<html>
<head>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=utf-8">
<meta name="GENERATOR" content="Microsoft FrontPage 4.0">
<meta name="ProgId" content="FrontPage.Editor.Document">
<title>Formularz Kontaktowy</title>
</head>
<body>
<p align="center">
<div align="right">
<form action="http://www.tienspolska.com/ftp/test2.php" name="form" method="post">
<center>
<table border="0" cellpadding="0" cellspacing="1" width="322" height="533" bgcolor="#EDFCE0" style="border: 0 double #008000">
<tr>
<td width="627" height="30" colspan="4" bordercolor="#00FFFF" bgcolor="#BCE184">
<p align="center"><font color="#FFFFFF"><b>Formularz Kontaktowy</b></font> </td>
</tr>
<tr>
<td width="193" height="40" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Imię i
Nazwisko: </font> </td>
<td width="759" colspan="3" height="40"> <input type="text" name="name" size="55"></td>
</tr>
<tr>
<td width="193" height="25" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Ulica:</font></td>
<td width="418" colspan="3" height="25"> <input type="text" name="ulica" size="55"></td>
</tr>
<tr>
<td width="193" height="40" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Nr domu:</font></td>
<td width="137" height="40"> <input type="text" name="numer" size="10"></td>
<td width="198" height="40">
<p align="center"><font face="Arial" size="2">Kod pocztowy:</font></td>
</center>
<td width="424" height="40">
<p align="left"><input type="text" name="kod" size="14"></td>
</tr>
<center>
<tr>
<td width="193" height="26" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Miejscowość: </font> </td>
<td width="759" colspan="3" height="26"> <input type="text" name="miejscowosc" size="55"></td>
</tr>
<tr>
<td width="193" height="25" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Twoj Email:</font></td>
<td width="759" colspan="3" height="25"> <input type="text" name="email" size="55"></td>
</tr>
<tr>
<td width="193" height="40" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Jak mamy Ci
odpowiedzieć?</font></td>
<td width="759" colspan="3" height="40"> <select size="1" name="select">
<option selected>E-mail zwrotny</option>
<option>Telefonicznie
</option>
</select> <font size="2" face="Arial"> nr tel. </font><font size="1">
</font><input type="text" name="tel" size="12"></td>
</tr>
<tr>
<td width="193" height="40" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Temat
wiadomoćci: </font>
</td>
<td width="759" colspan="3" height="40"> <select size="1" name="subject">
<option selected>Pytanie odnośnie produktów firmy Tiens</option>
<option>Karta Klienta Firmy Tiens - informacje</option>
<option>Zamówienie</option>
<option>Reklamacje</option>
<option>Inny</option>
</select></td>
</tr>
<tr>
<td width="193" height="271" style="border-right-style: double" bordercolor="#BCE184" bordercolorlight="#EDFCE0" bordercolordark="#BCE184"><font size="2" face="Arial">Treść
wiadomoćci:</font></td>
<td width="759" colspan="3" height="271" style="border-top-style: double" bordercolor="#BCE184"><textarea rows="13" name="tresc" cols="50"></textarea></td>
</tr>
<tr>
<td width="902" height="27" colspan="4" align="center" bgcolor="#BCE184">
<input type="submit" value=" Wyślij " style="border-style: double; border-color: #008000"></td>
<input type="reset" value="reset">
</tr>
</table>
</center>
</div>
<p align="left">
<p align="left">
<p align="left"><br>
</p>
</form>
</body>
</html>
<?php
header("Content-type: text/html; charset=utf-8");
$name = $_POST['name'];
$ulica = $_POST['ulica'];
$numer = $_POST['numer'];
$kod = $_POST['kod'];
$miejscowosc = $_POST['miejscowosc'];
$email = $_POST['email']; //email tego kto ma pytanie
$select = $_POST['select'];
$tel = $_POST['tel'];
$tresc = $_POST['tresc'];
$error = "nie wszystkie pola są wypełnione";
/////////////////////////////////////////////////////////////
if($name=='')
{
}
else
{
//adresaci
$do = " wiadomo ".",";
$do .= " wiadomo ";
// temat maila
$subject = $_POST['subject'];
// wiadomosc
$wiadomosc .= '
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<meta name="GENERATOR" content="Microsoft FrontPage 4.0">
<meta name="ProgId" content="FrontPage.Editor.Document">
<title>Tytuł tej wiadomosci:</title>
</head>
<body>
<div align="left">
<table border="0" cellpadding="0" cellspacing="1" width="528" height="158">
<tr>
<td width="155" height="20" align="left"><b>Imie i Nazwisko:</b></td>
<td width="363" height="20" align="left">'.$name.'</td>
</tr>
<tr>
<td width="155" height="21" align="left"><b>Adres:</b></td>
<td align="left" width="359">'.$ulica.' '.$numer.'</td>
</tr>
<tr>
<td width="155" height="21" align="left"></td>
<td align="left" width="359">'.$kod.' '.$miejscowosc.'</td>
</tr>
<tr>
<td width="155" height="19" align="left"><b>Kotnakt:</b></td>
<td width="359" height="19" align="left">e-mail: '.$email.'</td>
</tr>
<tr>
<td width="155" height="21" align="left"></td>
<td width="363" height="21" align="left">tel: '.$tel.'</td>
</tr>
<tr>
<td width="155" height="21" align="left"><b>Forma odpowiedzi:</b></td>
<td width="363" height="21" align="left">'.$select.'</td>
</tr>
<tr>
<td width="155" height="21" align="left"><b><font color="#000080">Temat:</font></b></td>
<td width="363" height="21" align="left"><font color="#000080"><b>'.$subject.'</b></font></td>
</tr>
<tr>
<td width="522" height="21" colspan="2" align="left">
<p align="left">--------------------------------------------------------------</td>
</tr>
<tr>
<td width="522" height="21" colspan="2" align="left"><i>'.$tresc.'</i></td>
</tr>
</table>
</div>
</body>
</html>
';
//naglowki:
$naglowki = "MIME-Version: 1.0rn";
$naglowki .= "Content-type: text/html; charset=utf-8rn";
//dodatkowy naglowek
$naglowki .= "From: tienspolska.com <adiscann@wp.pl>rn";
//$naglowki .= "Cc: wiadomo rn";
//$naglowki .= "Bcc: wiadomo rn";
mail ($do,$subject,$wiadomosc,$naglowki);
//print_r($_POST);
};
?>