Help needed on PHP Form Script

February 3, 201214 yr

Hi. Appollogise for this post but i'm seriously frustrated with this and don't know what to do next. I'm trying to create a booking form for a driving school but can't get the form content sent through email.

Here's the form info:

<form action="book.php" method="post">
   <div class="Book1">
         <br />
           <table width="883" border="0" align="left">
             <tr>
           <td width="200" align="left" valign="middle"><span class="text">Title:</span></td>
           <td width="223" align="left" valign="middle"><select name="title" id="title" onchange="changeRow3();">
             <option selected="selected">Mr</option>
             <option>Mrs</option>
             <option>Miss</option>
             <option value="other">Other</option>
           </select>
             <span class="text">Please specify:</span>
           <input name="titleOther" type="text" id="titleOther" size="7" /></td>
           <td width="202" align="left" valign="middle">Address:<span class="requiredfield">*</span></td>
           <td width="240" align="left" valign="middle"><input name="address1" type="text" id="Address1" class="validate[required]" size="40" /></td>
         </tr>
         <tr>
           <td align="left" valign="middle">First Name:*</td>
           <td align="left" valign="middle"><input name="name1" type="text" id="name1" class="validate[required]" size="34" /></td>
           <td align="left" valign="middle">Address(2)</td>
           <td align="left" valign="middle"><input name="address2" type="text" id="Address2" class="validate[required]" size="40" /></td>
         </tr>
         <tr>
           <td align="left" valign="middle">Surname:*</td>
           <td align="left" valign="middle"><input name="name2" type="text" id="name2" class="validate[required]" size="34" /></td>
           <td align="left" valign="middle">Town/City:*</td>
           <td align="left" valign="middle"><input name="city" type="text" id="city" class="validate[required]" size="40" /></td>
         </tr>
         <tr>
           <td align="left" valign="middle">Email Address:*</td>
           <td align="left" valign="middle"><input name="email" type="text" id="email" class="validate[required]" size="34" /></td>
           <td align="left" valign="middle">Post Code:*</td>
           <td align="left" valign="middle"><input name="postcode" type="text" id="postcode" class="validate[required]" size="12" /></td>
         </tr>
         <tr>
           <td align="left" valign="middle">Telephone no.<span class="requiredfield">*</span></td>
           <td align="left" valign="middle"><input name="phone" type="text" id="phone" class="validate[required]" size="34" /></td>
           <td align="left" valign="middle">Date Of Birth:</td>
           <td align="left" valign="middle"><input name="dob" type="text" id="dob" class="validate[required]" size="40" /></td>
         </tr>
     </table><br /></div>

       <div class="Book2"><br />
         <table width="850" border="0">
           <tr>
           <td width="256" align="left" valign="middle">Have you got a provisional licence?</td>
           <td width="162" align="left" valign="middle"><select name="provisional" id="select5">
             <option selected="selected">Yes</option>
             <option>No</option>
           </select></td>
           <td width="240" align="left" valign="middle">Driving Licence Number</td>
           <td width="174" align="left" valign="middle"><input name="licence" type="text" id="LicenceNo" class="validate[required]" size="22" /></td>
         </tr>
         <tr>
           <td rowspan="2" align="left" valign="middle">Have you booked your  Theory test?</td>
           <td rowspan="2" align="left" valign="middle"><select name="theory" id="Theory">
             <option>No</option>
             <option>Yes</option>
           </select></td>
           <td rowspan="2" align="left" valign="middle">Have you Passed your Practical test?</td>
           <td rowspan="2" align="left" valign="middle"><select name="practical" id="Provisional">
             <option>No</option>
             <option>Yes</option>
           </select></td>
         </tr>
         <tr>          </tr>
         <tr>
           <td align="left" valign="middle">When is your practical test?</td>
           <td align="left" valign="middle">Date:       .
             <input name="test1" type="text" class="validate[custom[dateornot]]" id="test1" size="10"/></td>
           <td align="left" valign="middle"><span class="text" id="Test2">Test Centre:
               <input name="test3" type="text" class="validate[custom[dateornot]]" id="test3" size="15"/>
           </span></td>
           <td align="left" valign="middle"><span class="text">Time:.
               <input name="test2" type="text" class="validate[custom[dateornot]]" id="test2" size="10"/>
           </span></td>
         </tr>
     </table></div>

