Having trouble updating a pre-existing form entry page...

I have to add new fields to this page http://www.thesarahgracefoundation.org/referachild.php?pg=refer_child, which I have done on another file, but when I post live and submit to the new info, I get “Submission Failed”. I added the new fields to PHPMyAdmin, and the details page also reflects the updated fields. I do not know what I am missing. Does anyone have any suggestions? Any help would be greatly appreciated. Thanks!

I posted both the new and old coded page below:

NEW CODED PAGE:

[code]<?

$pg = $_REQUEST[‘pg’];

$cat = $_REQUEST[‘cat’];

if (!$DOCUMENT_ROOT) { $docroot = $_SERVER[‘DOCUMENT_ROOT’];} else { $docroot = $DOCUMENT_ROOT; }

require_once("$docroot/common_scripts/db_fns.php");

// connect to db

$conn = db_connect();

if (!$conn) {

return “Could not connect to database server - please try later.”;

exit;

}

$submit = trim($_REQUEST[‘submit’]);

/***** New Refer A Child Submission *****/

if ($submit) {

$child_first_name = addslashes(trim($_REQUEST[‘child_first_name’]));

$child_last_name = addslashes(trim($_REQUEST[‘child_last_name’]));

$child_age = addslashes(trim($_REQUEST[‘child_age’]));

$child_dob = addslashes(trim($_REQUEST[‘child_dob’]));

$diagnosis = addslashes(trim($_REQUEST[‘diagnosis’]));

$parent_first_name = addslashes(trim($_REQUEST[‘parent_first_name’]));

$parent_last_name = addslashes(trim($_REQUEST[‘parent_last_name’]));

$parent_street_address = addslashes(trim($_REQUEST[‘parent_street_address’]));

$parent_city = addslashes(trim($_REQUEST[‘parent_city’]));

$parent_state = addslashes(trim($_REQUEST[‘parent_state’]));

$parent_zip = addslashes(trim($_REQUEST[‘parent_zip’]));

$parent_phone = addslashes(trim($_REQUEST[‘parent_phone’]));

$siblings = addslashes(trim($_REQUEST[‘siblings’]));

$first_name = addslashes(trim($_REQUEST[‘first_name’]));

$last_name = addslashes(trim($_REQUEST[‘last_name’]));

$relationship_to_child = addslashes(trim($_REQUEST[‘relationship_to_child’]));

$street_address = addslashes(trim($_REQUEST[‘street_address’]));

$city = addslashes(trim($_REQUEST[‘city’]));

$state = addslashes(trim($_REQUEST[‘state’]));

$zip = addslashes(trim($_REQUEST[‘zip’]));

$phone = addslashes(trim($_REQUEST[‘phone’]));

$email = addslashes(trim($_REQUEST[‘email’]));

$contact = addslashes(trim($_REQUEST[‘contact’]));

$comments = addslashes(trim($_REQUEST[‘comments’]));

$insert_string = "

insert into referachild (

  child_first_name, 

  child_last_name, 

  child_age, 
  
  child_dob,
  
  parent_first_name, 
  
  parent_last_name, 
  
  parent_street_address, 
  
  parent_city, 
  
  parent_state, 
  
  parent_zip, 
  
  parent_phone, 
  
  siblings, 
  
  first_name, 

  last_name, 

  relationship_to_child, 

  street_address, 

  city, 

  state, 

  zip, 

  phone, 

  email, 
  
  contact, 

  comments ) 

values (

  '$child_first_name', 

  '$child_last_name',

  '$child_age',
  
  '$child_dob',
  
  '$diagnosis',
  
  '$parent_first_name',
  
  '$parent_last_name',
  
  '$parent_street_address',
  
  '$parent_city',
  
  '$parent_state',
  
  '$parent_zip',
  
  '$parent_phone',
  
  '$siblings',
  
  '$first_name', 

  '$last_name',

  '$relationship_to_child',

  '$street_address',

  '$city',

  '$state',

  '$zip',

  '$phone',

  '$email', 
  
  '$contact', 

  '$comments' )";

// echo “INSERT STRING IS:
$insert_string
”;

$result = mysql_query($insert_string);

if ($result) { $msg = “Thank You
Someone From The Sarah Grace Foundation Will Contact You In Regards To Your Submission.”; } else { $msg = “Submission Failed!
Please try again later
If This Problem Persists, Please Contact The Webmaster
”; }

}

include("$docroot/includes/pg_header_top.php");

