Everything is working right now, have worked out where the files are kept and now I can make the pages look as I want, thank you for your help, good product!

Kind Regards,

Stuart and Patricia Bird
http: www.internetopals.com

I had looked at many PHP form generators sofware packages and yours stood out as being not only user friendly, but backed by a commitment to help the consumer navigate the nuances of collecting information from forms. Plus, I liked the very professional design of your website. I am a web designer and appreciate good solid web design. Thanks again!!!

Robert L Whitehead
http: www.robwhitehead.com

Home > Kmita Mail PHP form to email > Demo > Call back Form

Kmita Mail v.4 : Call Back Form Demo

Kmita Mail can be easily used for collecting information for registration for some event or registration of Internet Username and Password. The data submitted in the form can be stored in an MySQL database (PHP only) which can be integrated with various other application like Member login .

First Name
Last Name
Email Address
Country
Day Phone Number		0000 0000-0000000
Night Phone Number		0000 0000-0000000
Prefferred time of calling		to in hrs 00:00
		Enter the characters shown in the above image [0-9, A-F]:

Registration Form HTML

<form action="http://alldemos.kmitascripts.com/kmitam/submit.php" method="post" > <div align="justify"><span class="text">Kmita Mail can be easily used for collecting information for registration for some event or registration of Internet Username and Password. The data submitted in the form can be stored in an MySQL database (PHP only) which can be integrated with various other application like Member login . </span><br /> <br /> </div> <table width="95%" height="255" border="0" align="center" cellpadding="1" cellspacing="3"> <tr> <td height="25" class="text_justify_no_side_border"><div align="right"> <input type="hidden" name="formname" value="callback" /> First Name</div></td> <td width="12" height="25" class="text_justify_no_side_border"> </td> <td width="400" 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="right"> 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="right">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="right">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="right">Day Phone Number</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="Day_Telephone" type="text" id="Day_Telephone" /> 0000 0000-0000000</td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="right">Night Phone Number</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="Night_Telephone" type="text" id="Night_Telephone" /> 0000 0000-0000000</td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><div align="right">Prefferred time of calling</div></td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" class="text_justify_no_side_border"><input name="Preferred_time_from" type="text" id="Preferred_time_from" size="10" maxlength="15" /> to <input name="Preferred_time_to" type="text" id="Preferred_time_to" size="10" maxlength="15" /> in hrs 00:00</td> </tr> <tr> <td height="25" class="text_justify_no_side_border"><img src="http://alldemos.kmitascripts.com/kmitaadmin/kmitam/image.php" width="150" height="80" /> </td> <td height="25" class="text_justify_no_side_border"> </td> <td height="25" valign="top" class="text_justify_no_side_border"><p>Enter the characters shown in the above image [0-9, A-F]:<br /> <br /> <input name="secnum" type="text" id="secnum" /> </p> </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" /></td> </tr> </table> <p> </p> </form>

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