<?php
// geef e-mail adres op van ontvanger
$mail_ontv = "
[email protected]";
// is niet 100% !!!
function checkmail($mail)
{
$email_host = explode("@", $mail);
$email_host = $email_host['1'];
$email_resolved = gethostbyname($email_host);
if ($email_resolved != $email_host && eregi("^[0-9a-z]([-_.~]?[0-9a-z])*@[0-9a-z]([-.]?[0-9a-z])*\\.[a-z]{2,4}$",$mail))
$valid = 1;
return $valid;
}
// als er niet op submit is gedrukt, of als er wel op is gedrukt maar niet alles ingevoerd is
if (!$_POST['submit'] || $_POST['submit'] && (!$_POST['naam'] || !checkmail($_POST['mail']) || !$_POST['contactp'] || !$_POST['telefoon']))
{
if ($_POST['submit'] && (!$_POST['naam'] || !$_POST['mail'] || !checkmail($_POST['mail']) || !$_POST['contactp'] || !$_POST['telefoon']))
echo"<P class=\"text\" STYLE=\"background:white; color:red; padding:4px; border-style:solid; border-width:1px; margin:4px; text-align:center;\" >Het formulier is niet volledig ingevuld!</P><br>";
}
// form + tabel <br>
echo "<table border=\"0\" width=450 cellspacing=\"0\" cellpadding=\"0\">";
echo "<form method=\"POST\" ACTION=\"" . $_SERVER['PHP_SELF'] . "\">";
// naam <br>
echo "<tr><td width=150>Bedrijfsnaam: (<font color=red>*</font>)</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"naam\" value=\"" . $_POST['naam'] . "\"></td></tr>";
// space <br>
echo "<tr><td width=150> </td><td width=200> </td></tr>";
// adres
echo "<tr><td width=150>Adres:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"adres\" value=\"" . $_POST['adres'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=200> </td></tr>";
// postcode
echo "<tr><td width=150>Postcode:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"postcode\" value=\"" . $_POST['postcode'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// plaats
echo "<tr><td width=150>Plaats:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"plaats\" value=\"" . $_POST['plaats'] . "\"></td></tr>";
// space
echo "<tr><td width=250> </td><td width=250> </td></tr>";
// telefoon
echo "<tr><td width=250>Telefoon:(<font color=red>*</font>)</td>";
echo "<td width=200><input type=\"text\" STYLE=\"width: 210px\" name=\"telefoon\" value=\"" . $_POST['telefoon'] . "\"></td></tr>";
// space
echo "<tr><td width=250> </td><td width=250> </td></tr>";
// mail
echo "<tr><td width=250>E-mail adres:(<font color=red>*</font>)</td>";
echo "<td width=200><input type=\"text\" STYLE=\"width: 210px\" name=\"mail\" value=\"" . $_POST['mail'] . "\"></td></tr>";
// space
echo "<tr><td width=250> </td><td width=250> </td></tr>";
// Eerste contactpersoon
echo "<tr><td width=150>Contactpersoon:(<font color=red>*</font>)</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"contactp\" value=\"" . $_POST['contactp'] . "\"></td></tr>";
// space
echo "<tr><td> </td></tr>";
// Naam evenement
echo "<tr><td width=150>Naam evenement:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"eventnaam\" value=\"" . $_POST['eventnaam'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// mail
echo "<tr><td width=150>Omschrijving evenement:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"onderwerp\" value=\"" . $_POST['onderwerp'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// lokatie
echo "<tr><td width=150>Lokatie(s):</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"lokatie\" value=\"" . $_POST['lokatie'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// Datum
echo "<tr><td width=150>Datum:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"datum\" value=\"" . $_POST['datum'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// Tijden
echo "<tr><td width=150>Tijden:</td>";
