Form that users see
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Link to Us Application</title>
</head>
<body>
<form method="post" action="index.php?page=sendeailapp">
<!-- DO NOT change ANY of the php sections -->
<?php
$ipi = getenv("REMOTE_ADDR");
$httprefi = getenv ("HTTP_REFERER");
$httpagenti = getenv ("HTTP_USER_AGENT");
?>
<input type="hidden" name="ip" value="<?php echo $ipi ?>" />
<input type="hidden" name="httpref" value="<?php echo $httprefi ?>" />
<input type="hidden" name="httpagent" value="<?php echo $httpagenti ?>" />
Your FULL Name: <br />
<input type="text" name="fullname" size="35" />
<br /><br />
Your E-Mail Address: <br />
<input type="text" name="visitormail" size="35" />
<br /><br />
Admin Experience(Provide a short summary of your experience as an IRC server administrator ):<br />
<input type="text" name="adminexperience" size="35" />
<br /><br />
Motive(Explain why you want to run an IRC server for Ganja Farmer):<br />
<input type="text" name="motive" size="35" />
<br /><br />
Your Date of Birtd(DD/MM/YY):<br />
<input type="text" name="dob" size="35" />
<br /><br />
<strong>Server Details</strong><BR><BR>Server location
City:<br />
<input type="text" name="city" size="35" />
<br /><br />
State/Province/County:<br />
<input type="text" name="spc" size="35" />
<br /><br />
Country:<br />
<input type="text" name="country" size="35" />
<br /><br />
Continent:<br />
<input type="text" name="continent" size="35" />
<br /><br />
Server Hosting(At what location/datacenter is the server hosted? [E.G: Telehouse Docklands, London]):<br />
<input type="text" name="serverhosting" size="35" />
<br /><br />
Provider(Who are you renting your server/rack space/connectivity from? ):<br />
<input type="text" name="provider" size="35" /><BR><BR>
<strong>Server Ownership</strong><BR><BR>
The server/virtual server belongs to or is being rented by you.<BR>If you are <b><u>NOT</b></u> the owner of the server, please provide the owner's contact details.
<br /><br />
Owner's FULL Name:<br />
<input type="text" name="ownerfullname" size="35" />
<br /><br />
Owner's E-Mail Address:<br />
<input type="text" name="owneremailaddress" size="35" />
<br /><br />
Bunniess/Company Rented From:<br />
<input type="text" name="bc" size="35" />
<br /><br />
Root Access(You have root access to the server, if you <b><u>DO NOT</b></u> have root access to the server, please explain how you have access to the server and the authority to run an IRCd):<br />
<input type="text" name="rootaccess" size="35" />
<br /><br />
Processor (CPU) Information(Please provide information on the type and speed of the server's processor):<br />
<input type="text" name="processor" size="35" />
<br /><br />
Server Memory (RAM)(Please specify the amount of RAM installed in the server):<br />
<input type="text" name="servermemory" size="35" />
<br /><br />
Operating System(Describe the operating system that the server is running):<br />
<input type="text" name="operatingsystem" size="35" />
<br /><br />
Other Tasks(Describe any other tasks that the server is performing):<br />
<input type="text" name="othertasks" size="35" />
<br /><br />
Connection(Describe the server's connection to the Internet, include any bandwidth usage restrictions):<br />
<input type="text" name="connection" size="35" /><BR><BR>
<strong>IRC Server Details</strong><BR><BR>
Server Name(Choose a name for your IRCd. E.G: resistance.uk.eu.ganjafarmer.net):<br />
<input type="text" name="servername" size="35" />
<br /><br />
Server Task(Do you intend to run the server as a hub? If you do not want to run a hub, please specify the maximum number of clients that your server will hold):<br />
<input type="text" name="servertask" size="35" />
<br /><br />
IP Address(Please specify the IP address that you intend to the run the IRCd from):<br />
<input type="text" name="ipaddress" size="35" />
<br /><br />
Ports(What ports will your IRCd be listening on? [Seperate multiple ports with commas. E.G: 6666, 6667, 6668, 6669, 7000]):<br />
<input type="text" name="ports" size="35" />
<br /><br />
Trace Routes:<BR><BR>Run a traceroute from your server to the following servers and paste the results in the box below:<BR><BR>1.) resistance.de.eu.ganjafarmer.net<BR>2.) lightning.ca.us.ganjafarmer.net<BR>3.) Neko.il.us.NeonIRC.net<BR>4.) theone.nsw.au.ganjafarmer.net<BR>5.) the-rpg.ganjafarmer.net<br />
<textarea name="traceroute" rows="4" cols="40"></textarea>
<br /><br />
Message(Other):
<br /><br />
<textarea name="notes" rows="4" cols="40"></textarea>
<br /><br />
Message(Other-Other):
<br /><br />
<textarea name="message" rows="4" cols="40"></textarea>
<br /><br />
<input type="submit" value="Send Mail" />
<input type="reset" value="Reset All">
</form>
</body>
</html>
Form to send the email
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>E-Mail Sent</title>
</head>
<body>
<!-- Reminder: Add the link for the 'next page' (at the bottom) -->
<!-- Reminder: Change 'YourEmail' to Your real email -->
<BR><BR><H3>Information</H3>
<?php
if (eregi('http:', $notes)) {
die("Do NOT try that!! ");
}
if (!$visitormail == "" && (!strstr($visitormail, "@") || !strstr($visitormail, "."))) {
echo "<h2>Go Back - Enter a valid E-Mail!</h2>\n";
$badinput = "<h2>Feedback was NOT submitted!</h2>\n";
echo $badinput;
die(" ");
}
if (empty($visitor) || empty($visitormail) || empty($owneremailaddress)) {
echo "<h2>Go Back - Fill in all the fields!</h2>\n";
die(" ");
}
$todayis = date("l, F j, Y, g:i a");
$message = " $todayis [EST] \n
Your FULL Name: $fullname \n
Your E-Mail Address: $visitor ($visitormail)\n
Admin Experience: $adminexperience \n
Motive: $motive \n
Your Date of Birtd(DD/MM/YY): $dob \n
City: $city \n
State/Province/County: $spc \n
Country: $country \n
Continent: $continent \n
Server Hosting: $serverhosting \n
Provider: $provider \n
Owner's FULL Name: $ownerfullname \n
Owner's E-Mail Address: $owneremailaddress \n
Bunniess/Company Rented From: $bc \n
Root Access: $rootaccess \n
Processor (CPU) Information: $processor \n
Server Memory (RAM): $servermemory \n
Operating System: $operatingsystem \n
Other Tasks: $othertasks \n
Connection: $connection \n
Server Name: $servername \n
Server Task: $servertask \n
IP Address: $ipaddress \n
Ports: $ports \n
Trace Route: $traceroute \n
Other: $notes \n
";
$from = "From: $visitormail\r\n";
mail("admin@ganjafarmer.net", $subject, $message, $from);
?>
<p align="center">
Date: <?php echo $todayis ?>
<br />
Thank You: <?php echo $visitor ?> ( <?php echo $visitormail ?> )
<br />
IP: <?php echo $ip ?>
<br /><HR>
<center>NOTE:<br />i) We will try and reply to all E-Mails within 48 hours. If we have a high volume of E-Mails, it may take up to 1 week.<br />
ii) Do not try to spam, we have your IP. Proxy or not, we still have it.</center>
</p>
</body>
</html>