<html> <head><title>Example Form 4 Page 2</title></head> <body bgcolor="#3c8484"> <center> <img src="/tools/enhance/form_emailer_help/example4/dctitle.gif" border=0> </center> <h1>Order Form</h1>
<form action="/cgi-bin/cgiemail" method="post">
<!-- HTML Template used for the page after successful submission --> <input type="hidden" name="cgiemail_html" value="thank_you.html">
<!-- HTML Template used in case an error occurs --> <input type="hidden" name="cgiemail_error" value="error.html">
<!-- Message Template #1 for the email message that gets sent --> <input type="hidden" name="cgiemail_message" value="message1.txt">
<!-- Message Template #2 for the email message that gets sent --> <input type="hidden" name="cgiemail_message" value="message2.txt">
<!-- Message Template #3 for the format of data into the database --> <input type="hidden" name="cgiemail_message" value="database.save">
<!-- I prefer the date for this email to be sent in Pacific Standard Time--> <input type="hidden" name="cgiemail_timezone" value="PST">
<!-- TIME Shown in the form "Wednesday, February 17, 1999 18:46:41"--> <input type="hidden" name="cgiemail_timeformat" value="%A,%B %e, %Y %T">
<!-- Fields that must be submitted --> <input type="hidden" name="cgiemail_required" value="phone:Your voice phone number is required."> <input type="hidden" name="cgiemail_required" value="address1:Please supply your snail mail addres."> <input type="hidden" name="cgiemail_required" value="city:Your city is is required."> <input type="hidden" name="cgiemail_required" value="state:Please enter your TWO DIGIT state code."> <input type="hidden" name="cgiemail_required" value="zip:Mailing ZIPCODE is required.">
<table border=1><tr> <td><b>Ordering:</b></td> <td><b><font size=+1>$product</font></b></td></tr> <tr><td><b>Full Name:</b></td> <td><b>$full_name</b></td></tr> <tr><td><b>Address1:</b></td> <td><input name=address1></td></tr> <tr><td><b>Address2:</b></td> <td><input name=address2></td></tr> <tr><td><b>City/State/ZIP:</b></td> <td><input name=city size=10><input name=state size=2 maxlength=2><input name=zip size=5></td></tr> <tr><td><b>Phone Number:</b></td> <td><input name=phone></td></tr> <tr><td colspan=2><b>Optional Additional Instructions:</b><br><textarea rows=3 cols=60 name=instructions></textarea></td></tr> <tr><td colspan=2><input type=submit value="SUBMIT TEST ORDER"></td></tr> </table>
</form>
</body> </html>