Dear Customercare,

Now that is what I call SERVICE. I read the other testimonials and they bragged about your service. Here it is that I bought this software on a Saturday afternoon when most US Businesses are closed and I find out that you already set kmita mail up for me on my server. I was not expecting it until Tuesday or so. This has meant a lot to me and like one guy said already; Âthe customer care is worth the $20 aloneÂ. I will surely pass this information along to all that I know in the Internet Business.
Thank you so much,

Richard Legg
Oregon USA
www.mygolden opportunity.com

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

Kmita Mail v.4 : 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 Format 0000 0000-0000000

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="application" /> <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="Name" type="text" id="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="Last_Name" type="text" id="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="Address" id="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="Zip_code" type="text" id="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="Country" class="normalform" id="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<br />Format 0000 0000-0000000</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="Telephone" type="text" id="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="Employer" type="text" id="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="Employer_Address" id="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="Your_Position" type="text" id="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="Contact_employer" type="radio" value="Yes" checked="checked" /> Yes <input name="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="resume1" type="file" id="resume1" /> </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="resume2" type="file" id="resume2" /></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="resume3" type="file" id="resume3" /></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/kmitaadmin/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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