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Feedback Form

All input is blah blah ......

Send Data to:
Name: Email:
Shipping:
[ Excellent] [ Average] [ Poor]


Overall Rating:
[ Positive] [ Negative]

Request additional features for a feedback tutorial:
Email 'format' Validation - check @
Required Form Field Validation.
More intergratd HTML (in form).
Improved PHP form script generator.
A complete HTML form generator.


General Comments


Feedback Source Code

Thanks for your Feedback

Use Back - Enter valid e-mail\n"; $tellem = "

Feedback was NOT submitted

\n"; } if(empty($nameis) || empty($feedback) || empty($visitormail)) { echo "

Use Back - fill in all fields

\n"; } echo $tellem; if ($emailvalidation == "y") { $req1 = "Email format Validation \n" ; } if ($fieldvalidation == "y") { $req2 = "Required Form Field Validation \n"; } if ($htmlcontrol == "y") { $req3 = "More intergratd HTML (in form) \n"; } if ($phpform == "y") { $req4 = "Improved PHP form script generator \n"; } if ($htmlform == "y") { $req5 = "A complete HTML form generator \n"; } $req = $req1 . $req2 . $req3 . $req4 . $req5; $todayis = date("l, F j, Y, g:i a") ; $attn = $attn; $subject = $attn; $feedback = stripcslashes($feedback); $message = " $todayis [EST] \n Attention: $attn (Rating: $rating) \n From: $nameis ($visitormail)\n Requested: $req \n Feedback: $feedback \n Additional Info : IP = $ip \n Browser = $httpagent \n Referral = $httpref "; $from = "From: $visitormail\r\n"; mail("occe69@hotmail.com", $subject, $message, $from); $screenout = str_replace("\n", "
", $message); ?>