Anemon
New member
- Katılım
- 17 Ocak 2006
- Mesajlar
- 106
- Reaction score
- 0
- Puanları
- 0
- Yaş
- 38
Kod:
<form id="test" action="#" method="post">
<table width="100%" border="0" align="center" cellpadding="1" cellspacing="1">
<tr>
<td width="12%" nowrap class="rowh1"><font color="#FF0000">(*) </font>Teslim Edilecek Il : </td>
<td width="88%" class="row1">
<select name="t_sehir" id="t_sehir">
<option value="0">Lütfen Il Seçiniz</option>
<option value="Adana" >Adana</option>
<option value="Adiyaman" >Adiyaman</option>
<option value="Afyon" >Afyon</option>
<option value="Agri" >Agri</option>
<option value="Aksaray" >Aksaray</option>
<option value="Amasya" >Amasya</option>
<option value="Ankara" >Ankara</option>
<option value="Antalya" >Antalya</option>
<option value="Ardahan" >Ardahan</option>
<option value="Artvin" >Artvin</option>
<option value="Aydin" >Aydin</option>
<option value="Balikesir" >Balikesir</option>
<option value="Bartin" >Bartin</option>
<option value="Batman" >Batman</option>
<option value="Bayburt" >Bayburt</option>
<option value="Bilecik" >Bilecik</option>
<option value="Bingol" >Bingol</option>
<option value="Bitlis" >Bitlis</option>
<option value="Bolu" >Bolu</option>
<option value="Burdur" >Burdur</option>
<option value="Bursa" >Bursa</option>
<option value="Canakkale" >Canakkale</option>
<option value="Cankiri" >Cankiri</option>
<option value="Corum" >Corum</option>
<option value="Denizli" >Denizli</option>
<option value="Diyarbakir" >Diyarbakir</option>
<option value="Duzce" >Duzce</option>
<option value="Edirne" >Edirne</option>
<option value="Elazig" >Elazig</option>
<option value="Erzincan" >Erzincan</option>
<option value="Erzurum" >Erzurum</option>
<option value="Eskisehir" >Eskisehir</option>
<option value="Gaziantep" >Gaziantep</option>
<option value="Giresun" >Giresun</option>
<option value="Gumushane" >Gumushane</option>
<option value="Hakkari" >Hakkari</option>
<option value="Hatay" >Hatay</option>
<option value="Icel" >Icel</option>
<option value="Igdir" >Igdir</option>
<option value="Isparta" >Isparta</option>
<option value="Istanbul" >Istanbul</option>
<option value="Izmir" selected="selected">Izmir</option>
<option value="Kahramanmaras" >Kahramanmaras</option>
<option value="Karabuk" >Karabuk</option>
<option value="Karaman" >Karaman</option>
<option value="Kars" >Kars</option>
<option value="Kastamonu" >Kastamonu</option>
<option value="Kayseri" >Kayseri</option>
<option value="Kilis" >Kilis</option>
<option value="Kirikkale" >Kirikkale</option>
<option value="Kirklareli" >Kirklareli</option>
<option value="Kirsehir" >Kirsehir</option>
<option value="Kocaeli" >Kocaeli</option>
<option value="Konya" >Konya</option>
<option value="Kutahya" >Kutahya</option>
<option value="Malatya" >Malatya</option>
<option value="Manisa" >Manisa</option>
<option value="Mardin" >Mardin</option>
<option value="Mugla" >Mugla</option>
<option value="Mus" >Mus</option>
<option value="Nevsehir" >Nevsehir</option>
<option value="Nigde" >Nigde</option>
<option value="Ordu" >Ordu</option>
<option value="Osmaniye" >Osmaniye</option>
<option value="Rize" >Rize</option>
<option value="Sakarya" >Sakarya</option>
