Tengo en esta página este código:
http://noregretsinc.org/sponsors.php
Código PHP:
<?php include("header.html"); ?>
<tr>
<td width="156" height="463" style="background:URL(images/left-side.jpg)"><div id="divarrow"><img src="images/stuff_03.gif" alt="arrow"><span class="style1"> Georgia News </span></div>
<div id="divarrow"><img src="images/stuff_03.gif" alt="arrow"><span class="style1"> Our Sponsors </span></div>
<div id="divarrow"><img src="images/stuff_03.gif" alt="arrow"><span class="style1"> Feature Family </span></div>
<div id="divarrow"><img src="images/stuff_03.gif" alt="arrow"><span class="style1"> President´s letter </span></div>
<div id="divarrow"><img src="images/stuff_03.gif" alt="arrow"><span class="style1"> Resource List </span></div>
<br>
<br>
<br>
<br>
<br>
<br>
</td>
<td width="614" height="513" align="center" valign="top"><div id="scroll">
<blockquote>
<p><span class="style2">Sponsors...</span> </p>
<div align="left" class="style5">A Special Thank you...</div>
<p class="style3">Thank you all so very much for the generous commitments you make to sponsor our events. While the networking opportunity is very valuable to us all, events like the ones listed below provided an opportunity for at least a few more of our folks to achieve their goals, to break through the barriers which dared to cut off their dreams and to give themselves and their little ones an opportunity to live to their fullest potential. <br>
<form name="form1" method="post" action="">
<label>Business Name
<input type="text" name="name" id="name">
</label>
<p>
<label>Street Addres
<input type="text" name="street" id="street">
</label>
</p>
<p>
<label>City
<input type="text" name="city" id="city">
</label>
</p>
<p>
<label>State
<input type="text" name="state" id="state">
</label>
</p>
<p>
<label>Zip
<input type="text" name="zip" id="zip">
</label>
</p>
<p>
<label>Phone
<input type="text" name="phone" id="phone">
</label>
</p>
<p>
<label>Cel Phone
<input type="text" name="cel" id="cel">
</label>
</p>
<p>
<label>Email Address
<input type="text" name="email" id="email">
</label>
</p>
<p class="style6">Select an event</p>
<p>
<label>
<input type="radio" name="events" value="Candlelight Dinner" id="events_0">
Candlelight Dinner</label>
<br>
<label>
<input type="radio" name="events" value="Mother’s Day Marathon" id="events_1">
Mother’s Day Marathon</label>
<br>
<label>
<input type="radio" name="events" value="Fall Family Picnic" id="events">
Fall Family Picnic</label>
<br>
<label>
<input type="radio" name="events" value="Christmas Celebration" id="events">
Christmas Celebration </label>
<br>
<label>
<input type="radio" name="events" value="Amazing Moms Banquet" id="events">
</label>
Amazing Moms Banquet<br>
<label>
<input type="radio" name="events" value="Other Special Events" id="events">
Other Special Events</label>
</p>
<p>
<label>Comments and Questions<br>
<textarea name="comments" id="comments" cols="45" rows="10"></textarea>
</label>
<br>
</p>
<label>
<div align="center">
<input name="button" type="submit" class="style6" id="button" value="Submit">
</label>
<label>
<input name="button2" type="reset" class="style6" id="button2" value="Reset">
</label>
</div>
</form>
</div>
<br>
<div>
<?php
if (isset($_REQUEST[send]))
{
$name = $_POST['name'];
$street = $_POST['street'];
$city = $_POST['city'];
$state = $_POST['state'];
$zip = $_POST['zip'];
$phone = $_POST['phone'];
$cel = $_POST['cel'];
$email = $_POST['email'];
$events = $_POST['events'];
$header = 'From: ' . $email . "\r\n";
$header .= "X-Mailer: PHP/" . phpversion() . "\r\n";
$header .= "Mime-Version: 1.0 \r\n";
$header .= "Content-Type: text/plain";
$mensaje = "This message was sent by " . $name . "\r\n";
$mensaje .= "E-mail address: " . $email . " \r\n";
$mensaje .= "Telephone number: " . $phone . " \r\n";
$mensaje .= "City/Country: " . $city . " \r\n";
$mensaje .= "Comments: " . $_POST['comments'] . " \r\n";
$mensaje .= "Sent " . date('d/m/Y', time());
$para = '[email protected]';
$asunto = 'Sponsor request from your web page';
mail($para, $asunto, utf8_decode($mensaje), $header);
echo 'Your Sponsor form has been sent to us succesfully. We will contact you soon';
}
?>
</div>
</div>
<p> </p>
</blockquote>
</div></td>
</tr>
<?php include("footer.html"); ?>
Gracias