Hi Everyone!
This is a form I created in HTML:-
<div class="inputs">
<label for="name">Name:</label>
<input type="text" name="name" id="name" placeholder="Eg. Antonio Silver">
</div>
<div class="inputs">
<label for="email">E-Mail:</label>
<input type="email" name="email" id="email" placeholder="Eg. [email protected]">
</div>
<div class="inputs">
<label for="tel">Phone Number:</label>
<input type="tel" name="tel" id="tel" placeholder="Eg. +91 9876543210">
</div>
<div class="item3">
<div class="inputs">
<label for="date">Birth date:</label>
<input type="date" name="date" id="date">
</div>
</div>
<div class="item4">
<div class="inputs">
<label for="country">Country</label>
<select id="country">
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antartica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo">Congo, the Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cota D'Ivoire">Cote d'Ivoire</option>
<option value="Croatia">Croatia (Hrvatska)</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="France Metropolitan">France, Metropolitan</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard and McDonald Islands">Heard and Mc Donald Islands</option>
<option value="Holy See">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India" selected>India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran (Islamic Republic of)</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Democratic People's Republic of Korea">Korea, Democratic People's Republic of</option>
<option value="Korea">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macau">Macau</option>
<option value="Macedonia">Macedonia, The Former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia, Federated States of</option>
<option value="Moldova">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russia">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint LUCIA">Saint LUCIA</option>
<option value="Saint Vincent">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia">Slovakia (Slovak Republic)</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia">South Georgia and the South Sandwich Islands</option>
<option value="Span">Spain</option>
<option value="SriLanka">Sri Lanka</option>
<option value="St. Helena">St. Helena</option>
<option value="St. Pierre and Miguelon">St. Pierre and Miquelon</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syrian Arab Republic</option>
<option value="Taiwan">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (U.S)">Virgin Islands (U.S.)</option>
<option value="Wallis and Futana Islands">Wallis and Futuna Islands</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Serbia">Serbia</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
</div>
<div class="inputs">
<textarea name="problem" id="problem" placeholder="Let us know what you want to tell us..." rows="10" cols="130"></textarea>
</div>
<div class="item2">
<div class="inputs">
<p> How would you like to be contacted by Flash? </p> <br>
<input type="radio" name="contact-source" id="c-phone" value="c-phone">
<label for="c-phone">Phone</label> <br>
<input type="radio" name="contact-source" id="c-email" value="c-email">
<label for="c-email">E-Mail</label>
</div>
</div>
<div class="item1">
<div class="inputs">
<input type="checkbox" name="sign-up" id="sign-up" value="yes-sign-me-up" checked>
<label for="checkbox">I agree to sign up for E-Mail newsletters from Flash Motorcycles.</label>
</div>
</div>
<input type="submit" value="Submit">
</form>
This is the PHP which the form is linked to.
<?php
if(isset($_POST['submit'])){
$to = "[email protected]"; // this is your Email address
$from = $_POST['email']; // this is the sender's Email address
$name = $_POST['name'];
$tel = $_POST['tel'];
$date = $_POST['date'];
$country = $_POST['country'];
$review= $_POST['problem'];
$contactsource= $_POST['contact-source'];
$signup= $_POST['signup'];
$subject = "Form submission";
$subject2= "Copy of the Contact Us form submitted to Flash Motorcycles";
$message = "Name:" . $name . "\n\n" . "E-Mail:" . $from . "\n\n" . "Phone Number:" . $tel . "\n\n" . "Birth date:" . $date . "\n\n" . "Country:" . $country . "\n\n" ."Review:" . $review . "Agreement to newsletter:" . $signup . "\n\n" . "How to be contacted:". $contactsource . $_POST['message'];
$message2 = "Here is a copy of your message " . $name . "\n\n" . $_POST['message'];
$headers = "From:" . $from;
$headers2 = "From:" . $to;
if (mail($to, $subject, $message, $headers)) {
echo "Thank you. Your review has been sent to Flash Motorcycles. They will respond shortly.";
}
else {
echo "Error! Your review could not be sent to Flash Motorcycles due to some technical errors!";
}
if (mail($from, $subject2, $message2, $headers2)) {
echo "A copy of your mail has been sent for you.";
}
else {
echo "We failed to send the copy of your review to yourself. Sorry!";
}
// You can also use header('Location: thank_you.php'); to redirect to another page.
}
?>
Although, when I click on submit button, it shows a white screen and the mail is not sent. Please help me to fix this