/***** Extra JavaScript For Form Validation *****/

?>

<? include("$docroot/includes/pg_header_bottom.php"); include("$docroot/includes/pg_frame_top.php"); include("$docroot/includes/pg_frame_left.php"); include("$docroot/includes/pg_frame_middle.php"); /***** Main *****/ ?>
        <script language="javascript">

          document.title = "The Sarah Grace Foundation - Refer A Child";

        </script>
        <table border="0" cellpadding="0" cellspacing="0" width="550">
          <tr>
            <td colspan="3" valign="bottom"><img src="http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr_top.gif" /></td>
          </tr>
          <tr>
            <td colspan="3" valign="bottom"><img src="http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr-refer_child.gif" /></td>
          </tr>
          <tr bgcolor="ECBDD8">
            <td colspan="3" valign="bottom"><table border="0" cellpadding="3" cellspacing="3" width="95%" align="center">
                <tr>
                  <td class="regtext"><?  if ($msg) { // Form Was Submitted

                  ?>
                      <br />
                      <?=$msg?>
                      <br />
                      <br />
                      <?

                      } else { // Display Form

                  ?>
                      <br />
                    If you know of a child who needs our help, please complete the form below and we will contact you. Or if you prefer to fill out our pdf form and fax it to us, please click here. Thank you. <br />
                    <br />
                    <form action="referachild.php" method="post" name="referachild" id="referachild" onsubmit="return verify();">
                      <table border="0" cellpadding="2" cellspacing="2">
                        <tr>
                          <td class="hdrtext">Child's First Name</td>
                          <td><input class="forminput" size="33" type="text" name="child_first_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Child's Last Name</td>
                          <td><input class="forminput" size="33" type="text" name="child_last_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Child's Age</td>
                          <td><select name="child_age" class="forminput">
                            <option value="3 months">3 months</option>
                            <option value="6 months">6 months</option>
                            <option value="9 months">9 months</option>
                            <option value="1">1 year</option>
                            <option value="2">2 years</option>
                            <option value="3">3 years</option>
                            <option value="4">4 years</option>
                            <option value="5">5 years</option>
                            <option value="6">6 years</option>
                            <option value="7">7 years</option>
                            <option value="8">8 years</option>
                            <option value="9">9 years</option>
                            <option value="10">10 years</option>
                            <option value="11">11 years</option>
                            <option value="12">12 years</option>
                            <option value="13">13 years</option>
                            <option value="14">14 years</option>
                            <option value="15">15 years</option>
                            <option value="16">16 years</option>
                            <option value="17">17 years</option>
                            <option value="18">18 years</option>
                          </select>                              </td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Child's Date Of Birth </td>
                          <td><input class="forminput" size="33" type="text" name="child_dob" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Diagnosis:</td>
                          <td><textarea name="diagnosis" rows="4" cols="31" class="forminput"></textarea></td>
                        </tr>
                        
                        <tr>
                          <td class="hdrtext">Parent's First Name </td>
                          <td><input class="forminput" size="33" type="text" name="parent_first_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Parent's Last Name </td>
                          <td><input class="forminput" size="33" type="text" name="parent_last_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Parent's Address </td>
                          <td><input class="forminput" size="33" type="text" name="parent_street_address" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">City</td>
                          <td><input class="forminput" size="33" type="text" name="parent_city" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">State</td>
                          <td><select name="parent_state" class="forminput">
                            <option value = "">Select Your State</option>
                            <option value = "AK">Alaska</option>
                            <option value = "AL">Alabama</option>
                            <option value = "AR">Arkansas</option>
                            <option value = "AZ">Arizona</option>
                            <option value = "CA">California</option>
                            <option value = "CO">Colorado</option>
                            <option value = "CT">Connecticut</option>
                            <option value = "DC">District of Columbia</option>
                            <option value = "DE">Delaware</option>
                            <option value = "FL">Florida</option>
                            <option value = "GA">Georgia</option>
                            <option value = "HI">Hawaii</option>
                            <option value = "IA">Iowa</option>
                            <option value = "ID">Idaho</option>
                            <option value = "IL">Illinois</option>
                            <option value = "IN">Indiana</option>
                            <option value = "KS">Kansas</option>
                            <option value = "KY">Kentucky</option>
                            <option value = "LA">Louisiana</option>
                            <option value = "MA">Massachusetts</option>
                            <option value = "MD">Maryland</option>
                            <option value = "ME">Maine</option>
                            <option value = "MI">Michigan</option>
                            <option value = "MN">Minnesota</option>
                            <option value = "MO">Missouri</option>
                            <option value = "MS">Mississippi</option>
                            <option value = "MT">Montana</option>
                            <option value = "NC">North Carolina</option>
                            <option value = "ND">North Dakota</option>
                            <option value = "NE">Nebraska</option>
                            <option value = "NH">New Hampshire</option>
                            <option value = "NJ">New Jersey</option>
                            <option value = "NM">New Mexico</option>
                            <option value = "NV">Nevada</option>
                            <option value = "NY">New York</option>
                            <option value = "OH">Ohio</option>
                            <option value = "OK">Oklahoma</option>
                            <option value = "OR">Oregon</option>
                            <option value = "PA">Pennsylvania</option>
                            <option value = "RI">Rhode Island</option>
                            <option value = "SC">South Carolina</option>
                            <option value = "SD">South Dakota</option>
                            <option value = "TN">Tennessee</option>
                            <option value = "TX">Texas</option>
                            <option value = "UT">Utah</option>
                            <option value = "VA">Virginia</option>
                            <option value = "VT">Vermont</option>
                            <option value = "WA">Washington</option>
                            <option value = "WI">Wisconsin</option>
                            <option value = "WV">West Virginia</option>
                            <option value = "WY">Wyoming</option>
                          </select></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Zip</td>
                          <td><input class="forminput" size="10" type="text" name="parent_zip" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Phone # </td>
                          <td><input class="forminput" size="25" type="text" name="parent_phone" /></td>
                        </tr>
                        
