contact form

[hanayo]

Okay I want to make a contact form similar to this: http://stopattheshop.com/analytic.php?wf_id=6176&wf_name=AQUOS%20high%20definition%20compatible%20television&wf_brand=SHARP&man_id=0&selected_item=LC65SE94U&prod_id=0&retailer_id=0&thelink=/_CGI/MODEL?KEY=SHP:LC65SE94U

I know how to edit out all the variables, change the images, etc the ONLY thing I DON'T know how to do is the actual 'analytical_feedback.php' form part.  Can anyone tell me how to make that form?

Thanks

[hanayo]

This is what I have tried so far:

Code: [Select]

<?php
// Website Contact Form Generator 
// http://www.tele-pro.co.uk/scripts/contact_form/ 
// This script is free to use as long as you  
// retain the credit link  

// get posted data into local variables
$EmailFrom = Trim(stripslashes($_POST['EmailFrom'])); 
$EmailTo = "info@leveltenstudios.net";


// validation
$validationOK=true;
if (Trim($EmailFrom)=="") $validationOK=false;
if (!$validationOK) {
  print "<meta http-equiv=\"refresh\" content=\"0;URL=error.htm\">";
  exit;
}

// prepare email body text
$Body = "";
$Body .= "FirstName: ";
$Body .= $name;
$Body .= "\n";
$Body .= "LastName: ";
$Body .= $lname;
$Body .= "\n";
$Body .= "E-mail: ";
$Body .= $email;
$Body .= "\n";
$Body .= "Phone: ";
$Body .= $phone;
$Body .= "\n";
$Body .= "City: ";
$Body .= $IDcity;
$Body .= "\n";
$Body .= "State/Province: ";
$Body .= $Province_State;
$Body .= "\n";
$Body .= "Zip Code/Postal: ";
$Body .= $postalcode;
$Body .= "\n";
$Body .= "Questions: ";
$Body .= $comments;
$Body .= "\n";
$Body .= "email_opt_in: ";
$Body .= $email_opt_in;
$Body .= "\n";

// send email 
$success = mail($EmailTo, $Subject, $Body, "From: <$EmailFrom>");

// redirect to success page 
if ($success){
  print "<meta http-equiv=\"refresh\" content=\"0;URL=http://www.nlm-pro.com\">";
}
else{
  print "<meta http-equiv=\"refresh\" content=\"0;URL=error.htm\">";
}
?>