Email Address</div>
<div id="Layer6" style="position: absolute; left: 228px; top: 112px; width: 144px; height: 26px; z-index: 6; vertical-align: middle">
<input name="email" type="text" id="email" />
</div>
<div id="Layer7" style="position: absolute; left: 15px; top: 140px; width: 207px; height: 26px; z-index: 7; vertical-align: middle">
How much do you love Dazeal?
</div>
<div id="Layer8" style="position: absolute; left: 228px; top: 140px; width: 151px; height: 26px; z-index: 8; vertical-align: middle">
<label><select name="select">
<option value="little">A Little</option>
<option value="lot">A Lot</option>
<option value="obsessed">More than I can say</option>
</select>
</label>
<input type="hidden" name="MM_insert" value="form1" />
</div>
<div id="Layer9" style="position: absolute; left: 228px; top: 168px; width: 56px; height: 28px; z-index: 9; vertical-align: middle">
<input type="submit" name="Submit" value="Submit" />
</div>
<div id="Layer10" style="position: absolute; left: 10px; top: 15px; width: 1023px; height: 19px; z-index: 10"></div>
</form>
</body>
</html>
