Contact us Form

Written by @m_k_amin 21 November 2012

You can create the contact us form for your site. It asks for the visitors name, website, email and inquire that they have; it will send it to the email that you set. Please edit your email on the top of the code and the form is ready!

Code Snippet:

                                                
                                                <!-- this script is provided by www.phpfreecode.com coded by: Kerixa Inc. -->
<!-- This Script is from www.phpfreecpde.com, Coded by: Kerixa Inc-->
<?php
if(isset($_POST['submit_msg'])) 
{
						$admin_email='admin@yourite.com';//// Change it to your site adimin email address

   if (empty($_POST['name_msg'])){ 
      die('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>Error!</i></h1><font color="#ff0000"> <br>caution : please type your name in form</font><br><br><a href  ONCLICK="window.history.go(-1);">Back to form</a><center></font>'); 
   }; 
  if (empty($_POST['email_msg'])){ 
      die('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>Error!</i></h1><font color="#ff0000"> <br>caution : please type your email</font><br><br><a href  ONCLICK="window.history.go(-1);">Back to form</a><center></font>'); 
   }; 
   if (empty($_POST['msg_body'])){ 
      die('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>Error!</i></h1><font color="#ff0000"> <br>caution : please type your text</font><br><br><a href  ONCLICK="window.history.go(-1);">Back to form</a><center></font>'); 
   }; 
   if(!strpos($_POST['email_msg'],"@")) 
   { 
      print('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>Error!</i></h1><font color="#ff0000"> <br>caution : type your Emali correctly</font><br><br><center><font face="Tahoma" style="font-size: 9pt">example : info@phpfreecode.Com </center></font><br><a href ONCLICK="window.history.go(-1);">Back to form</a><center></font>'); 
      die(''); 
   }; 

   $name_msg = htmlspecialchars($_POST['name_msg']); 
   $msg_body = htmlspecialchars($_POST['msg_body']); 
   $url_msg=$_POST['url_msg'];
   $from  = htmlspecialchars($_POST['email_msg']); 

   $url_msg  = str_replace('http://','',$_POST['url_msg']); 
   if (!empty($url_msg)) $name_msg = "<a target=_blank href=http://".htmlspecialchars($url_msg).">".$name_msg."</a>"; 
   $body = '<html>
<head>
<title>Send comment</title>

</head> 
<body> 
<table border="1" width="100%" text="#000000" style="font-family:tahoma;font-size:8pt;padding:7px;border-style: dashed; border-width: 3px" bgcolor="#D6DFF7" bordercolor="#D6DFF7" cellspacing="0" cellpadding="0">
<tr>
<td colspan="2" align="center" bgcolor="#D6DFF7"  style="height: 25px; font-size:small">=&gt; new comment &lt;=</td>
</tr>
<tr>

<td width="15%" bgcolor="#D6DFF7" dir="rtl" style="height: 25px; font-size:small; text-align: left">Name & Web address</td>
<td width="85%"  bgcolor="#FFFFFF" align="left" style="height:25px; font-size:small ">'.$name_msg.'</td>
</tr>
<tr>
<td width="15%" bgcolor="#D6DFF7" dir="rtl" style="height: 25px; font-size:small; text-align: left">Comment</td>
<td width="85%" bgcolor="#FFFFFF" align="left" style="height: 25px; font-size:small ">'.$msg_body.'</td>
</tr>
</table> 
</body> 
</html>'; 
if(!mail($admin_email,'New Contact us',$body,"From: <$from>\n"."MIME-Version: 1.0\n"."Content-type: text/html")) 
{ 
   die('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>The Comment Could not be send!</i></h1>
<font size="5" color="#ff0000"> Please try later</font><br><br><a href ONCLICK="window.history.go(-1);">return to form</a><center></font>'); 
}else 
{ 
   print('<p><p><center><font face="Tahoma" color="#003399" style="font-size: 9pt"><h1><i>Thank You!</i></h1><font color="#ff0000"> <br>Your comment has been sent successfully</font><br>Thanks for your comment<br><br><span style="cursor:hand" ONCLICK="window.history.go(-1);"> return to comment  </span>|  <a href="http://www.phpfreecode.com" target="_blank">powered by phpfreecode.com</a><center></font>'); 
} 