                        <tr>
                          <td class="hdrtext">Sibling Name(s), Ages, Gender </td>
                          <td class="hdrtext"><textarea name="siblings" cols="31" rows="4" class="forminput"></textarea></td>
                        </tr>
                        
                        <tr>
                          <td class="hdrtext">Your First Name</td>
                          <td><input class="forminput" size="33" type="text" name="first_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Your Last Name</td>
                          <td><input class="forminput" size="33" type="text" name="last_name" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Your Relationship To The Child</td>
                          <td><select name="relationship_to_child" class="forminput">
                            <option>Parent</option>
                            <option>Guardians</option>
                            <option>Friend</option>
                            <option>Treating Physician</option>
                            <option>Medical Professional</option>
                            <option>Social Worker</option>
                          </select>                              </td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Your Street Address</td>
                          <td><input class="forminput" size="33" type="text" name="street_address" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">City</td>
                          <td><input class="forminput" size="33" type="text" name="city" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">State</td>
                          <td><select name="state" class="forminput">
                            <option value = "">Select Your State</option>
                            <option value = "AK">Alaska</option>
                            <option value = "AL">Alabama</option>
                            <option value = "AR">Arkansas</option>
                            <option value = "AZ">Arizona</option>
                            <option value = "CA">California</option>
                            <option value = "CO">Colorado</option>
                            <option value = "CT">Connecticut</option>
                            <option value = "DC">District of Columbia</option>
                            <option value = "DE">Delaware</option>
                            <option value = "FL">Florida</option>
                            <option value = "GA">Georgia</option>
                            <option value = "HI">Hawaii</option>
                            <option value = "IA">Iowa</option>
                            <option value = "ID">Idaho</option>
                            <option value = "IL">Illinois</option>
                            <option value = "IN">Indiana</option>
                            <option value = "KS">Kansas</option>
                            <option value = "KY">Kentucky</option>
                            <option value = "LA">Louisiana</option>
                            <option value = "MA">Massachusetts</option>
                            <option value = "MD">Maryland</option>
                            <option value = "ME">Maine</option>
                            <option value = "MI">Michigan</option>
                            <option value = "MN">Minnesota</option>
                            <option value = "MO">Missouri</option>
                            <option value = "MS">Mississippi</option>
                            <option value = "MT">Montana</option>
                            <option value = "NC">North Carolina</option>
                            <option value = "ND">North Dakota</option>
                            <option value = "NE">Nebraska</option>
                            <option value = "NH">New Hampshire</option>
                            <option value = "NJ">New Jersey</option>
                            <option value = "NM">New Mexico</option>
                            <option value = "NV">Nevada</option>
                            <option value = "NY">New York</option>
                            <option value = "OH">Ohio</option>
                            <option value = "OK">Oklahoma</option>
                            <option value = "OR">Oregon</option>
                            <option value = "PA">Pennsylvania</option>
                            <option value = "RI">Rhode Island</option>
                            <option value = "SC">South Carolina</option>
                            <option value = "SD">South Dakota</option>
                            <option value = "TN">Tennessee</option>
                            <option value = "TX">Texas</option>
                            <option value = "UT">Utah</option>
                            <option value = "VA">Virginia</option>
                            <option value = "VT">Vermont</option>
                            <option value = "WA">Washington</option>
                            <option value = "WI">Wisconsin</option>
                            <option value = "WV">West Virginia</option>
                            <option value = "WY">Wyoming</option>
                          </select>                              </td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Zip</td>
                          <td><input class="forminput" size="10" type="text" maxlength="10" name="zip" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Phone # </td>
                          <td><input class="forminput" size="25" type="text" name="phone" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Email</td>
                          <td><input class="forminput" size="33" type="text" name="email" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">May we contact you via email? </td>
                          <td class="hdrtext"><input class="forminput" size="10" type="text" name="contact" /></td>
                        </tr>
                        <tr>
                          <td class="hdrtext">Comments:</td>
                          <td><textarea name="comments" rows="4" cols="31" class="forminput"></textarea></td>
                        </tr>
                        <tr>
                          <td colspan="2"><div align="center"><br />
                            <input type="submit" class="formbutton" name="submit" value="Submit Referal" />
                          </div></td>
                        </tr>
                      </table>
                    </form>
                    <br />
                    <?

