rendered paste body<?php
// Define your email address - where to send messages - here
define("MAIL_TARGET","test@hotmail.com");
// Here you can redefine error messages
define("errorTitle","Invalid Title!");
define("errorFirstName","Invalid First Name!");
define("errorSurname","Invalid Surname!");
define("errorAddressLine1","Invalid Address Line 1!");
define("errorAddressLine2","Invalid Address Line 2!");
define("errorTown","Invalid Town!");
define("errorCounty","Invalid County!");
define("errorPostcode","Invalid Postcode!");
define("errorEmail","Invalid E-Mail!");
define("errorTel","Invalid Telephone number!");
define("errorPAddressLine1","Invalid Address Line 1!");
define("errorPAddressLine2","Invalid Address Line 2!");
define("errorPTown","Invalid Town!");
define("errorPCounty","Invalid County!");
define("errorPPostcode","Invalid Postcode!");
define("errorType","Invalid Type!");
define("errorBuiltForm","Invalid Built Form!");
define("errorBedrooms","Invalid Bedrooms!");
define("errorBuilt","Invalid Built Form!");
define("errorConservation","Invalid Conversation!");
define("errorExtensions","Invalid Extensions!");
define("errorPreferredDay","Invalid Preferred Day!");
define("errorComments","Invalid Comments!");
function createForm($title="",$first_name="",$surname="",$address_line_1="",$address_line_2="",$town="",$county="",$postcode="",$email="",$tel="",$same_address="",$property_address_1="",$property_address_2="",$property_town="",$property_county="",$property_postcode="",$type="",$built_form="",$bedrooms="",$built="",$conservation="",$extensions="",$preferred_day="",$comments="",$error1="",$error2="",$error3="",$error4="",$error5="",$error6="",$error7="",$error8="",$error9="",$error10="",$error11="",$error12="",$error13="",$error14="",$error15="",$error16="",$error17="",$error18="",$error19="",$error20="",$error21="",$error22=""){
?>
<p>If you would like to book a survey please fill in the form below and a member of staff will contact you to confirm an appointment.</p>
<p><em>*</em> Required Fields</p>
<form id="book_form" name="theform" method="post" action="<?php echo $_SERVER['PHP_SELF']; ?>" onSubmit="validate(this);">
<div class="fieldset">
<fieldset>
<legend><span>Your details</span></legend>
<div class="book_question">
<label for="title">Title<em>*</em></label>
<select class="input" name="title" id="title">
<option value=""> </option>
<option value="Dr"<?php if($title == 'Dr') echo 'selected="selected"'; ?>>Dr</option>
<option value="Ms"<?php if($title == 'Ms') echo 'selected="selected"'; ?>>Ms</option>
<option value="Mr"<?php if($title == 'Mr') echo 'selected="selected"'; ?>>Mr</option>
<option value="Miss"<?php if($title == 'Miss') echo 'selected="selected"'; ?>>Miss</option>
<option value="Mrs"<?php if($title == 'Mrs') echo 'selected="selected"'; ?>>Mrs</option> <option value="Other"<?php if($title == 'Other') echo 'selected="selected"'; ?>>Other</option>
</select>
<span class="form_error"><?php if($error1 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error1;?></span>
</div>
<div class="book_question">
<label for="first_name">First Name<em>*</em></label>
<input class="input" id="first_name" name="first_name" value="<?php echo $first_name; ?>">
<span class="form_error"><?php if($error2 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error2; ?></span>
</div>
<div class="book_question">
<label for="surname">Surname<em>*</em></label>
<input class="input" id="surname" name="surname" value="<?php echo $surname; ?>">
<span class="form_error"><?php if($error3 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error3; ?></span>
</div>
<div class="book_question">
<label for="address_line_1">Address Line 1<em>*</em></label>
<input class="input" id="address_line_1" name="address_line_1" value="<?php echo $address_line_1; ?>">
<span class="form_error"><?php if($error4 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error4; ?></span>
</div>
<div class="book_question">
<label for="address_line_2">Address Line 2<em>*</em></label>