echo "<td width=250><input type=\"text\" STYLE=\"width: 210px\" name=\"tijden\" value=\"" . $_POST['tijden'] . "\"></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// benodigde diensten
echo '<tr><td width=150 valign=top>Benodigde diensten:</td>';
echo '<td width=250>';
echo '<INPUT TYPE="checkbox" NAME="diensten1" VALUE="Dansers">Dansers<br>';
echo '<INPUT TYPE="checkbox" NAME="diensten2" VALUE="Rock and Roll bandje">Rock and Roll bandje<br>';
echo '<INPUT TYPE="checkbox" NAME="diensten3" VALUE="Parkeerbegeleiding">Parkeerbegeleiding<br>';
echo '<INPUT TYPE="checkbox" NAME="diensten4" VALUE="Fotograaf">Fotograaf<br>';
echo '<INPUT TYPE="checkbox" NAME="diensten5" VALUE="Logistieke oplossingen">Logistieke oplossingen<br>';
echo '<INPUT TYPE="checkbox" NAME="diensten7" VALUE="Management">Management<br>';
echo '</td></tr>';
// space
echo "<tr><td width=210> </td><td width=250> </td></tr>";
// mail
echo "<tr><td width=150>Bericht:</td>";
echo "<td width=250><TEXTAREA name=\"msggs\" STYLE=\"width: 210px\" ROWS=\"6\" COLS=\"20\">" . htmlentities($_POST['msggs']) . "</TEXTAREA></td></tr>";
// space
echo "<tr><td width=150> </td><td width=250> </td></tr>";
// button
echo "<tr><td> </td>";
echo "<td><input type=\"submit\" name=\"submit\" value=\"Versturen\"></td></tr>";
// sluit form + tabel
echo "</form>";
echo "</table>";
// versturen naar
{
// set datum
$datum = date("d.m.Y H:i");
// set ip
$ip = $_SERVER['REMOTE_ADDR'];
$inhoud_mail = "===================================================\n";
$inhoud_mail .= "Ingevulde contact formulier\n";
$inhoud_mail .= "===================================================\n\n";
$inhoud_mail .= $_SERVER['SCRIPT_URI'] . "\n\n";
$inhoud_mail .= "Bedrijfsnaam: " . $_POST['naam'] . "\n";
$inhoud_mail .= "Adres: " . $_POST['adres'] . "\n";
$inhoud_mail .= "Postcode: " . $_POST['postcode'] . "\n";
$inhoud_mail .= "Plaats: " . $_POST['plaats'] . "\n";
$inhoud_mail .= "Telefoon: " . $_POST['telefoon'] . "\n";
$inhoud_mail .= "Eerste contactpersoon: " . $_POST['contactp'] . "\n";
$inhoud_mail .= "Naam evenement: " . $_POST['eventnaam'] . "\n";
$inhoud_mail .= "Omschrijving: " . $_POST['onderwerp'] . "\n";
$inhoud_mail .= "Lokatie: " . $_POST['lokatie'] . "\n";
$inhoud_mail .= "Datum: " . $_POST['datum'] . "\n";
$inhoud_mail .= "Tijden: " . $_POST['tijden'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten1'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten2'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten3'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten4'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten5'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten6'] . "\n";
$inhoud_mail .= "Diensten: " . $_POST['diensten7'] . "\n";
$inhoud_mail .= "Bericht:\n";
$inhoud_mail .= $_POST['msggs'] . "\n\n";
$inhoud_mail .= "Verstuurd op " . $datum . " via het ip " . $ip . "\n\n";
$inhoud_mail .= "===================================================\n\n";
$headers = "From: " . $_POST['naam'] . " <" . $_POST['mail'] . ">";
$headers = stripslashes($headers);
$headers = str_replace("\n", "", $headers); // Verwijder \n
$headers = str_replace("\r", "", $headers); // Verwijder \r
$headers = str_replace("\"", "\\\"", str_replace("\\", "\\\\", $headers)); // Slashes van quotes
$_POST['onderwerp'] = str_replace("\n", "", $_POST['onderwerp']); // Verwijder \n
$_POST['onderwerp'] = str_replace("\r", "", $_POST['onderwerp']); // Verwijder \r
$_POST['onderwerp'] = str_replace("\"", "\\\"", str_replace("\\", "\\\\", $_POST['onderwerp'])); // Slashes van quotes
mail($mail_ontv, $_POST['onderwerp'], $inhoud_mail, $headers);
echo "Uw offerte-aanvraag is verzonden. Wij nemen zo spoedig mogelijk contact met u op."; }
?>