Hi,
I have an situation on my hands I have a form that I am stuck using PHP for
thanks to my friends choice of hosting company, I have no idea on how to
setup a form in PHP other than HTML or in Flash, I need some one any one
to give me some advice on this Posted layout it seems to work but not
really,
I managed to get it set up but for some reason when you hit Submit and an
error message goes off at the top the form is Reset. Other than that I am
not
sure I wrote all the code correctly.
Sorry About the long post....
Any advice would be great.
www.mdycentrutionmtg.com/formtest.php
------------------------Formtest.php------------------------------
<?PHP
if ($submit) {
if ($firstname <= "")
$message = "Please enter your first name.";
else
if ($lastname <= "")
$message = "Please enter your last name.";
else
if ($homephone <= "")
$message = "Please enter your home phone number.";
else
if ($address <= "")
$message = "Please enter your current home address.";
else
if ($city <= "")
$message = "Please enter which city you currently live in.";
else
if ($state <= "")
$message = "Please enter which state you currently live in.";
else
if ($zip <= "")
$message = "Please enter your zip code.";
else
if ($monthlypayment <= "")
$message = "Please enter the amount of your monthly payment.";
else
if ($presentemployer <= "")
$message = "Please enter the name of your present employer.";
else
if ($rateofpay <= "")
$message = "Please enter your rate of pay.";
else
if ($hoursperweek <= "")
$message = "Please enter the average amount of hours worked in a week.";
else
if ($deposit <= "")
$message = "Please enter the amount of your deposit.";
else
if ($maxpayment <= "")
$message = "Please enter an average payment your comfortable with.";
if ($message)
echo ($yo);
else {
mail("[EMAIL PROTECTED]",
"Form Results",
"First Name $firstname",
"Middle Initial $middleinital",
"Last Name $lastname",
"Social Security Number $ss",
"Marital Status $maritalstatus",
"Home Phone $homephone",
"Address $address",
"City $city",
"State $state",
"Zip $zip",
"Apt Number $apt",
"Time at address $monthsataddress Months $yearsataddress Years",
"Type of residence $typeofres",
"Monthly Payment $monthlypayment",
"Current Employer $presentemployer",
"Time with Employer $monthswithemployer Months $yearswithemployer Years",
"Rate of Pay $rateofpay Dollars per $rateofpayper",
"Hours per week $hoursperweek",
"Work Phone $workphone",
"Work History $workhistory",
"Other Income $otherincome",
"Deposit $deposit",
"Maximum Payment $maxpayment",
"Type of Loan $typeofloan",
"Co First Name $cofirstname",
"Co Middle Initial $comiddleinital",
"Co Last Name $colastname",
"Co Social Security Number $coss",
"Co Marital Status $comaritalstatus",
"Co Home Phone $cohomephone",
"Co Address $coaddress",
"Co City $cocity",
"Co State $costate",
"Co Zip $cozip",
"Co Apt Number $coapt",
"Co Time at address $comonthsataddress Months $coyearsataddress Years",
"Co Type of residence $cotypeofres",
"Co Monthly Payment $comonthlypayment",
"Co Current Employer $copresentemployer",
"Co Time with Employer $comonthswithemployer Months $coyearswithemployer
Years",
"Co Rate of Pay $corateofpay Dollars per $corateofpayper",
"Co Hours per week $cohoursperweek",
"Co Work Phone $coworkphone",
"From: $firstname $lastname",
"Subject: Online Form Application");
$message = "Thank You.";
}
}
?>
<html>
<head>
<title>Centurion Loan Form</title>
</head>
<body bgcolor="#71c4ca">
<form method="post">
<p>
<div align="center">
<table border="0" cellpadding="0" cellspacing="0" width="660">
<tr>
<td colspan="2">
<div align="center">
<b>Loan Form</b>
<address><font size="-2">Please fill in all the fields below to the
best of your knowledge if you have any questions </font><font
size="-2">please feel free to call me at 248-770-7518<br>