<input class="input" id="address_line_2" name="address_line_2" value="<?php echo $address_line_2; ?>">
<span class="form_error"><?php if($error5 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error5; ?></span>
</div>
<div class="book_question">
<label for="town">Town<em>*</em></label>
<input class="input" id="town" name="town" value="<?php echo $town; ?>">
<span class="form_error"><?php if($error6 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error6; ?></span>
</div>
<div class="book_question">
<label for="county">County<em>*</em></label>
<input class="input" id="county" name="county" value="<?php echo $county; ?>">
<span class="form_error"><?php if($error7 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error7; ?></span>
</div>
<div class="book_question">
<label for="postcode">Postcode<em>*</em></label>
<input class="input" id="postcode" name="postcode" size="8" value="<?php echo $postcode; ?>">
<span class="form_error"><?php if($error8 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error8; ?></span>
</div>
<div class="book_question">
<label for="email">E-Mail<em>*</em></label>
<input class="input" id="email" name="email" value="<?php echo $email; ?>">
<span class="form_error"><?php if($error9 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error9; ?></span>
</div>
<div class="book_question">
<label for="tel">Tel<em>*</em></label>
<input class="input" id="tel" name="tel" size="12" value="<?php echo $tel; ?>">
<span class="form_error"><?php if($error10 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error10; ?></span>
</div>
</fieldset>
</div>
<div class="fieldset">
<fieldset>
<legend><span>Property Address</span></legend>
<label for="same_address" class="same_address">Same Address as Above</label>
<input name="same_address" id="same_address" type="checkbox">
<?php if(isset($_POST['same_address'])) {
$property_address_1 = $address_line_1;
$property_address_2 = $address_line_2;
$property_town = $town;
$property_county = $county;
$property_postcode = $postcode;
}
?>
<label for="property_address_1">Address Line 1</label>
<input class="input" id="property_address_1" name="property_address_1" value="<?php echo $property_address_1; ?>">
<span class="form_error"><?php if($error11 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error11; ?></span>
<label for="property_address_2">Address Line 2</label>
<input class="input" id="property_address_2" name="property_address_2" value="<?php echo $property_address_2; ?>">
<span class="form_error"><?php if($error12 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error12; ?></span>
<label for="property_town">Town</label>
<input class="input" id="property_town" name="property_town" value="<?php echo $property_town; ?>">
<span class="form_error"><?php if($error13 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error13; ?></span>
<label for="property_county">County</label>
<input class="input" id="property_county" name="property_county" value="<?php echo $property_county; ?>">
<span class="form_error"><?php if($error14 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error14; ?></span>
<label for="property_postcode">Postcode</label>
<input class="input" id="property_postcode" name="property_postcode" size="8" value="<?php echo $property_postcode; ?>">
<span class="form_error"><?php if($error15 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error15; ?></span>
</fieldset>
</div>
<div class="fieldset">
<fieldset>
<legend><span>Propery Information</span></legend>
<label for="type">Type<em>*</em></label>
<select class="input" name="type" id="type">
<option value=""> </option>
<option value="House"<?php if($type == 'House') echo 'selected="selected"'; ?>>House</option>
<option value="Flat"<?php if($type == 'Flat') echo 'selected="selected"'; ?>>Flat</option>
<option value="Bungalow"<?php if($type == 'Bungalow') echo 'selected="selected"'; ?>>Bungalow</option>
<option value="Maisonette"<?php if($type == 'Maisonette') echo 'selected="selected"'; ?>>Maisonette</option>
</select>
