Service Request Form
"; echo $error."
"; echo "Please go back and fix these errors.
"; die(); } // validation expected data exists if(!isset($_POST['name']) || !isset($_POST['address']) || !isset($_POST['email']) || !isset($_POST['telephone']) || !isset($_POST['comments'])) { died('We are sorry, but there appears to be a problem with the form you submitted.'); } $name = $_POST['name']; // required $address = $_POST['address']; // required $email_from = $_POST['email']; // required $telephone = $_POST['telephone']; // not required $web = $_POST['web']; // not required $fax = $_POST['fax']; // not required $outbound = $_POST['outbound']; // not required $inbound = $_POST['inbound']; // not required $technical = $_POST['technical']; // not required $chatting = $_POST['chatting']; // not required $financial = $_POST['financial']; // not required $others = $_POST['others']; // not required $comments = $_POST['comments']; // required $error_message = ""; $email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/'; if(!preg_match($email_exp,$email_from)) { $error_message .= 'The Email Address you entered does not appear to be valid.
'; } $string_exp = "/^[A-Za-z .'-]+$/"; if(!preg_match($string_exp,$name)) { $error_message .= 'The Name you entered does not appear to be valid.
'; } if(strlen($comments) < 2) { $error_message .= 'The Comments you entered do not appear to be valid.
'; } if(strlen($error_message) > 0) { died($error_message); } $email_message = "You have received a new message (SERVICE REQUEST) sent via the contact form of ALTRIA TELESERVICES. Details below.\n\n"; function clean_string($string) { $bad = array("content-type","bcc:","to:","cc:","href"); return str_replace($bad,"",$string); } $email_message .= "Name: ".clean_string($name)."\n"; $email_message .= "Address: ".clean_string($address)."\n"; $email_message .= "Email: ".clean_string($email_from)."\n"; $email_message .= "Phone: ".clean_string($telephone)."\n"; $email_message .= "Website: ".clean_string($web)."\n"; $email_message .= "Fax: ".clean_string($fax)."\n"; $email_message .= "Outbound: ".clean_string($outbound)."\n"; $email_message .= "Inbound: ".clean_string($inbound)."\n"; $email_message .= "Technical: ".clean_string($technical)."\n"; $email_message .= "Chatting: ".clean_string($chatting)."\n"; $email_message .= "Financial: ".clean_string($financial)."\n"; $email_message .= "Others: ".clean_string($others)."\n"; $email_message .= "Brief Description of the service: ".clean_string($comments)."\n"; // create email headers $headers = 'From: '.$email_from."\r\n". 'Reply-To: '.$email_from."\r\n" . 'X-Mailer: PHP/' . phpversion(); @mail($email_to, $email_subject, $email_message, $headers); ?> Thank you for contacting us. We will be in touch with you very soon.