"; // CSS classes & styles $classError = "error"; // class for error messages below input fields $classTxt = "text"; // class for field caption cell $classField = "field"; // class for input/textarea field cell $classInputbutton = "inputButton"; // class for submit button $classInputline = "inputLine"; // class for input lines $classInputfield = "inputField"; // class for textareas $styleInputline = "width:300px;"; // add. styles for input lines $styleInputfield = "width:300px; height:60px;"; // add. styles for textareas $styleInputbutton = "width:300px;"; // add. styles for submit button $styleInputradio = "vertical-align:middle;"; // add. styles for radio input fields $styleInputselect = "width:300px;"; // email $targetAddress = "info@taxichauffeursopleiding.nl"; $emailSubject = "Inschrijving vanaf website"; // misc text $txtSend = "Verzenden"; $txtMandatory = "verplicht invullen"; $msgDate = "Datum"; $dateFormat = "d. M Y, H:i"; $txtRemainingChars = "Resterende karakters:"; // indent for field values in email message $msgIndent = 15; // errors (above/below the field) $posError = "above"; //thank you messages $txtThankyou = "

Bedankt voor de inschrijving! Wij nemen zo spoedig mogelijk contact met u op.

"; // form fields /* every form field is an array consisting of 6 elements: 1) field caption 2) field name 3) field type: line, field, radio, select, checkbox, multiselect, divider 4) additional info: if field type is - 'radio' this field contains the radio captions/values like so: {caption1|value1} {caption2|value2} {caption3|value3}... - 'select' this field contains the radio captions/values like so: {caption1|value1} {caption2|value2} {caption3|value3}... - 'email' the field value must be a valid emailaddress - 'checkbox' this field contains the radio captions/values like so: {caption1|value1} {caption2|value2} {caption3|value3}... - 'multiselect' this field contains the radio captions/values like so: {caption1|value1} {caption2|value2} {caption3|value3}... - 'divider' -> you can specify something like '
' in the caption field - 'field' this values optional defines a max chars number 5) mandatory ('*') or not ('') 6) error message if empty on submit and set to mandatory previously */ $fields[] = array("Graag contact opnemen via:", "contact", "checkbox", "{Telefoon|telefoon}{Email|email}", "", ""); $fields[] = array("
", "", "divider", "", "", ""); $fields[] = array("Chauffeursdiploma Taxivervoer (praktijk)", "", "", "", "", ""); $fields[] = array("Beperkte of volledige chauffeurskaart", "praktijk", "checkbox", "{Beperkt|beperkt}{Volledig|volledig}", "", "

Kies een opleidingsvorm

"); $fields[] = array("Maak uw keuze", "auto", "checkbox", "{Met eigen auto|eigen}{Met auto van de rijschool|rijschool}", "", "

Kies voor eigen auto of auto rijschool

"); //$fields[] = array("Theorie-opleiding", "", "", "", "", ""); //$fields[] = array("Maak uw keuze", "theorie", "checkbox", "{Klassikaal|klassikaal}{Zelfstudie|zelfstudie}", "", "

Kies een opleidingsvorm

"); //$fields[] = array("
", "", "divider", "", "", ""); //$fields[] = array("Alleen de praktijkopleiding", "", "", "", "", ""); //$fields[] = array("Beperkte of volledige chauffeurskaart", "praktijk", "checkbox", "{Beperkt|beperkt}{Volledig|volledig}", "", "

Kies een opleidingsvorm

"); //$fields[] = array("Maak uw keuze", "auto", "checkbox", "{Met eigen auto|eigen}{Met auto van de rijschool|rijschool}", "", "

Kies voor eigen auto of auto rijschool

"); //$fields[] = array("
", "", "divider", "", "", ""); //$fields[] = array("Alleen de theorieopleiding", "", "", "", "", ""); //$fields[] = array("Maak uw keuze", "theorie", "checkbox", "{Klassikaal|klassikaal}{Zelfstudie|zelfstudie}", "", "

Kies een opleidingsvorm

"); $fields[] = array("
", "", "divider", "", "", ""); $fields[] = array("Aanhef", "aanhef", "radio", "{Dhr|dhr}{Mevr|mevr}", "", ""); $fields[] = array("Naam", "naam", "line", "", "*", "

naam invullen a.u.b.

"); $fields[] = array("Adres", "adres", "line", "", "*", "

adres invullen a.u.b.

"); $fields[] = array("Postcode", "postcode", "line", "", "*", "

postcode invullen a.u.b.

"); $fields[] = array("Woonplaats", "woonplaats", "line", "", "*", "

woonplaats invullen a.u.b.

"); $fields[] = array("Geboortedatum [dd-mm-jjjj]", "geboortedatum", "line", "", "*", "

geboortedatum invullen a.u.b.

"); $fields[] = array("Geboorteplaats", "geboorteplaats", "line", "", "*", "

geboorteplaats invullen a.u.b.

"); $fields[] = array("Telefoonnummer", "telefoonnummer", "line", "", "*", "

telefoonnummer invullen a.u.b.