<option value="Samsun" >Samsun</option>
<option value="Sanliurfa" >Sanliurfa</option>
<option value="Siirt" >Siirt</option>
<option value="Sinop" >Sinop</option>
<option value="Sirnak" >Sirnak</option>
<option value="Sivas" >Sivas</option>
<option value="Tekirdag" >Tekirdag</option>
<option value="Tokat" >Tokat</option>
<option value="Trabzon" >Trabzon</option>
<option value="Tunceli" >Tunceli</option>
<option value="Usak" >Usak</option>
<option value="Van" >Van</option>
<option value="Yalova" >Yalova</option>
<option value="Yozgat" >Yozgat</option>
<option value="Zonguldak" >Zonguldak</option>
</select><label id="citymsj" class="mesajs"></label>
<label id="cargomsj" class="mesajs"></label>
</td>
</tr>
<tr>
<td nowrap class="rowh1"><font color="#FF0000">(*) </font>Alici : </td>
<td width="88%" class="row1"><input name="t_al" type="text" id="t_al" value="" size="30" maxlength="100">
<label id="namemsj" class="mesajs"></label></td>
</tr>
<tr>
<td valign="top" nowrap class="rowh2"><font color="#FF0000">(*)</font> Adres : </td>
<td class="row2"><textarea name="t_adres" cols="30" rows="5" id="t_adres"></textarea>
<br><label id="adresmsj" class="mesajs"></label></td>
</tr>
<tr>
<td nowrap class="rowh1">Firma : </td>
<td width="88%" class="rowh1"><input name="t_firma" type="text" id="t_firma" value="" size="30" maxlength="100"></td>
</tr>
<tr>
<td nowrap class="rowh2">Alternatif Alici : </td>
<td class="row2"><input name="t_alici" type="text" id="t_alici" value="" size="30" maxlength="50"></td>
</tr>
<tr>
<td nowrap class="rowh1"><font color="#FF0000">(*)</font> E-Posta : </td>
<td class="row1"><input name="t_mail" type="text" id="t_mail" value="" size="30" maxlength="50">
<label id="mailmsj" class="mesajs"></label></td>
</tr>
<tr>
<td nowrap class="rowh2"><font color="#FF0000">(*)</font> Telefon #1 : </td>
<td class="row2"><input name="t_tel" type="text" id="t_tel" value="" size="30" maxlength="30">
<label id="telmsj" class="mesajs"></label></td>
</tr>
<tr>
<td nowrap class="rowh1">Fax #2 : </td>
<td class="row1"><input name="t_fax" type="text" id="t_fax" value="" size="30" maxlength="30"></td>
</tr>
<tr>
<td nowrap class="rowh2">Semt : </td>
<td class="row2"><input name="t_state" type="text" id="t_state" value="" size="30" maxlength="30"></td>
</tr>
<tr>
<td nowrap class="rowh2">Almak istediğiniz Ürün </td>
<td class="row2"><select name="t_urun" id="t_urun">
<option value="0">Lütfen Ürünü Seçiniz</option>
<option value="Gold Shape Firming Cream" >Gold Shape Firming Cream</option>
<option value="Gold Shape Slimming Face" >Gold Shape Slimming Face</option>
<option value="Nature's Way" >Nature's Way</option>
<option value="Sea Clay" >Sea Clay</option>
</select></td>
</tr>
</table></td>
</tr>
</table></td>
<td valign="top"><table width="100%" border="0" align="center" cellpadding="0" cellspacing="0">
<tr>
<td><table width="100%" border="0" cellpadding="0" cellspacing="0" background="">
<tr>
<td width="100%" class="join_sub"><b>:: Fatura Bilgileri ::</b></td>
</tr>
</table>
<table width="100%" border="0" align="center" cellpadding="1" cellspacing="1">
<tr>
<td class="row2" colspan="2">
<a href="JavaScript:;" onClick="_Copy()"></a></td>
