http://www.klaverportalen.dk/send.phpSource:
<html>
<head>
<title>Untitled Document</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<link rel="stylesheet" href="/css/general.css">
<script language="JavaScript">
<!--
function MM_openBrWindow(theURL,winName,features) { //v2.0
window.open(theURL,winName,features);
}
//-->
</script>
</head>
<body bgcolor="#003366" text="#FFFFFF" link="#FFFFFF" class="text" vlink="#FFFFFF" alink="#FFFFFF" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<form name="form1" method="post" action=<? echo $PHP_SELF =$_SERVER['PHP_SELF']; ?>>
<table width="100%" border="0" cellspacing="0" cellpadding="0" align="center" class="text">
<tr>
<td width="45%">Firma:</td>
<td width="55%">
<input type="text" name="firma" size="40">
</td>
</tr>
<tr>
<td width="45%">Kontaktperson:</td>
<td width="55%">
<input type="text" name="navn" size="40">
</td>
</tr>
<tr>
<td width="45%">Adresse:</td>
<td width="55%">
<input type="text" name="adresse1" size="40">
</td>
</tr>
<tr>
<td width="45%">Adresse:</td>
<td width="55%">
<input type="text" name="adresse2" size="40">
</td>
</tr>
<tr>
<td width="45%">Postnummer og By:</td>
<td width="55%">
<input type="text" name="postnr" size="3">
<input type="text" name="by" size="31">
</td>
</tr>
<tr>
<td width="45%" height="11">Email:</td>
<td width="55%" height="11">
<input type="text" name="email" size="40">
</td>
</tr>
<tr>
<td width="45%">Link til eksisterende hjemmeside:</td>
<td width="55%"><input type="text" name="link" size="40"> </td>
</tr>
<tr>
<td width="45%">Kontakt mig for hjemmeside:</td>
<td width="55%">
<input type="checkbox" name="kontaktes" value="checkbox">
</td>
</tr>
<tr>
<td width="45%"> </td>
<td width="55%">
<input type="submit" name="Send" value="Send tilmelding">
<input type="reset" name="slet" value="Slet">
</td>
</tr>
</table>
</form>
<?
if (isset($firma) && isset($navn) && isset($email)) {
mail("postmaster@klaverportalen.dk", "Mail fra hjemmesiden", "Firma: $firma\nNavn: $adresse1\nAdresse: $adresse2\nPostnr.: $postnr\nBy: $by\nEmail: $link\nLink: $email\n$kontaktes", "From:$email");
echo "Din tilmelding er sendt og vi vil kontakte Dem snarest muligt.";
} else{
echo "<center>Udfyld venligst alle felter</center>";
?>
<?PHP
}
?>
<br>
<a href="#" onClick="MM_openBrWindow('/hjemmeside.htm','','width=400,height=400')">Hjemmeside-info??</a>
</body>
</html>