This is a great script and the support is good too.

- Robin Wiggs, United Kingdom

Thank you, and thank you very much for the fast response! I trialed Quask's FormArtist and they never got back at all.
You've got a nice website too! Hats off to your designer.

- Robert A. Newell, United States

Home > Kmita Mail PHP form to email > Demo > Application Form

Kmita Mail v.3 : Application Form Demo

Contact form is the most widely used form using Kmita Mail. You can validate the field inputs, show errors in each field, send autoresponder, add this data to MySQL database and lot more.

Personal Information
First Name
Last Name
Email Address
Address
Zip Code
Country
Telephone

Employment History
Present or Most Recent Employer
Current Employer
Employer Address
Your Position
May we contact them?		Yes No

Kindly attach your resume and other documents here


		Only *.DOC files allowed File size less than 50 KB
		Enter the characters shown in the above image [0-9, A-F]:

Contact Form HTML

<form action="http://alldemos.kmitascripts.com/kmitam/submit.php" method="post" enctype="multipart/form-data" > <span class="text">Contact form is the most widely used form using Kmita Mail. You can validate the field inputs, show errors in each field, send autoresponder, add this data to MySQL database and lot more.</span><br /> <input type="hidden" name="formname" value="application0.php" /> <br /> <table width="95%" height="647" border="0" align="center" cellpadding="1" cellspacing="3"> <tr bgcolor="#F3F3F3"> <td height="25" colspan="3" class="text_justify_no_side_border"><strong>Personal Information </strong></td> </tr> <tr> <td width="193" height="25" class="text_justify_no_side_border"><div align="left">First Name</div></td> <td width="12" height="25" class="text_justify_no_side_border"> </td> <td width="323" height="25" class="text_justify_no_side_border"><input name="rn_Name" type="text" id="rn_Name" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Last Name</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="rn_Last_Name" type="text" id="rn_Last_Name" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Email Address </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="re_Email" type="text" id="re_Email" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Address</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><textarea name="rn_Address" id="rn_Address"></textarea></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Zip Code </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="rn_Zip_code" type="text" id="rn_Zip_code" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Country</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><font size="2"> <select name="rn_Country" class="normalform" id="rn_Country"> <option value="India">India</option> <option value="USA" selected="selected">USA</option> <option value="Canada">Canada</option> <option value="France">France</option> <option value="UK">UK</option> <option value="Germany">Germany</option> <option value="Mexico">Mexico</option> <option value="Belgium">Belgium</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Telephone</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="rn_Telephone" type="text" id="rn_Telephone" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left"></div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> </tr> <tr> <td height="25" colspan="3" bgcolor="#F2F2F2" class="text_justify_no_side_border"><div align="left" class="style6"><strong>Employment History</strong></div></td> </tr> <tr> <td height="25" colspan="3" class="text_justify_no_side_border"><div align="left"></div> Present or Most Recent Employer </td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Current Employer</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="km_Employer" type="text" id="km_Employer" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Employer Address </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><textarea name="km_Employer_Address" id="km_Employer_Address"></textarea></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">Your Position </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="km_Your_Position" type="text" id="km_Your_Position" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left">May we contact them? </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="km_Contact_employer" type="radio" value="Yes" checked="checked" /> Yes <input name="km_Contact_employer" type="radio" value="No" /> No</td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="left"></div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> </tr> <tr> <td height="25" valign="top" class="text_justify_no_side_border"><div align="left">Kindly attach your resume and other documents here </div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><p> <input name="userfile1" type="file" id="userfile1" /> </p></td> </tr> <tr> <td height="25" valign="top" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="userfile2" type="file" id="userfile2" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="userfile3" type="file" id="userfile3" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border">Only *.DOC files allowed<br /> File size less than 50 KB </td> </tr> <tr> <td height="25" class="text_justify_no_side_border"> <div align="right"><img src="http://alldemos.kmitascripts.com/kmitam/image.php" width="150" height="80" /></span></div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border">Enter the characters shown in the above image [0-9, A-F]: <br /> <input name="secnum" type="text" id="secnum" /></td> </tr> <tr> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> </tr> <tr> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="submit" type="submit" value="Submit" /></td> </tr> </table>  </form>

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