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By: Xmoo | Date: Oct 6 2008 13:33 | Format: PHP | Expires: never | Size: 1.84 KB | Hits: 1281
- {
- $extra = $info->extra;
- echo "".$extra."";
- echo "<br><br><br>";
- }
- ?>
- <?php if ($_SERVER['REQUEST_METHOD'] == 'POST') {
- $insert = "INSERT INTO bloem_actie (product, v_naam, v_adres, v_postcode, v_plaats, v_email)
- values ('". $_POST["product"] ."', '". $_POST["v_naam"] ."', '". $_POST["v_adres"] ."', '". $_POST["v_postcode"] ."', '". $_POST["v_plaats"] ."', '". $_POST["v_email"] ."')";
- echo "<h3>Uw deelname is genoteerd.</h3>";
- }
- else {
- echo "<form action="actie.php" method="post">";
- echo "<label for="Product2" id="Product2">Product*</label>
- <select name="product">
- <option value="1">1</option>
- <option value="2">2</option>
- <option value="3">3</option>
- <option value="4">4</option>
- </select>";
- echo "<br /><br />";
- echo "<label for="Voornaam" id="Voornaam">V/A Naam*</label>";
- echo "<input type="text" name="v_naam" size="49"/>";
- echo "<br />";
- echo "<label for="Adres" id="Adres">Adres + nr.*</label>";
- echo "<input type="text" name="v_adres" size="49"/>";
- echo "<br />";
- echo "<label for="Postcode" id="Postcode">Postcode*</label>";
- echo "<input type="text" name="v_postcode" size="49"/>";
- echo "<br />";
- echo "<label for="Plaats" id="Plaats">Woonplaats*</label>";
- echo "<input type="text" name="v_plaats" size="49"/>";
- echo "<br />";
- echo "<label for="Email" id="Email">Email*</label>";
- echo "<input type="text" name="v_email" size="49"/><br>";
- echo "<center><input type="submit" name="submit" value="" class="submit-button" /></center>";
- echo "</form>";
- }
- ?>
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