I have this as part of my client browser side webpage but I need to convert over to php.mail format and come across in email format.
There is an option of the client browser also to receive a copy of the same email of the details below they fill in.
Please could some assist with the correct format php for this to work ?
Thanks in advance.
:o
<p>Title: <br> <input type="text" name="title" /><br />
<br> First name:<br/><input type ="text" Name="fname" /> <br/>
<br/> Surname :<br/> <input type="text" Name="surname" /><br/>
<br > Address:<br/> <input Name="add" type="text" size="40" maxlength="50" />
<br/>
<br > Address 1:<br/><input Name="add1" type="text" size="40" maxlength="50" /><br/>
<br> Address 2:<br/><input Name="add2" type="text" size="40"maxlength="50" /> <br/>
<br> Address 3:<br/><input Name="add3" type="text" size="40" maxlength="50" /> <br/>
<br> Postcode :<br/><input type="text" Name="pcode"/><br/>
<br> Home Tel :<br/><input type="text" Name="hometel"/><br/>
<br> Work Tel :<br/><input type="text" Name="worktel"/><br/>
<br> Mob Tel :<br/> <input type="text" Name="mobtel"/><br/>
Email :
Date of Alleged cold call:
Who contacted you?
Have you ever had an accident?
Yes No
If yes, who did you make a claim through?
Are you registered with the Telephone Preference Service (TPS)
Yes No
Additional comments
Please tick if you require a copy of details filled in on this complaint form 1
Yes
Please tick YES below before proceeding
Yes
I confirm that I have read and understood the terms and conditions relating to this complaints procedure. I accept that if my complaint is found to not be valid that I may be responsible for an administration fee for dealing with this complaints procedure.
<br/>
<br/>
<br/>
<input name="submit value=" type="submit" value="Submit"send info />
<input type="reset" name="reset value="resent />
<br/><br/>