Okay, this is really weird. When I click submit on this form it doesn’t submit. It just reloads the page and displays the empty form. So, I fill the form out again, and this time it works.
Now, what’s even weirder is that after the form submitted, I copied the url and pasted it into IE just to test it there. And it showed my thank you message, as if I had submitted the form. WTF?
Any help on this would be greatly appreciated.
<?php
print '<h1>Mission Trip Application</h1>';
if(isset($_POST['submit']))
{
$area_1 = $_POST['area_1'];
$area_3 = $_POST['area_3'];
$area_2 = $_POST['area_2'];
$area_4 = $_POST['area_4'];
$dates_1 = $_POST['dates_1'];
$dates_3 = $_POST['dates_3'];
$dates_2 = $_POST['dates_2'];
$dates_4 = $_POST['dates_4'];
$medical = $_POST['medical'];
$dental = $_POST['dental'];
$evangelism = $_POST['evangelism'];
$construction = $_POST['construction'];
$medical_title = $_POST['medical_title'];
$contact_time = $_POST['contact_time'];
$contact_type = $_POST['contact_type'];
$name = $_POST['name'];
$work_phone = $_POST['work_phone'];
$home_phone = $_POST['home_phone'];
$email = $_POST['email'];
$address = $_POST['address'];
$city = $_POST['city'];
$state = $_POST['state'];
$zip = $_POST['zip'];
$headers = 'MIME-Version: 1.0' . "\r\n";
$headers .= 'Content-type: text/html; charset=iso-8859-1' . "\r\n";
$headers .= 'From:' . $name . ' - <' . $email . '>' . "\r\n";
$subject = 'Evangelistic International Ministries - Mission Trip Application';
$message = '<h1>Mission Trip Application</h1>
<table border="0" width="600px">
<tr>
<td colspan="2">I am interested in the following geographical areas:</td>
</tr>
<tr>
<td width="232">1. ' . $area_1 . '</td>
<td width="190">3. ' . $area_3 . '</td>
</tr>
<tr>
<td>2. ' . $area_2 . '</td>
<td>4. ' . $area_4 . '</td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="2">The possible dates or time of year that I would most likely be available:</td>
</tr>
<tr>
<td>1. ' . $dates_1 . '</td>
<td>3. ' . $dates_3 . '</td>
</tr>
<tr>
<td>2. ' . $dates_2 . '</td>
<td>4. ' . $dates_4 . '</td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="2">I would be interested in a: </td>
</tr>
<tr>
<td colspan="2"> ' . $medical . '</td>
</tr>
<tr>
<td colspan="2"> ' . $dental . '</td>
</tr>
<tr>
<td colspan="2"> ' . $evangelism . '</td>
</tr>
<tr>
<td colspan="2"> ' . $construction . '</td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>What is your medical title and specialty?</td>
<td> ' . $medical_title . '</td>
</tr>
<tr>
<td valign="top">Best time to contact:</td>
<td>
' . $contact_time . '
<br />
' . $contact_type . '</td>
</tr>
<tr>
<td>Name:</td>
<td> ' . $name . '</td>
</tr>
<tr>
<td>Work Phone:</td>
<td> ' . $work_phone . '</td>
</tr>
<tr>
<td>Home Phone:</td>
<td> ' . $home_phone . '</td>
</tr>
<tr>
<td>Email:</td>
<td> ' . $email . '></td>
</tr>
<tr>
<td>Address:</td>
<td> ' . $address . '</td>
</tr>
<tr>
<td>City:</td>
<td> ' . $city . '</td>
</tr>
<tr>
<td>State:</td>
<td> ' . $state . '</td>
</tr>
<tr>
<td>Zip:</td>
<td> ' . $zip . '</td>
</tr>
</table>';
if(isset($medical))
{
$to = '...';
}
else
{
$to = '...';
}
mail($to, $subject, $message, $headers);
print 'Thank you';
}
else
{
print '<form method="post">
<table border="0">
<tr>
<td colspan="2">I am interested in the following geographical areas:</td>
</tr>
<tr>
<td width="232">1. <input type="text" name="area_1" /></td>
<td width="190">3. <input type="text" name="area_3" /></td>
</tr>
<tr>
<td>2. <input type="text" name="area_2" /></td>
<td>4. <input type="text" name="area_4" /></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="2">The possible dates or time of year that I would most likely be available:</td>
</tr>
<tr>
<td>1. <input type="text" name="dates_1" /></td>
<td>3. <input type="text" name="dates_3" /></td>
</tr>
<tr>
<td>2. <input type="text" name="dates_2" /></td>
<td>4. <input type="text" name="dates_4" /></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="2">I would be interested in a: </td>
</tr>
<tr>
<td colspan="2"><input type="checkbox" name="medical" value="Medical/Surgical"/>Medical/Surgical</td>
</tr>
<tr>
<td colspan="2"><input type="checkbox" name="dental" value="Dental"/>Dental</td>
</tr>
<tr>
<td colspan="2"><input type="checkbox" name="evangelism" value="Evangelism"/>Evangelism</td>
</tr>
<tr>
<td colspan="2"><input type="checkbox" name="construction" value="Construction Project" />Construction Project</td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>What is your medical title and specialty?</td>
<td><input type="text" name="medical_title" /></td>
</tr>
<tr>
<td valign="top">Best time to contact:</td>
<td>
<input type="text" name="contact_time" />
<br />
<input type="radio" name="contact_type" value="Home" />
Home
<input type="radio" name="contact_type" value="Work" />
Work</td>
</tr>
<tr>
<td>Name:</td>
<td><input type="text" name="name" /></td>
</tr>
<tr>
<td>Work Phone:</td>
<td><input type="text" name="work_phone" /></td>
</tr>
<tr>
<td>Home Phone:</td>
<td><input type="text" name="home_phone" /></td>
</tr>
<tr>
<td>Email:</td>
<td><input type="text" name="email" /></td>
</tr>
<tr>
<td>Address:</td>
<td><input type="text" name="address" /></td>
</tr>
<tr>
<td>City:</td>
<td><input type="text" name="city" /></td>
</tr>
<tr>
<td>State:</td>
<td><input type="text" name="state" /></td>
</tr>
<tr>
<td>Zip:</td>
<td><input type="text" name="zip" /></td>
</tr>
<tr>
<td></td>
<td><input type="submit" name="submit" value="Submit" /></td>
</tr>
</table>
</form>';
}
?>
MODX Staff