fas
By: fas | Date: Sep 24 2008 18:09 | Format: PHP | Expires: never | Size: 3.11 KB | Hits: 1123
- <?php
- $insert = "INSERT INTO bloem_db (a_voornaam, a_achternaam, a_adres, a_postcode, a_email, v_voornaam, v_achternaam, v_adres, v_postcode, v_email, bericht)
- values ('". $_POST["a_voornaam"] ."', '". $_POST["a_achternaam"] ."', '". $_POST["a_adres"] ."', '". $_POST["a_postcode"] ."', '". $_POST["a_email"] ."', '". $_POST["v_voornaam"] ."', '". $_POST["v_achternaam"] ."', '". $_POST["v_adres"] ."', '". $_POST["v_postcode"] ."', '". $_POST["v_email"] ."', '". $_POST["bericht"] ."')";
- echo "<h3>U aanvraag is verstuurd.</h3>";
- } else echo "Your form has not been submitted.";
- } else {
- echo "You better check the checkbox.";
- }
- } else {
- echo "<form action="index.php" method="post" name="form">";
- echo "<label for="Naam" id="Naam">Voornaam*</label>";
- echo "<input type="text" name="a_voornaam" size="49"/>";
- echo "<br />";
- echo "<label for="Achternaam" id="Achternaam">Achternaam*</label>";
- echo "<input name="a_achternaam" type="text" size="49" />";
- echo "<br />";
- echo "<label for="Adres" id="Adres">Adres*</label>";
- echo "<input type="text" name="a_adres" size="49"/>";
- echo "<br />";
- echo "<label for="Postcode" id="Postcode">Postcode*</label>";
- echo "<input type="text" name="a_postcode" size="49"/>";
- echo "<br />";
- echo "<label for="Email" id="Email">Email*</label>";
- echo "<input type="text" name="a_email"size="49" />";
- echo "<br />";
- echo "<br />";
- echo "<br />";
- echo "<br style="margin-bottom:1em;" />";
- echo "<label for="Voornaam2" id="Voornaam2">Voornaam*</label>";
- echo "<input type="text" name="v_voornaam" size="49"/>";
- echo "<br />";
- echo "<label for="Achternaam2" id="Achternaam2">Achternaam*</label>";
- echo "<input type="text" name="v_achternaam" size="49"/>";
- echo "<br />";
- echo "<label for="Adres2" id="Adres2">Adres*</label>";
- echo "<input type="text" name="v_adres" size="49"/>";
- echo "<br />";
- echo "<label for="Postcode2" id="Postcode2">Postcode*</label>";
- echo "<input type="text" name="v_postcode" size="49"/>";
- echo "<br />";
- echo "<label for="Email2" id="Email2">Email*</label>";
- echo "<input type="text" name="v_email" size="49"/>";
- echo "<br />";
- echo "<label for="Berichtje" id="Berichtje" >Berichtje*</label>";
- echo "<input type="text" size="49" name="bericht" value=""/>";
- echo "<br />";
- echo "<label><INPUT TYPE="checkbox" NAME="checkbox" VALUE="1"></label> <b>Ik ga akkoord met de algemene voorwaarden.</b>";
- echo "<p>";
- echo "<input type="submit" name="submit" value="Create user" class="submit-button" />";
- echo "</p>";
- echo "</form>";
- }
- ?>
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