                     }

                  ?>
                  </td>
                </tr>
            </table></td>
          </tr>
          <tr>
            <td colspan="3" valign="bottom"><img src="http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr_bottom.gif" /></td>
          </tr>
          <tr>
            <td colspan="3" valign="bottom"><br /></td>
          </tr>
        </table>
        <?

include("$docroot/includes/pg_frame_bottom.php");

?>[/code]

OLD CODED PAGE:

[code]<?

$pg = $_REQUEST[‘pg’];

$cat = $_REQUEST[‘cat’];

if (!$DOCUMENT_ROOT) { $docroot = $_SERVER[‘DOCUMENT_ROOT’];} else { $docroot = $DOCUMENT_ROOT; }

require_once("$docroot/common_scripts/db_fns.php");

// connect to db

$conn = db_connect();

if (!$conn) {

return “Could not connect to database server - please try later.”;

exit;

}

$submit = trim($_REQUEST[‘submit’]);

/***** New Refer A Child Submission *****/

if ($submit) {

$child_first_name = addslashes(trim($_REQUEST[‘child_first_name’]));

$child_last_name = addslashes(trim($_REQUEST[‘child_last_name’]));

$child_age = addslashes(trim($_REQUEST[‘child_age’]));

$first_name = addslashes(trim($_REQUEST[‘first_name’]));

$last_name = addslashes(trim($_REQUEST[‘last_name’]));

$relationship_to_child = addslashes(trim($_REQUEST[‘relationship_to_child’]));

$street_address = addslashes(trim($_REQUEST[‘street_address’]));

$city = addslashes(trim($_REQUEST[‘city’]));

$state = addslashes(trim($_REQUEST[‘state’]));

$zip = addslashes(trim($_REQUEST[‘zip’]));

$phone = addslashes(trim($_REQUEST[‘phone’]));

$email = addslashes(trim($_REQUEST[‘email’]));

$comments = addslashes(trim($_REQUEST[‘comments’]));

$insert_string = "

insert into referachild (

  child_first_name, 

  child_last_name, 

  child_age, 
  
  first_name, 

  last_name, 

  relationship_to_child, 

  street_address, 

  city, 

  state, 

  zip, 

  phone, 

  email, 

  comments ) 

values (

  '$child_first_name', 

  '$child_last_name',

  '$child_age',
  
  '$first_name', 

  '$last_name',

  '$relationship_to_child',

  '$street_address',

  '$city',

  '$state',

  '$zip',

  '$phone',

  '$email', 

  '$comments' )";

// echo “INSERT STRING IS:
$insert_string
”;

$result = mysql_query($insert_string);

if ($result) { $msg = “Thank You
Someone From The Sarah Grace Foundation Will Contact You In Regards To Your Submission.”; } else { $msg = “Submission Failed!
Please try again later
If This Problem Persists, Please Contact The Webmaster
”; }

}

include("$docroot/includes/pg_header_top.php");

/***** Extra JavaScript For Form Validation *****/

?>

<? include("$docroot/includes/pg_header_bottom.php"); include("$docroot/includes/pg_frame_top.php"); include("$docroot/includes/pg_frame_left.php"); include("$docroot/includes/pg_frame_middle.php"); /***** Main *****/ ?>
        <script language="javascript">

          document.title = "The Sarah Grace Foundation - Refer A Child";

