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View Full Version : Feedback form to email and store in db.


massman
11 Sep 2006, 07:59 PM
I have a feedback form which I want to both email the data and stores it in a local database. Any tutorial/examples will be appreciated.

What do I need from my ISP? Here is my form code ...

===========================
<html>
<head>
<title>feedback Form</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">

<style type="text/css">
<!--
body {
margin-top: 0px;
}
.style2 {
font-family: Arial, Helvetica, sans-serif;
font-size: x-small;
}
.style3 {font-family: Arial, Helvetica, sans-serif}
-->
</style></head>
<body bgcolor="#FFFFFF" leftmargin="0" marginwidth="0">
<form name="form1" method="post" action="">
<div align="center">
<table width=724 border="0" cellpadding="4" cellspacing="2">
<tr>
<td align="left" valign="top"><p align="left" class="style3">&nbsp;</p> </td>
<td bgcolor="#FFFF66"><p align="right"><span class="style3"></span></p>
<p align="right">&nbsp;</p>
<p align="right">&nbsp;</p> <p align="left"><span class="style3"><strong> Feedback Information
</strong></span></p> </td>
</tr>
<tr valign="top">
<td colspan="2"> </td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">* First Name: </span></div></td>
<td><span class="style2">
<input type="text" name="textfield1" size="50">
</span></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">* Last Name:</span></div></td>
<td><span class="style2">
<input type="text" name="textfield12" size="50">
</span></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">* Email Address: </span></div></td>
<td><span class="style2">
<input type="text" name="textfield2" size="50">
</span></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">Street Address:</span></div></td>
<td><div align="left"><span class="style2">
<input type="text" name="textfield22" size="50">
</span></div></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">City:</span></div></td>
<td><div align="left"><span class="style2">
<input type="text" name="textfield222" size="50">
</span></div></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">State: </span></div></td>
<td><div align="left"><span class="style2">
<select name="select">
<option value="California">California</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="Colorado">Colorado</option>
</select>
</span></div></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">Zip: </span></div></td>
<td><div align="left"><span class="style2">
<input type="text" name="textfield23" size="50">
</span></div></td>
</tr>
<tr valign="top">
<td><div align="right"><span class="style2">Phone:</span></div></td>
<td><div align="left"><span class="style2">
<input type="text" name="textfield2222" size="50">
</span></div></td>
</tr>
<tr valign="top">
<td width="42%"> <p align="right" class="style2">Question or Comment:<br>
<br>
</p>
</td>
<td width="58%"> <p align="left"><span class="style2">
<textarea name="textfield4" rows="10" cols="50"></textarea>
</span></p>
</td>
</tr>
<tr valign="top">
<td bgcolor="#66FF99"><div align="right">
<p>&nbsp;</p>
<p class="style3"><strong>Optional Information </strong></p>
</div></td>
<td>&nbsp;</td>
</tr>
<tr valign="top">
<td class="style2"><div align="right" class="style3">Your Occupation: </div></td>
<td><div align="left">
<p>
<label>
<input type="radio" name="RadioGroup1" value="Professional">
Professional</label>
<br>
<label>
<input type="radio" name="RadioGroup1" value="Tradesman">
Tradesman</label>
<br>
<label>
<input type="radio" name="RadioGroup1" value="Other">
Other</label>
<br>
</p>
</div></td>
</tr>
<tr valign="top">
<td class="style2"><div align="right" class="style3">Your Age: </div></td>
<td><div align="left">
<input type="text" name="textfield">
</div></td>
</tr>
<tr valign="top">
<td colspan="2">
<div align="right">
<blockquote>
<blockquote>
<blockquote>
<p>
<input name="Reset" type="reset" id="Reset" value="Reset">
<input type="submit" name="Submit" value="Submit">
</p>
</blockquote>
</blockquote>
</blockquote>
</div></td>
</tr>
</table>
<span class="style2"> </span></div>
</form>
</body>
</html>