rendered paste body
<center><img src="http://indianaclassifiedads.com/banner.jpg"></center>
<div style="float:left; margin:2.5em" >
<form method="post" action="<?php echo $_SERVER['']?>">
<table>
<tr>
<td width="320px">Thank you for taking the time to get to know us better. We invite you to offer any comments or suggestions on how we can better serve you by using the email form below.
</td>
</tr>
</table>
<table>
<tr>
<td height="8" width="90px" align="right" valign="middle" bgcolor="#FFFFCC" nowrap class="light-brown" style="padding-left: 4px; padding-right: 4px; padding-top: 4px; padding-bottom: 4px"><span class="section-txt"><strong>Name:</strong></span></td><td><input type="text" name="fromEmail" size="25"></td>
</tr>
<tr>
<td height="8" width="90px" align="right" valign="middle" bgcolor="#FFFFCC" nowrap class="light-brown" style="padding-left: 4px; padding-right: 4px; padding-top: 4px; padding-bottom: 4px"><span class="section-txt"><strong>E-mail:
</strong></span></td><td><input type="text" name="name" size="25"></td>
</tr>
</table>
<table>
<tr>
<td height="8" width="90px" align="right" valign="middle" bgcolor="#FFFFCC" nowrap class="light-brown" style="padding-left: 4px; padding-right: 4px; padding-top: 4px; padding-bottom: 4px"><span class="section-txt"><strong>Subject
</strong></span></td>
<td>
<select size="1" name="subject">
<option value="" selected>Select</option>
<option value="Feedback">Feedback</option>
<option value="Suggestions">Suggestions</option>
<option value="Complain">Complaint</option>
<option value="Questions">Questions</option>
<option value="Billing">Billing</option>
</select>
</td>
</tr>
<table>
Your Message:<br>
<textarea cols="35" rows="5" name="message">Message Here</textarea>
<input type="submit" value="Submit"></table>
</form></div>
<td valign="top" bgcolor="#30414E" class="body" style="padding:10px;"><div style="width:475px;">
<div>
<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr>
<td class="result-cell-border" valign="bottom"> </td>
<td class ="result-cell-border" height="73" colspan="2"><p><strong>Support, Billing, and Contact information located below. These our are direct e-mail links to the company.</strong>
</p>
</tr>
<tr>
<td class="result-cell-border" valign="bottom"> </td>
<td class="result-cell-border" height="73" valign="bottom" width="233">Feedback <br>
<br></td>
<td class="result-cell-border" valign="middle"><a href="mailto:feedback@indianaclassifiedads.com">Feedback@indianaclassifiedads.com</a></td>
</tr>
<tr>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="middle"> </td>
</tr>
<tr>
<td class="result-cell-border" valign="bottom" width="30"> </td>
<td class="result-cell-border" height="73" valign="bottom" width="233">Suggestions
<br>
<br></td>
<td class="result-cell-border" valign="middle"><p><a href="mailto:suggestions@indianaclassifieds.com">Suggestions@indianaclassifieds.com</font></a></p></td>
</tr>
<tr>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="middle"> </td>
</tr>
<tr>
<td class="result-cell-border" valign="bottom" width="30"> </td>
<td class="result-cell-border" height="73" valign="bottom" width="233">Complaints
<br>
<br> </td>
<td class="result-cell-border" valign="middle"><a href="mailto:complaint@indianaclassifiedads.com">Complaint@indianaclassifiedads.com</td>
</tr>
<tr>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="middle"> </td>
</tr>
<tr>
<td class="result-cell-border" valign="bottom"> </td>
<td class="result-cell-border" height="73" valign="bottom">Questions<br>
<br></td>
<td class="result-cell-border" valign="middle"><a href="questions@indianaclassifiedads.com">Questions@indianaclassifiedads.com</a>
</td>
</tr>
<tr>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="middle"> </td>
</tr>
<tr>
<td class="result-cell-border" valign="bottom" width="30"> </td>
<td class="result-cell-border" height="73" valign="bottom" width="233">Billing<br>
<br></td>
<td class="result-cell-border" valign="middle"><a href="mailto:billing@indianaclassifiedads.com" rel="nofollow">Billing@indianaclassifiedads.com<br>
</a></td>
</tr>
<tr>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="bottom"> </td>
<td class="result-cell-border" height="5" valign="middle"> </td>
</tr>
</table></div>
<?php
$recipient = 'tdd1984@yahoo.com';
$subject = $_POST['subject'];
$from = $_POST['name'];
$msg = "Message from: $from\n\n".$_POST['message'];
mail($recipient, $subject, $msg);
?>
</body>
</html>