Contact script - One2xs Forum

Lid · Topicstarter

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Lid sinds: 2008
Laatst gezien: 19 okt 2019

5 jun 2009, 17:38

Ik heb nu dit script :

<table>
<tr>
  <td>Voornaam&nbsp;*</td>
  <td><input class="inputText" id="customer_first_name" name="customer[first_name]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Achternaam&nbsp;*</td>
  <td><input class="inputText" id="customer_name" name="customer[name]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Email *</td>
  <td><input class="inputText" id="customer_email" name="customer[email]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Nogmaals uw email *</td>
  <td><input class="inputText" id="customer_email_confirmation" name="customer[email_confirmation]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Sofi nummer</td>
  <td><input class="inputText" id="customer_sofi_number" name="customer[sofi_number]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Geslacht*</td>
  <td><input id="customer_sex_m" name="customer[sex]" type="radio" value="m" 
     >&nbsp;Man <input id="customer_sex_f" name="customer[sex]" type="radio" value="f" > Vrouw</td>
  <td></td>
</tr>
<tr>
  <td>Geboortedatum*</td>
  <td><select id="customer_birthdate_3i" name="customer[birthdate(3i)]">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option selected value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select id="customer_birthdate_2i" name="customer[birthdate(2i)]">
<option value="1">Januari</option>
<option value="2">Februari</option>
<option value="3">Maart</option>
<option value="4">April</option>
<option value="5">Mei</option>
<option selected value="6">Juni</option>
<option value="7">Juli</option>
<option value="8">Augustus</option>
<option value="9">September</option>
<option value="10">Oktober</option>
<option value="11">November</option>
<option value="12">December</option>
</select>
<select id="customer_birthdate_1i" name="customer[birthdate(1i)]">
<option value="1991" selected>1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
<option value="1903">1903</option>
<option value="1902">1902</option>
<option value="1901">1901</option>
<option value="1900">1900</option>
</select>
  </td>
  <td></td>
</tr>
<tr>
   <td> Bedrijfsnaam</td>
   <td><input class="inputText" id="customer_company_name" name="customer[company_name]" size="30" ></td>
   <td></td>
</tr>
<tr>
  <td>KVK nummer</td>
  <td><input class="inputText" id="customer_kvk_number" name="customer[kvk_number]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>BTW plichtig*</td>
  <td><input id="customer_btw_required_true" name="customer[btw_required]" type="radio" value="true" >&nbsp;Ja <input checked id="customer_btw_required_false" name="customer[btw_required]" type="radio" value="false" 
     >&nbsp;Nee </td>
  <td></td>
</tr>
<tr>
  <td>BTW nummer</td>
  <td><input class="inputText" id="customer_btw_number" name="customer[btw_number]" size="30" ></td>
  <td></td>
</tr>

<tr>
  <td> Adres*</td>
  <td><input class="inputText" id="customer_address" name="customer[address]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Huisnummer&nbsp;*</td>
  <td><input class="inputText" id="customer_address_number" name="customer[address_number]" size="6" maxsize="6" ></td>
  <td></td>
</tr>
<tr>
  <td>  Poscode*</td>
  <td><input class="inputText" id="customer_address_number_postfix" name="customer[address_number_postfix]" size="6" maxsize="6" ></td>
  <td></td>
</tr>

<tr>
  <td>Plaats&nbsp;*</td>
  <td><input class="inputText" id="customer_zip" name="customer[zip]" size="30" 
     ></td>
  <td></td>
</tr>
  
</tr>
<tr>
  <td>Provincie</td>
  <td><input class="inputText" id="customer_province" name="customer[province]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Land</td>
  <td><select id="customer_country_id" name="customer[country_id]"><option value="1" selected>Nederland</option>
<option value="2">Belgie</option>
<option value="9">Duitsland</option></select></td>
  <td></td>
</tr>
<tr>
  <td>Telefoonnummer&nbsp;*</td>
  <td><input class="inputText" id="customer_phone" name="customer[phone]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Fax</td>
  <td><input class="inputText" id="customer_fax" name="customer[fax]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Website</td>
  <td><input class="inputText" id="customer_url" name="customer[url]" size="30" 
     ></td>
  <td></td>
</tr>
<tr>
  <td>Uitbetalings methode*</td>
  <td>
      <input checked id="customer_payment_method_bank" name="customer[payment_method]" type="radio" value="bank" > Bank&nbsp;Of
      <input id="customer_payment_method_paypal" name="customer[payment_method]" type="radio" value="paypal" 
     >Paypal
   </td>
  <td></td>
</tr>
<tr>
  <td>Paypal email</td>
  <td><input class="inputText" id="customer_paypal_email" name="customer[paypal_email]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Rekening Nummer</td>
  <td><input class="inputText" id="customer_account_number" name="customer[account_number]" size="30" ></td>
  <td></td>
</tr>
<tr>
  <td>Eigenaar Rekening</td>
  <td><input class="inputText" id="customer_account_holder" name="customer[account_holder]" size="30" ></td>
  <td> Bijvoorbeeld: A. Jansen</td>
</tr>
<tr>
  <td>Bank</td>
  <td><input class="inputText" id="customer_account_bank" name="customer[account_bank]" size="30" ></td>
  <td>Bijvoorbeeld: Rabobank</td>
</tr>
<tr>
  <td>Motivatie *</td>
  <td><TEXTAREA id=customer_motivation name=customer[motivation] rows=8 cols=35></TEXTAREA></td>
  <td>
     Motivatie voor het aanvragen van uw service nummer<br>
     
  </td>
</tr>
<tr>
  <td colspan="2"><input name="customer[terms_of_service]" type="hidden" value="0" 
     ><input id="customer_terms_of_service" name="customer[terms_of_service]" type="checkbox" value="1" 
     > Ik heb de <A HREF="http://myphonenumber.webs.com/algemenevoorwaarden.htm" TARGET="_blank">Voorwaarden</A> voor My Phone Number.nl gelezen en geaccepteerd</td>
  <td></td>
</tr>
</table>
<DIV></DIV>
   <div id="mainContent">
    <div class="content">
     <div id="main_content">
<form action="/signup/customer" method="post">
  
  <input name="commit" type="submit" value="Verzend" > 
</form>
     </div>
    </div><!----- einde home  ------>
   </div><!----- einde canvas  ------>
<DIV></DIV>
<DIV></DIV>
</BODY>
</html>

Dit wil ik in html maar aan het begin dat het automatisch wordt gestuurt naar je mail adres.
kan iemand dit ervan maken ?

Remcoboy

Lid · Topicstarter