}
?>
<html>
<head>
<style type="text/css">
.style1 {
	text-align: center;
}
.style2 {
	font-size: 40pt;
	color: #0000FF;
	font-family: "Times New Roman", Times, serif;
}
.style3 {
	font-size: medium;
	color: #0000FF;
	font-family: "Times New Roman", Times, serif;
}
.style5 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-top-style: solid;
	border-top-width: 0px;
	background-color: #CCFFFF;
}
.style6 {
	text-align: center;
	border-left-style: solid;
	border-left-width: 0px;
	border-right-style: solid;
	border-right-width: 0px;
	border-top-style: solid;
	border-top-width: 0px;
	background-color: #CCCCFF;
}
.style8 {
	border: 3px dashed #0000CC;
}
.style9 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	background-color: #CCFFFF;
}
.style11 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-bottom-style: solid;
	border-bottom-width: 0px;
}
.style12 {
	font-family: "Times New Roman", Times, serif;
	padding-left: 10px;
	background-color: #CCFFFF;
}
.style13 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	background-color: #D5F1FF;
}
.style15 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-bottom-style: solid;
	border-bottom-width: 0px;
	background-color: #D5F1FF;
}
.style17 {
	font-family: "Times New Roman", Times, serif;
	padding-left: 10px;
	background-color: #D5F1FF;
}
.style18 {
	font-family: "Times New Roman", Times, serif;
	border-left-style: solid;
	border-left-width: 0px;
	padding-left: 10px;
	background-color: #CCFFFF;
	text-align: center;
}
.style19 {
	font-size: xx-small;
}
</style>
</head>
<body>
<form method="post" action="">
<table align="center" class="style8" style="width: 551">
	<tr>
		<td class="style6" colspan="2" style="height: 136px"><span class="style2">
		<strong class="style11">Contact us</strong></span><br class="style3">
		<span class="style3">Tell us what is in your mind</span></td>
	</tr>
	<tr>
		<td class="style12" style="width: 268px; height: 40;"><strong>Your Name:</strong></td>
		<td class="style5" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="name_msg" size="33" id="fa" dir="ltr" tabindex="1" maxlength="30"   lang="fa" style="float: left; width: 204px; height: 25px;" value="" onclick="this.value=''"><div class="style1">
		</div>
		</span> </td>
	</tr>
	<tr>
		<td class="style17" style="width: 268px; height: 40;"><strong>Your Email:</strong></td>
		<td class="style13" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="email_msg" size="33" dir="ltr" tabindex="3" maxlength="30" id="fa1" style="float: left; width:204px; height: 25px;" value="" onclick="this.value=''"></span></td>
	</tr>
	<tr>
		<td class="style12" style="width: 268px; height: 40;"><strong>Your website:</strong></td>
		<td class="style9" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="url_msg" size="21" dir="ltr" tabindex="2" maxlength="30" id="fa0" style="float: left; width: 204px; height: 25px;" value="" onclick="this.value=''"></span></td>
	</tr>
	<tr>
		<td class="style17" style="width: 268px; height: 123px;"><strong>Comment:</strong></td>
		<td class="style15" style="width: 421px; height: 123;"><span dir="ltr">
		<textarea rows="6" name="msg_body" dir="ltr" id="fa2" tabindex="4" lang="fa" onclick="this.value=''" style="width: 400px"></textarea></span></td>
	</tr>
	<tr>
		<td class="style18" style="height: 78px;" colspan="2">
<span dir="ltr">
<input type="submit" value="Submit" name="submit_msg" tabindex="5" id="fa3" style="float:center; width: 114px; height: 35px;" ><br></span>
		<br class="style19"><font face="Tahoma"><a target="_blank" href="http://www.phpfreecode.com/"><span style="font-size: 8pt; text-decoration: none">PHP Free Code</span></a></font>
</td>
	</tr>
</table>
</form>
</body>
</html>
<a target='_blank' href='www.phpfreecode.com' style='font-size: 8pt; text-decoration: none'>Php Best Codes</a>                                                
                                            

Example:


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