<span class="form_error"><?php if($error16 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error16; ?></span>
<label for="built_form">Built Form<em>*</em></label>
<select class="input" name="built_form" id="built_form">
<option value=""> </option>
<option value="Detached"<?php if($built_form == 'Detached') echo 'selected="selected"'; ?>>Detached</option>
<option value="Link_Detached"<?php if($built_form == 'Link_Detached') echo 'selected="selected"'; ?>>Link Detached</option>
<option value="Semi_Detached"<?php if($built_form == 'Semi_Detached') echo 'selected="selected"'; ?>>Semi Detached</option>
<option value="End_Terrace"<?php if($built_form == 'End_Terrace') echo 'selected="selected"'; ?>>End Terrace</option>
<option value="Mid_Terrace"<?php if($built_form == 'Mid_Terrace') echo 'selected="selected"'; ?>>Mid Terrace</option>
</select>
<span class="form_error"><?php if($error17 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error17; ?></span>
<label for="bedrooms">Bedrooms<em>*</em></label>
<select class="input" name="bedrooms" id="bedrooms">
<option value=""> </option>
<option value="1"<?php if($bedrooms == '1') echo 'selected="selected"'; ?>>1</option>
<option value="2"<?php if($bedrooms == '2') echo 'selected="selected"'; ?>>2</option>
<option value="3"<?php if($bedrooms == '3') echo 'selected="selected"'; ?>>3</option>
<option value="4"<?php if($bedrooms == '4') echo 'selected="selected"'; ?>>4</option>
<option value="5"<?php if($bedrooms == '5') echo 'selected="selected"'; ?>>5</option>
<option value="6+"<?php if($bedrooms == '6+') echo 'selected="selected"'; ?>>6+</option>
</select>
<span class="form_error"><?php if($error18 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error18; ?></span>
<label for="built">Year built<em>*</em></label>
<select class="input" name="built" id="built">
<option value=""> </option>
<option value="pre1900"<?php if($built == 'pre1900') echo 'selected="selected"'; ?>>Pre 1900</option>
<option value="1900-1929"<?php if($built == '1900-1929') echo 'selected="selected"'; ?>>1900 - 1929</option>
<option value="1930-1949"<?php if($built == '1930-1949') echo 'selected="selected"'; ?>>1930 - 1949</option>
<option value="1950-1966"<?php if($built == '1950-1966') echo 'selected="selected"'; ?>>1950 - 1966</option>
<option value="1967-1975"<?php if($built == '1967-1975') echo 'selected="selected"'; ?>>1967 - 1975</option>
<option value="1976-1982"<?php if($built == '1976-1982') echo 'selected="selected"'; ?>>1976 - 1982</option>
<option value="1983-1990"<?php if($built == '1983-1990') echo 'selected="selected"'; ?>>1983 - 1990</option>
<option value="1991-1995"<?php if($built == '1991-1995') echo 'selected="selected"'; ?>>1991 - 1995</option>
<option value="1996-2002"<?php if($built == '1996-2002') echo 'selected="selected"'; ?>>1996 - 2002</option>
<option value="2003-2006"<?php if($built == '2003-2006') echo 'selected="selected"'; ?>>2003 - 2006</option>
<option value="2007"<?php if($built == '2007') echo 'selected="selected"'; ?>>2007</option>
<option value="unsure"<?php if($built == 'unsure') echo 'selected="selected"'; ?>>Unsure</option>
</select>
<span class="form_error"><?php if($error19 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error19; ?></span>
<label for="conservation">Conservation Area<em>*</em></label>
<select class="input" name="conservation" id="conservation">
<option value=""> </option>
<option value="yes"<?php if($conservation == 'yes') echo 'selected="selected"'; ?>>Yes</option>
<option value="no"<?php if($conservation == 'no') echo 'selected="selected"'; ?>>No</option>
<option value="dont_know"<?php if($conservation == 'dont_know') echo 'selected="selected"'; ?>>Don't know</option>
</select>
<span class="form_error"><?php if($error20 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error20; ?></span>
<label for="extensions">Extensions<em>*</em></label>
<select class="input" name="extensions" id="extensions">
<option value=""> </option>
<option value="0"<?php if($extnesions == '0') echo 'selected="selected"'; ?>>0</option>