       <div class="Book3">
       <h3>What days are you available to take lessons?<br />
       </h3>
       <table width="850
       " border="0">
 <tr>
   <td width="99" align="left" valign="middle">Monday</td>
   <td width="243" align="left" valign="middle"><select name="monday" size=".5" id="monday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select>
     Tuesday</td>
   <td width="152" align="left" valign="middle"><select name="tuesday" size=".5" id="tuesday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select></td>
   <td width="118" align="left" valign="middle">Wednesday</td>
   <td width="115" align="left" valign="middle"><select name="wednesday" size=".5" id="wednesday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select></td>
   </tr>
 <tr>
   <td height="25" align="left" valign="middle">Thursday</td>
   <td align="left" valign="middle"><select name="thursday" size=".5" id="thursday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select>
     Friday</td>
   <td align="left" valign="middle"><select name="friday" size=".5" id="friday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select></td>
   <td align="left" valign="middle">Saturday</td>
   <td align="left" valign="middle"><select name="saturday" size=".5" id="saturday">
     <option selected="selected">N/A</option>
     <option>AM</option>
     <option>PM</option>
     <option>Evening</option>
     <option>Anytime</option>
   </select></td>
 </tr>
       </table><br />
       <label>

       </label>
       <br /><br />

       </div><br /><textarea name="additionalinformation" cols="80" rows="5" placeholder="Please supply any additional information that may be relevant here" id="additionalinformation"></textarea><br />
       <br />
       Where did you hear about us?  
       <select name="where" id="where" onChange="changeRow4();"><option selected="selected">Recommended</option><option>Google</option><option>Other search engine</option><option>Seen car going around</option><option>The phone book</option><option value="whereother">Other</option></select><br /><br />
     <input name="Reset" type="reset" class="send" value="Clear Form!" />        
         <input name="Reset2" type="submit" class="send" value="Book Lesson!" onclick="index.php" />
         <br /><br />
   </p></form>

And the php script:

<?php

$_subject = "Website Booking Form Submission";

$_title = $_POST['Title']; 
$_titleother = $_POST['TitleOther']; 
$_name1 = $_POST['Name1']; 
$_name2 = $_POST['Name2'];
$_address1 = $_POST['Address1'];
$_address2 = $_POST['Address2'];
$_city = $_POST['City'];
$_postcode = $_POST['Postcode'];
$_dob = $_POST['Date Of Birth'];
$_email = $_POST['Email'];
$_number = $_POST['Contact Number'];

$_provisional = $_POST['Provisional Licence '];
$_licence = $_POST['Licence Number'];
$_theory = $_POST['Theory test'];
$_practical = $_POST['Practical Test Booked'];
$_test1 = $_POST['Test Date'];
$_test3 = $_POST['Test Time'];
$_test4 = $_POST['Test Centre'];

$_monday = $_POST['Monday'];
$_tuesday = $_POST['Tuesday'];
$_wednesday = $_POST['Wednesday'];
$_thursday = $_POST['Thursday'];
$_friday = $_POST['Friday'];
$_saturday = $_POST['Saturday'];



$_message1 = "From: " . $_name1 . "\n\n" . "Contact number: " . $_number . "\n\n" . "postcode: " . $_postcode . "\n\n" . "email: " . $_email . "\n\n" . 

$_from = "From: " . $_POST['name1'];



ini_set("booking_from", "contact@r-m-t.org.uk ");





mail ( "contact@r-m-t.org.uk", $_subject, $_from );
header("Location: ../booking-done.php?name=" . $name1 ."");

?>

I've tried everything I could find to try and get the form to send, at the minute I've managed to get the header and the first name to send only and am now despiratly in need of new hair. If anyone can help and identify where I've gone wrong I would greatly appreciate some input.

Many thanksbooking.php book.php

February 4, 201214 yr

shouldn't

mail ( "contact@r-m-t.org.uk", $_subject, $_from );

Be something like..

mail($email, $_subject, $_message1, $_from);

Also. I highly hope this is just for practicing purposes. As that script is highly insecure in the situation you decided to actually store any of that data.

Edited February 4, 201214 yr by Samus

Help needed on PHP Form Script

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