</font></address>
</div>
<address>
<div align="center">
<font size="2"><?php echo $message; ?></font></div>
<p>
</p>
</address>
</td>
</tr>
<tr>
<td>
<p>Borrower</p>
</td>
<td>Co-Borrower</td>
</tr>
<tr>
<td>
</td>
<td></td>
</tr>
<tr>
<td>First Name</td>
<td>First Name</td>
</tr>
<tr>
<td><input type="text" name="firstname" size="25" maxlength="30"
tabindex="1"> MI <input type="text" name="middleinitial" size="2"
maxlength="2" tabindex="2"></td>
<td><input type="text" name="cofirstname" size="25" maxlength="30"
tabindex="23"> MI <input type="text" name="comiddleinitial" size="2"
maxlength="2" tabindex="24"></td>
</tr>
<tr>
<td>Last Name</td>
<td>Last Name</td>
</tr>
<tr>
<td><input type="text" name="lastname" size="25" maxlength="30"
tabindex="3"></td>
<td><input type="text" name="colastname" size="25" maxlength="30"
tabindex="25"></td>
</tr>
<tr>
<td>
<p>S.S. #</p>
</td>
<td>
<p>S.S. #</p>
</td>
</tr>
<tr>
<td>
<p><input type="text" name="ss" size="25" maxlength="11"
tabindex="4"></p>
</td>
<td>
<p><input type="text" name="coss" size="25" maxlength="11"
tabindex="26"></p>
</td>
</tr>
<tr>
<td>Marital status</td>
<td>Marital status</td>
</tr>
<tr>
<td><select name="maritalstatus" size="1" tabindex="5">
<option value="Single" selected>Single</option>
<option value="Married">Married</option>
<option value="Divorced">Divorced</option>
<option value="In the process of devorce">In the process of
devorce</option>
</select></td>
<td><select name="comaritalstatus" size="1" tabindex="27">
<option value="Single" selected>Single</option>
<option value="Married">Married</option>
<option value="Divorced">Divorced</option>
<option value="In the process of devorce">In the process of
devorce</option>
</select></td>
</tr>
<tr>
<td>Home phone number</td>
<td>Home phone number</td>
</tr>
<tr>
<td><input type="text" name="homephone" size="25" maxlength="25"
value="" tabindex="6"></td>
<td><input type="text" name="cohomephone" size="25" maxlength="25"
value="" tabindex="28"></td>
</tr>
<tr>
<td>Present address</td>
<td>Present address</td>
</tr>
<tr>
<td><input type="text" name="address" size="32" maxlength="36"
value="" tabindex="7"></td>
<td><input type="text" name="coaddress" size="32" maxlength="36"
value="" tabindex="29"></td>
</tr>
<tr>
<td>City</td>
<td>City</td>
</tr>
<tr>
<td><input type="text" name="city" size="20" maxlength="20" value=""
tabindex="8"> State <input type="text" name="state" size="4" maxlength="2"
value="" tabindex="9"></td>
<td><input type="text" name="cocity" size="20" maxlength="20" value=""
tabindex="30"> State <input type="text" name="costate" size="4"
maxlength="2" value="" tabindex="31"></td>
</tr>
<tr>
<td>Zip code</td>
<td>Zip code</td>
</tr>
<tr>
<td><input type="text" name="zip" size="6" maxlength="12" value=""
tabindex="10"> Apt. # <input type="text" name="apt" size="5" maxlength="12"
value="" tabindex="11"></td>
<td><input type="text" name="cozip" size="5" maxlength="12" value=""
tabindex="32"> Apt. # <input type="text" name="coapt" size="5"
maxlength="12" value="" tabindex="33"></td>
</tr>
<tr>
<td>Time at this address</td>
<td>Time at this address</td>
</tr>
<tr>
<td><input type="text" name="monthsataddress" size="4" maxlength="2"
value="" tabindex="12"> Months <input type="text" name="yearsataddress"
size="4" maxlength="2" value="" tabindex="13"> Years</td>
<td><input type="text" name="comonthsataddress" size="4" maxlength="2"
value="" tabindex="34"> Months <input type="text" name="coyearsataddress"
size="4" maxlength="2" value="" tabindex="35"> Years</td>
</tr>
<tr>
<td>Type of residence</td>
<td>Type of residence</td>
</tr>
<tr>
<td><select name="typeofres" size="1" tabindex="14">
<option value="Rent" selected>Rent</option>
<option value="Own">Own</option>
</select></td>