<option value="1"<?php if($extensions == '1') echo 'selected="selected"'; ?>>1</option>
<option value="2"<?php if($extensions == '2') echo 'selected="selected"'; ?>>2</option>
<option value="3"<?php if($extensions == '3') echo 'selected="selected"'; ?>>3</option>
<option value="4"<?php if($extensions == '4') echo 'selected="selected"'; ?>>4</option>
<option value="5+"<?php if($extensions == '5+') echo 'selected="selected"'; ?>>5+</option>
</select>
<span class="form_error"><?php if($error21 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error21; ?></span>
<label for="preferred_day">Preferred Day<em>*</em></label>
<select class="input" name="preferred_day" id="preferred_day">
<option value=""> </option>
<option value="monday"<?php if($preferred_day == 'monday') echo 'selected="selected"'; ?>>Monday</option>
<option value="tuesday"<?php if($preferred_day == 'tuesday') echo 'selected="selected"'; ?>>Tuesday</option>
<option value="wednesday"<?php if($preferred_day == 'wednesday') echo 'selected="selected"'; ?>>Wednesday</option>
<option value="thursday"<?php if($preferred_day == 'thursday') echo 'selected="selected"'; ?>>Thursday</option>
<option value="friday"<?php if($preferred_day == 'friday') echo 'selected="selected"'; ?>>Friday</option>
<option value="saturday"<?php if($preferred_day == 'saturday') echo 'selected="selected"'; ?>>Saturday</option>
<option value="sunday"<?php if($preferred_day == 'sunday') echo 'selected="selected"'; ?>>Sunday</option>
</select>
<span class="form_error"><?php if($error22 == TRUE) echo "<img src='images/error.png' width='19' height='19' > "; echo $error22; ?></span>
<div class="comments">
<label for="comments">Comments</label>
<textarea class="input" id="comments" name="comments" cols="30" rows="7"></textarea>
<input class="submit_comments" name="submit" type="submit" value="Submit" >
</div>
</fieldset>
</div>
</form>
<?php
}
function isValidEmail($email){
$pattern = "^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,3})$";
if (eregi($pattern, $email)){
return true;
}
else {
return false;
}
}
function sendMail($title,$first_name,$surname,$address_line_1,$address_line_2,$town,$county,$postcode,$email,$tel,$same_address,$property_address_1,$property_address_2,$property_town,$property_county,$property_postcode,$type,$built_form,$bedrooms,$built,$conservation,$extensions,$preferred_day,$comments){
$agent = $_SERVER['HTTP_USER_AGENT'];
$ip = $_SERVER['REMOTE_ADDR'];
$host = $_SERVER['REMOTE_HOST'];
$port = $_SERVER['REMOTE_PORT'];
$above = $agent."\r\n".$ip."\r\n".$host."\r\n".$port."\r\n";
$time = date("G:i d/m/Y");
$subject = "WEBSITE BOOK A SURVEY SUBMISSION";
$from = "From: $name <$email>\r\nReply-To: $email\r\n";
$content = htmlspecialchars("Browser: $agent\r\n Ip: $ip\r\n Port: $port\r\r\n Sent: $time\r\n
Title: $title \r\n
First Name: $first_name \r\n
Surname: $surname \r\n
Address Line 1: $address_line_1 \r\n
Address Line 2: $address_line_2 \r\n
Town: $town \r\n
County: $county \r\n
E-Mail: $email \r\n
Tel: $tel \r\n\r\n
Same Address For Property: $same_address \r\n
Property Address Line 1: $property_address_1 \r\n
Property Address Line 2: $property_address_2 \r\n
Property Town: $property_town \r\n
Property County: $property_county \r\n
Property Postcode: $property_postcode \r\n\r\n
Type: $type \r\n
Built Form: $built_form \r\n
Bedrooms: $bedrooms \r\n
Built: $built \r\n
Conservation: $conservation \r\n
Extensions: $extensions \r\n
Preferred Day: $preferred_day \r\n\r\n
Comments: $comments \r\n");
$content = wordwrap($content,70);
mail(MAIL_TARGET,$subject,$content,$from);
}
if (!isset($_POST['submit'])) {
createForm();
} else {
$title = isset($_POST['title']) ? $_POST['title'] : "";
$first_name = isset($_POST['first_name']) ? $_POST['first_name'] : "";
$surname = isset($_POST['surname']) ? $_POST['surname'] : "";
$address_line_1 = isset($_POST['address_line_1']) ? $_POST['address_line_1'] : "";
$address_line_2 = isset($_POST['address_line_2']) ? $_POST['address_line_2'] : "";
$town = isset($_POST['town']) ? $_POST['town'] : "";