</tr>
<tr>
<td width="12%" nowrap class="rowh1">Ad & Soyad : </td>
<td width="88%" class="row1"><input name="f_name" type="text" id="f_name" value="" size="30" maxlength="100"></td>
</tr>
<tr>
<td valign="top" nowrap class="rowh2">Adres : </td>
<td class="row2"><textarea name="f_adr" cols="30" rows="5" id="f_adr"></textarea></td>
</tr>
<tr>
<td nowrap class="rowh1">Firma : </td>
<td width="88%" class="rowh1"><input name="f_firma" type="text" id="f_firma" value="" size="30" maxlength="100"></td>
</tr>
<tr>
<td nowrap class="rowh2">Vergi Dairesi : </td>
<td class="row2"><input name="f_daire" type="text" id="f_daire" size="30" maxlength="50"></td>
</tr>
<tr>
<td nowrap class="rowh1">Vergi No : </td>
<td class="row1"><input name="f_daireno" type="text" id="f_daireno" size="30" maxlength="30" /></td>
</tr>
<tr>
<td nowrap class="rowh2">Sehir : </td>
<td class="row2"><input name="f_city" type="text" id="t_city" size="30" maxlength="30"></td>
</tr>
<tr>
<td nowrap class="rowh2">Telefon #1 : </td>
<td class="row2"><input name="f_tel" type="text" id="f_tel" value="" size="30" maxlength="30"></td>
</tr>
</table></td>
</tr>
</table></td>
</tr>
<tr>
<td height="30" colspan="2" align="right" class="rowh2">
<label id="codemsj" class="mesajs"></label>
<input name="submit" type="submit" class="dogru" value="gonder" />
<input name="Reset" type="reset" class="dogru" value="Temizle" /> </form>
<script type="text/javascript">
var dogru = new Dogrulama('test');</script>
<?
if($_POST['submit']){
$kime = "*****";
$konu .= "Siparis Formu PTT";
$t_sehir = $_REQUEST['t_sehir'] ;
$t_al = $_REQUEST['t_al'] ;
$t_adres = $_REQUEST['t_adres'];
$t_firma = $_REQUEST['t_firma'];
$t_alici = $_REQUEST['t_alici'] ;
$t_mail = $_REQUEST['t_mail'];
$t_tel = $_REQUEST['t_tel'];
$t_fax = $_REQUEST['t_fax'];
$t_state = $_REQUEST['t_state'];
$t_urun = $_REQUEST['t_urun'];
$f_name = $_REQUEST['f_name'];
$f_adr = $_REQUEST['f_adr'];
$f_firma = $_REQUEST['f_firma'];
$f_daire = $_REQUEST['f_daire'];
$f_daireno = $_REQUEST['f_daireno'];
$f_city = $_REQUEST['f_city'];
$f_tel = $_REQUEST['f_tel'];
$header .= "From: Siparis Formu Havale <$email>\n";
$header .= "Content-Type: text/html; charset=windows-1254";
$gonder = "
<table>
<tr>
<td>Teslim Edilicek Adres</td>
<td >$t_sehir</td>
</tr>
<tr>
<td>Alici:</td>
<td>$t_al</td>
</tr>
<tr>
<td>Adres: </td>
<td>$t_adres</td>
</tr>
<tr>
<td>Firma</td>
<td>$t_firma</td>
</tr>
<tr>
<td>Alternatif Alici :</td>
<td>$t_alici</td>
</tr>
<tr>
<td>E-Posta:</td>
<td>$t_mail</td>
</tr>
<tr>
<td>Telefon :</td>
<td>$t_tel</td>
</tr>
<tr>
<td>Fax :</td>
<td>$t_fax</td>
</tr>
<tr>
<td>Semt:</td>
<td>$t_state</td>
</tr>
<tr>
<td>Almak istedigi urun:</td>
<td>$t_urun</td>
</tr>
<tr>
<td>Ad Soyad:</td>
<td>$f_name</td>
</tr>
<tr>
<td>Adres:</td>
<td>$f_adr</td>
</tr>
<tr>
<td>Firma:</td>
<td>$f_firma</td>
</tr>
<tr>
<td>Vergi Dairesi:</td>
<td>$f_daire</td>
</tr>
<tr>
<td>Vergi NO:</td>
<td>$f_daireno</td>
</tr>
<tr>
<td>Sehir:</td>
<td>$f_city</td>
</tr>
<tr>
<td>Telefon:</td>
<td>$f_tel</td>
</tr>
</table>
";
$sent = mail($kime, $konu, $gonder, $header);
if($sent)
{print "Mesajiniz Gönderildi!"; }
else
{print "Mesajiniz Gönderilemedi!"; }
}
?>