· 9 years ago · Jan 25, 2017, 05:04 PM
1<?php session_start(); ?>
2<?php
3// The email address where the form info is submitted
4$serviceEmail = "jiel@admerasia.com";
5
6function validateEmail($email) {
7 if (ereg("^.+@.+\..+$", $email)) {
8 return true;
9 } else {
10 return false;
11 }
12}
13
14function writeSelected($stateSelected, $state) {
15 if ($stateSelected == $state) {
16 echo "selected";
17 }
18}
19
20if ($_POST['submit']) {
21
22 $firstName = trim($_POST['first_name']);
23 $lastName = trim($_POST['last_name']);
24 $title = trim($_POST['title']);
25 $company = trim($_POST['company']);
26 $address = trim($_POST['address']);
27 $city = trim($_POST['city']);
28 $state = $_POST['state'];
29 $zip = trim($_POST['zip']);
30 $emailAddress = trim($_POST['email_address']);
31 $officeNumber = trim($_POST['office_number']);
32 $faxNumber = trim($_POST['fax_number']);
33 $dateFounded = trim($_POST['date_founded']);
34 $otherOffices = trim($_POST['other_offices']);
35
36 $agenciesOffered = $_POST['agencies_offered'];
37 $mediaOffered = $_POST['media_offered'];
38 $advertiserCorprationsOffered = $_POST['advertiser_corporations_offered'];
39 $affiliatedFirmsOffered = $_POST['affiliated_firms_offered'];
40 $otherServiceOffered = $_POST['other_service_offered'];
41 $otherServiceDescription = trim($_POST['other_service_description']);
42
43 $grossBillingsRevenue = $_POST['gross_billings_revenue'];
44 $totalEmployees = $_POST['total_employees'];
45
46 $keyPersonnelTitles = trim($_POST['key_personnel_titles']);
47 $majorAccountsBrands = trim($_POST['major_accounts_brands']);
48
49 if ($firstName == "") {
50 $errorMessage = "Please enter a first name.";
51 $isValid = false;
52 } else if ($lastName == "") {
53 $errorMessage = "Please enter a last name.";
54 $isValid = false;
55 } else if ($company == "") {
56 $errorMessage = "Please enter a company name.";
57 $isValid = false;
58 } else if ($address == "") {
59 $errorMessage = "Please enter an address.";
60 $isValid = false;
61 } else if ($city == "") {
62 $errorMessage = "Please enter a city.";
63 $isValid = false;
64 } else if ($state == "") {
65 $errorMessage = "Please select a state.";
66 $isValid = false;
67 } else if ($zip == "") {
68 $errorMessage = "Please enter a zip.";
69 $isValid = false;
70 } else if (validateEmail($emailAddress) == false) {
71 $errorMessage = "Please enter a valid email address.";
72 $isValid = false;
73 } else if ($officeNumber == "") {
74 $errorMessage = "Please enter an office number.";
75 $isValid = false;
76 } else if ($grossBillingsRevenue == "") {
77 $errorMessage = "Please choose a Category.";
78 $isValid = false;
79 }
80
81 $captcha;
82 if(isset($_POST['g-recaptcha-response'])){
83 $captcha=$_POST['g-recaptcha-response'];
84 }
85 if(!$captcha){
86 echo '<h2>Please check the the captcha form.</h2>';
87 exit;
88 }
89 $secretKey = "6LcpDhMUAAAAAOs8YlIcmbSCusGIifxgcVXeYcI2";
90 $ip = $_SERVER['REMOTE_ADDR'];
91 $response=file_get_contents("https://www.google.com/recaptcha/api/siteverify?secret=".$secretKey."&response=".$captcha."&remoteip=".$ip);
92 $responseKeys = json_decode($response,true);
93 if(intval($responseKeys["success"]) !== 1) {
94 echo '<h2>You are spammer ! Get the @$%K out</h2>';
95 } else {
96 echo '<h2>Thanks for posting comment.</h2>';
97 }
98
99 if ($isValid) {
100 // Send email to new user
101 $from = "From: \"$firstName $lastName\" <$emailAddress>";
102 $subject = "3AF Form Submission";
103
104 $body = "\n";
105 $body .= "First Name: $firstName\n";
106 $body .= "Last Name: $lastName\n";
107 $body .= "Title: $title\n";
108 $body .= "Company: $company\n";
109 $body .= "Address: $address\n";
110 $body .= "City: $city\n";
111 $body .= "State: $state\n";
112 $body .= "Zip: $zip\n";
113 $body .= "Email Address: $emailAddress\n";
114 $body .= "Office Number: $officeNumber\n";
115 $body .= "FAX Number: $faxNumber\n";
116 $body .= "Date Founded: $dateFounded\n";
117 $body .= "Other Full Service Offices:\n$otherOffices\n";
118
119 $body .= "\nServices Offered:\n";
120
121 $body .= $agenciesOffered ? " Agencies\n" : "";
122 $body .= $mediaOffered ? " Media\n" : "";
123 $body .= $advertiserCorprationsOffered ? " Advertiser/Corporations\n" : "";
124 $body .= $affiliatedFirmsOffered ? " Affiliated Firms\n" : "";
125
126 if ($otherServiceOffered) {
127 $body .= " Other: $otherServiceDescription\n\n";
128 }
129
130 $body .= "Categories: $grossBillingsRevenue\n";
131 $body .= "Total Employees: $totalEmployees\n";
132 $body .= "Key Personnel/Titles: $keyPersonnelTitles\n";
133 $body .= "Major Accounts/Brands: $majorAccountsBrands\n";
134
135 $body .= "\n";
136
137 mail($serviceEmail, $subject, $body, $from);
138
139
140 switch ($grossBillingsRevenue) {
141 case "Media, Market Researchers, Suppliers, and other Industry Partners Vendors":
142 $membershipDues = "1,000";
143 break;
144 case "Advertising Agencies, Public Relations Firms and Special Events Companies":
145 $membershipDues = "2,000";
146 break;
147 case "Corporations Advertisers":
148 $membershipDues = "5,000";
149 break;
150 case "Individual":
151 $membershipDues = "500";
152 break;
153 case "Student":
154 $membershipDues = "50";
155 break;
156 }
157
158 header("Location: membership_form_ok.php?membership_dues=$membershipDues");
159 }
160}
161?>
162
163<!-- Paste html here -->