$county = isset($_POST['county']) ? $_POST['county'] : "";
$postcode = isset($_POST['postcode']) ? $_POST['postcode'] : "";
$email = isset($_POST['email']) ? $_POST['email'] : "";
$tel = isset($_POST['tel']) ? $_POST['tel'] : "";
$same_address = isset($_POST['same_address']) ? $_POST['same_address'] : "";
$property_address_1 = isset($_POST['property_address_1']) ? $_POST['property_address_1'] : "";
$property_address_2 = isset($_POST['property_address_2']) ? $_POST['property_address_2'] : "";
$property_town = isset($_POST['property_town']) ? $_POST['property_town'] : "";
$property_county = isset($_POST['property_county']) ? $_POST['property_county'] : "";
$property_postcode = isset($_POST['property_postcode']) ? $_POST['property_postcode'] : "";
$type = isset($_POST['type']) ? $_POST['type'] : "";
$built_form = isset($_POST['built_form']) ? $_POST['built_form'] : "";
$bedrooms = isset($_POST['bedrooms']) ? $_POST['bedrooms'] : "";
$built = isset($_POST['built']) ? $_POST['built'] : "";
$conservation = isset($_POST['conservation']) ? $_POST['conservation'] : "";
$extensions = isset($_POST['extensions']) ? $_POST['extensions'] : "";
$preferred_day = isset($_POST['preferred_day']) ? $_POST['preferred_day'] : "";
$comments = isset($_POST['comments']) ? $_POST['comments'] : "";
$error = false;
if (strlen($title)<2) {
$error = true;
$error1 = errorTitle;
}
if (strlen($first_name)<2) {
$error = true;
$error2 = errorFirstName;
}
if (strlen($surname)<2) {
$error = true;
$error3 = errorSurname;
}
if (strlen($address_line_1)<2) {
$error = true;
$error4 = errorAddressLine1;
}
if (strlen($address_line_2)<2) {
$error = true;
$error5 = errorAddressLine2;
}
if (strlen($town)<3) {
$error = true;
$error6 = errorTown;
}
if (strlen($county)<3) {
$error = true;
$error7 = errorCounty;
}
if (strlen($postcode)<3) {
$error = true;
$error8 = errorPostcode;
}
if (!isValidEmail($email)) {
$error = true;
$error9 = errorEmail;
}
if (strlen($tel)<3) {
$error = true;
$error10 = errorTel;
}
if (strlen($property_address_1)=="") {
$error = true;
$error11 = errorPAddressLine1;
}
if (strlen($property_address_2)=="") {
$error = true;
$error12 = errorPAddressLine2;
}
// if (strlen($property_town)=="") {
// $error = true;
// $error13 = errorPTown;
// }
// if (strlen($property_county)<3) {
// $error = true;
// $error14 = errorPCounty;
// }
// if (strlen($property_postcode)<3) {
// $error = true;
// $error15 = errorPPostcode;
// }
if (strlen($type)=="") {
$error = true;
$error16 = errorType;
}
if (strlen($built_form)=="") {
$error = true;
$error17 = errorBuiltForm;
}
if (strlen($bedrooms)=="") {
$error = true;
$error18 = errorBedrooms;
}
if (strlen($built)=="") {
$error = true;
$error19 = errorBuilt;
}
if (strlen($conservation)=="") {
$error = true;
$error20 = errorConservation;
}
if (strlen($extensions)=="") {
$error = true;
$error21 = errorExtensions;
}
if (strlen($preferred_day)=="") {
$error = true;
$error22 = errorPreferredDay;
}
if (strlen($comments)=="") {
$error = true;
$error23 = errorComments;
}
if ($error){
createForm($title,$first_name,$surname,$address_line_1,$address_line_2,$town,$county,$postcode,$email,$tel,$same_address,$property_address_1,$property_address_2,$property_town,$property_county,$property_postcode,$type,$built_form,$bedrooms,$built,$conservation,$extensions,$preferred_day,$comments,$error1,$error2,$error3,$error4,$error5,$error6,$error7,$error8,$error9,$error10,$error11,$error12,$error13,$error14,$error15,$error16,$error17,$error18,$error19,$error20,$error21,$error22);
}
else {
sendMail($title,$first_name,$surname,$address_line_1,$address_line_2,$town,$county,$postcode,$email,$tel,$same_address,$property_address_1,$property_address_2,$property_town,$property_county,$property_postcode,$type,$built_form,$bedrooms,$built,$conservation,$extensions,$preferred_day,$comments);
?>
<div id="contact_submission">
<img src="images/book_sent.jpg" height="174" width="261">
<h3>Thank you for your booking!</h3>
<p><small>You will be contacted by a member of staff shortly to confirm a time and date!</small></p>
</div>
<?php
}
}
?>