        </script>

        <table border=0 cellpadding=0 cellspacing=0 width=550>

          <tr>

            <td colspan=3 valign=bottom><img src=http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr_top.gif></td>

          </tr>

          <tr>

            <td colspan=3 valign=bottom><img src=http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr-refer_child.gif></td>

          </tr>

          <tr bgcolor=ECBDD8>

            <td colspan=3 valign=bottom>

              <table border=0 cellpadding=3 cellspacing=3 width=95% align=center>

                <tr>

                  <td class=regtext> 

                  

                    <?  if ($msg) { // Form Was Submitted

                  ?>

                    <br>
                    <?=$msg?>

                    <br>
                    <br>

                    <?

                      } else { // Display Form

                  ?>	

                  

                    <br>
                    If you know of a child who needs our help, please complete the form below and we will contact you. Or if you prefer to fill out our pdf form and fax it to us, please click here. Thank you. <br>
                      <br>
                    <form name=referachild method=post action=referachild.php onSubmit="return verify();">

                    <table border=0 cellpadding=2 cellspacing=2>

                      <tr>

                        <td class=hdrtext>Child's First Name</td>

                        <td><input class=forminput size=33 type=text name=child_first_name></td>
                      </tr>

                      <tr>

                        <td class=hdrtext>Child's Last Name</td>

                        <td><input class=forminput size=33 type=text name=child_last_name></td>
                      </tr>

                      <tr>

                        <td class=hdrtext>Child's Age</td>

                        <td>

                          <select name=child_age class=forminput>

                            <option value="3 months">3 months</option>

                            <option value="6 months">6 months</option>

                            <option value="9 months">9 months</option>

                            <option value="1">1 year</option>

                            <option value="2">2 years</option>

                            <option value="3">3 years</option>

                            <option value="4">4 years</option>

                            <option value="5">5 years</option>

                            <option value="6">6 years</option>

                            <option value="7">7 years</option>

                            <option value="8">8 years</option>

                            <option value="9">9 years</option>

                            <option value="10">10 years</option>

                            <option value="11">11 years</option>

                            <option value="12">12 years</option>

                            <option value="13">13 years</option>

                            <option value="14">14 years</option>

                            <option value="15">15 years</option>

                            <option value="16">16 years</option>

                            <option value="17">17 years</option>

                            <option value="18">18 years</option>
                          </select>                            </td>
                      </tr>
                      <tr>

                        <td class=hdrtext>Your First Name</td>

                        <td><input class=forminput size=33 type=text name=first_name></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>Your Last Name</td>

                        <td><input class=forminput size=33 type=text name=last_name></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>Your Relationship To The Child</td>

                        <td>

                          <select name=relationship_to_child class=forminput>

                            <option>Parent</option>

                            <option>Guardians</option>
							
							<option>Friend</option>

                            <option>Treating Physician</option>

                            <option>Medical Professional</option>

                            <option>Social Worker</option>
                          </select>                            </td>
                      </tr>

                      <tr>

                        <td class=hdrtext>Your Street Address</td>

                        <td><input class=forminput size=33 type=text name=street_address></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>City</td>

                        <td><input class=forminput size=33 type=text name=city></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>State</td>