<td><select name="cotypeofres" size="1" tabindex="36">
<option value="Co-Rent" selected>Rent</option>
<option value="Co-Own">Own</option>
</select></td>
</tr>
<tr>
<td>Amount of monthly payment</td>
<td>Amount of monthly payment</td>
</tr>
<tr>
<td>$<input type="text" name="monthlypayment" size="4" maxlength="4"
value="" tabindex="15"></td>
<td>$<input type="text" name="comonthlypayment" size="4" maxlength="4"
value="" tabindex="37"></td>
</tr>
<tr>
<td>Present employer</td>
<td>Present employer</td>
</tr>
<tr>
<td><input type="text" name="presentemployer" size="25" maxlength="25"
value="" tabindex="16"></td>
<td><input type="text" name="copresentemployer" size="25"
maxlength="25" value="" tabindex="38"></td>
</tr>
<tr>
<td>How long with this employer</td>
<td>How long with this employer</td>
</tr>
<tr>
<td><input type="text" name="monthswithemployer" size="4"
maxlength="2" value="" tabindex="17"> Months <input type="text"
name="yearswithemployer" size="4" maxlength="4" value="" tabindex="18">
Years</td>
<td><input type="text" name="comonthswithemployer" size="4"
maxlength="2" value="" tabindex="39"> Months <input type="text"
name="coyearswithemployer" size="4" maxlength="4" value="" tabindex="40">
Years</td>
</tr>
<tr>
<td>Rate of pay</td>
<td>Rate of pay</td>
</tr>
<tr>
<td>$<input type="text" name="rateofpay" size="3" maxlength="3"
value="" tabindex="19"> / <select name="rateofpayper" size="1"
tabindex="20">
<option value="Hour" selected>Hour</option>
<option value="Week">Week</option>
<option value="Month">Month</option>
</select></td>
<td>$<input type="text" name="corateofpay" size="3" maxlength="3"
value="" tabindex="41"> / <select name="corateofpayper" size="1"
tabindex="42">
<option value="Hour" selected>Hour</option>
<option value="Week">Week</option>
<option value="Month">Month</option>
</select></td>
</tr>
<tr>
<td>Average number of hours / week</td>
<td>Number of hours / week</td>
</tr>
<tr>
<td><input type="text" name="hoursperweek" size="3" maxlength="3"
value="" tabindex="21"></td>
<td><input type="text" name="cohoursperweek" size="3" maxlength="3"
value="" tabindex="43"></td>
</tr>
<tr>
<td>Work phone number</td>
<td>Work phone number</td>
</tr>
<tr>
<td><input type="text" name="workphone" size="25" maxlength="12"
value="" tabindex="22"></td>
<td><input type="text" name="coworkphone" size="25" maxlength="12"
value="" tabindex="44"></td>
</tr>
<tr>
<td colspan="2">Description of two year work history if less than two
years with present employer</td>
</tr>
<tr>
<td colspan="2"><textarea name="workhistory" cols="63" rows="4"
tabindex="45"></textarea></td>
</tr>
<tr>
<td colspan="2">Description of any other income recieved on a monthly
basis</td>
</tr>
<tr>
<td colspan="2"><textarea name="otherincome" cols="63" rows="4"
tabindex="46"></textarea></td>
</tr>
<tr>
<td colspan="2">
<p>Amount of cash available to put down towards a new home</p>
</td>
</tr>
<tr>
<td colspan="2">$<input type="text" name="deposit" size="10"
maxlength="8" value="" tabindex="47"></td>
</tr>
<tr>
<td colspan="2">Maximum payment you are comfortable with for a new
home</td>
</tr>
<tr>
<td colspan="2">$<input type="text" name="maxpayment" size="10"
maxlength="8" value="" tabindex="48"> /Month</td>
</tr>
<tr>
<td colspan="2">
<div align="left">
Please Pick the type of loan your applying for<br>
<select name="typeofloan" size="1" tabindex="49">
<option value="Mortgage loan" selected>Mortgage Loan</option>
<option value="Refinancing">Refinancing</option>
</select>
<p><br>
</p>
</div>
</td>
</tr>
</table>
<input type="submit" name="submit" value="submit" tabindex="50"> <input
type="reset" value="RESET" tabindex="51"></div>
</form>
<p><font color="#71c4ca">Loan Application</font></p>
<p></p>
</body>
</html>
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