                        <td>

                          <select name=state class=forminput>

                            <option VALUE = "">Select Your State</option>

                            <option VALUE = "AK">Alaska</option>

                            <option VALUE = "AL">Alabama</option>

                            <option VALUE = "AR">Arkansas</option>

                            <option VALUE = "AZ">Arizona</option>

                            <option VALUE = "CA">California</option>

                            <option VALUE = "CO">Colorado</option>

                            <option VALUE = "CT">Connecticut</option>

                            <option VALUE = "DC">District of Columbia</option>

                            <option VALUE = "DE">Delaware</option>

                            <option VALUE = "FL">Florida</option>

                            <option VALUE = "GA">Georgia</option>

                            <option VALUE = "HI">Hawaii</option>

                            <option VALUE = "IA">Iowa</option>

                            <option VALUE = "ID">Idaho</option>

                            <option VALUE = "IL">Illinois</option>

                            <option VALUE = "IN">Indiana</option>

                            <option VALUE = "KS">Kansas</option>

                            <option VALUE = "KY">Kentucky</option>

                            <option VALUE = "LA">Louisiana</option>

                            <option VALUE = "MA">Massachusetts</option>

                            <option VALUE = "MD">Maryland</option>

                            <option VALUE = "ME">Maine</option>

                            <option VALUE = "MI">Michigan</option>

                            <option VALUE = "MN">Minnesota</option>

                            <option VALUE = "MO">Missouri</option>

                            <option VALUE = "MS">Mississippi</option>

                            <option VALUE = "MT">Montana</option>

                            <option VALUE = "NC">North Carolina</option>

                            <option VALUE = "ND">North Dakota</option>

                            <option VALUE = "NE">Nebraska</option>

                            <option VALUE = "NH">New Hampshire</option>

                            <option VALUE = "NJ">New Jersey</option>

                            <option VALUE = "NM">New Mexico</option>

                            <option VALUE = "NV">Nevada</option>

                            <option VALUE = "NY">New York</option>

                            <option VALUE = "OH">Ohio</option>

                            <option VALUE = "OK">Oklahoma</option>

                            <option VALUE = "OR">Oregon</option>

                            <option VALUE = "PA">Pennsylvania</option>

                            <option VALUE = "RI">Rhode Island</option>

                            <option VALUE = "SC">South Carolina</option>

                            <option VALUE = "SD">South Dakota</option>

                            <option VALUE = "TN">Tennessee</option>

                            <option VALUE = "TX">Texas</option>

                            <option VALUE = "UT">Utah</option>

                            <option VALUE = "VA">Virginia</option>

                            <option VALUE = "VT">Vermont</option>

                            <option VALUE = "WA">Washington</option>

                            <option VALUE = "WI">Wisconsin</option>

                            <option VALUE = "WV">West Virginia</option>

                            <option VALUE = "WY">Wyoming</option>
                          </select>                            </td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>Zip</td>

                        <td><input class=forminput size=10 type=text maxlength=10 name=zip></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>Phone # </td>

                        <td><input class=forminput size=25 type=text name=phone></td>
                      </tr> 

                      <tr>

                        <td class=hdrtext>Email</td>

                        <td><input class=forminput size=33 type=text name=email></td>
                      </tr>

                      <tr>

                        <td class=hdrtext>Comments:</td>

                        <td><textarea name=comments rows=4 cols=31 class=forminput></textarea></td>
                      </tr> 

                      <tr>

                        <td colspan=2><br><input type=submit class=formbutton name=submit value="Submit Referal"></td>
                      </tr>        
                    </table>        

                    </form>

                    <br>    

                  <?

                     }

                  ?>          

                  </td>

                </tr>

              </table>

            </td>

          </tr>

          <tr>

            <td colspan=3 valign=bottom><img src=http://<?=$_SERVER['SERVER_NAME']?>/images/hdrs/body_hdr_bottom.gif></td>

          </tr>

          <tr>

            <td colspan=3 valign=bottom><br></td>

          </tr>

        </table>
<? include("$docroot/includes/pg_frame_bottom.php"); ?>[/code]

MOD EDIT: Added code tags

First: we’re not a debugging tool that you can just post your entire source to and expect to solve it for you. It’s your code, it’s your problem.
Second: we have a marvelous Debugging Tips and Tricks thread, which you can access by clicking the link in my signature, most notable of which would be the error_reporting(E_ALL); function. Have you tried debugging?
Third: did things go well before the change? If so, show us the code that you’ve changed, not the entire page. We don’t want to see code that runs well, and in the rare case that we do, we’ll ask you to post it.

Please see also the Posting Guidelines on how to create a proper thread.

So sorry for not following the proper procedure. :oops: I am trying to absorb as much of this as possible. Anyway, here is my dilemma. I have an existing page I must update by adding new fields of information for a person to enter. The page is active and currently working here: http://www.thesarahgracefoundation.org/ … efer_child

In order for me to add new fields to this code it appears as if I must add data to the following four locations,

if ($submit) {

$child_first_name = addslashes(trim($_REQUEST[‘child_first_name’]));

$insert_string = "
insert into referachild (
child_first_name, )
values (
‘$child_first_name’,

Then form data for the new field.’’

Can anyone help me understand what I am doing incorrectly?

Thanks,
Ortizwerx

Okay, again: have you tried debugging, as per the link in my signature? I’m pretty sure the code you gave me throws at least a few notices and warnings, and I’d like to see what they are. Secondly, echo out your queries, show us what you’re running against the database (and what’s returned) so we know what the traffic looks like there.

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