"); $fields[] = array("Mobiel", "mobiel", "line", "", "*", "

mobiele nummer invullen a.u.b.

"); $fields[] = array("Email", "email", "line", "", "*", "

geldig emailadres invullen a.u.b.

"); $fields[] = array("BSN(**)", "bsn", "line", "", "*", "

bsn nr. invullen a.u.b.

"); $fields[] = array("Opmerking", "opmerking", "field", "", "", ""); //$fields[] = array("
", "", "divider", "", "", ""); //$fields[] = array("Ik ga akkoord met de voorwaarden", "voorwaarden", "checkbox", "{akkoord|akkoord}", "*", "

je moet akkoord gaan met de voorwaarden

"); // ################ END CONFIG ########################################################## // ####################################################################################### $version = "1.5"; $errorPointer = ($posError == "above") ? "↓ " : "↑ "; function spaces($num, $fill=" "){ $foo=""; for ($i=0; $i<$num; $i++) $foo.=$fill; return $foo; } function isValidEmail($addr){ if(eregi("^[a-z0-9]+([_.-][a-z0-9]+)*@([a-z0-9]+([.-][a-z0-9]+)*)+\\.[a-z]{2,4}$", $addr)) return true; else return false; } function jsCharCount(){ if ($GLOBALS['cfCharCountFunc'] != 1){ $html = "\n"; $GLOBALS['cfCharCountFunc'] = 1; return $html; } } // start form evaluation unset($error); if ($_REQUEST['do']=="send"){ $error = false; $fromAddress = ""; $message = ""; foreach ($fields as $field){ if ($field[4] == "*"){ if ($field[3] == "email"){ if (!isValidEmail($_REQUEST[$field[1]])) $error[$field[1]] = $field[5]; }else{ if ($_REQUEST[$field[1]] == "" || $_REQUEST[$field[1]] == " " || $_REQUEST[$field[1]] == " ") $error[$field[1]] = $field[5]; } } } if ($error === false){ $message = $emailSubject." \n"; for ($i = 0; $i < strlen($emailSubject); $i++) $message .= "*"; $message .= " \n\n$msgDate:".spaces($msgIndent-strlen($msgDate)).date($dateFormat); foreach ($fields as $field){ if ($field[2] == "divider"){ $message .= "\n-----------------------------------"; }else{ $message .= "\n".$field[0].":".spaces($msgIndent-strlen($field[0])); if ($field[3] == "email"){ $message .= "mailto:".$_REQUEST[$field[1]]; $fromAddress = "From: ".$_REQUEST[$field[1]]; }else if ($field[2] == "checkbox" || $field[2] == "multiselect"){ $multi = ""; foreach ($_REQUEST[$field[1]] as $val){ $divider = ($multi != "") ? ", " : ""; $multi .= (isset($val) && $val != "") ? $divider.$val : ""; } $message .= $multi; }else $message .= $_REQUEST[$field[1]]; } $message .= " "; } mail($targetAddress, $emailSubject, $message, $fromAddress); //echo "
$message
"; echo $txtThankyou; } } if ($error!==false){ $html = ""; // draw form //$html .= "\n\n \n\n"; $html .= "
\n"; $html .= "\n"; foreach ($fields as $field){ $htmlError = ""; $htmlField = ""; if ($field[2] == "divider"){ $html .= ""; }else{ $html .= "\n\n"; } //$html .= "\n"; $html .= "\n"; $html .= "\n"; $html .= "\n"; $html .= "\n"; $html .= "
".$field[0]."
".$field[0].$field[4]." "; } switch ($field[2]){ case "line": $htmlField = ""; if (isset($error[$field[1]])) $htmlError = "
".$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; case "field": if (is_numeric($field[3])){ $attrVal = "cfCount('cf_".$field[1]."', 'cf_remchars_".$field[1]."', ".$field[3].")"; $attr = "onkeydown=\"$attrVal\" onkeyup=\"$attrVal\""; }else $attr = ""; $htmlField .= "\n"; if (is_numeric($field[3])){ $remChars = (isset($_REQUEST[$field[1]])) ? ($field[3] - strlen($_REQUEST[$field[1]])) : $field[3]; $htmlField .= jsCharCount()."
$txtRemainingChars ".$remChars.""; } if (isset($error[$field[1]])) $htmlError .= "
".$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; case "radio": preg_match_all("/\{(.*?)\}/", $field[3], $foo); $options = $foo[1]; $i=1; foreach ($options as $opt){ $opt = explode("|", $opt); $label = $opt[0]; $value = (isset($opt[1])) ? $opt[1] : $opt[0]; $checked = ($_REQUEST[$field[1]] == $value) ? "checked" : ""; $htmlField .= "   "; $i++; } if (isset($error[$field[1]])) $htmlError .= "
".$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; case "checkbox": preg_match_all("/\{(.*?)\}/", $field[3], $foo); $options = $foo[1]; $i=1; foreach ($options as $opt){ $opt = explode("|", $opt); $label = $opt[0]; $value = (isset($opt[1])) ? $opt[1] : $opt[0]; $checked = ($_REQUEST[$field[1]][($i)] == $value) ? "checked" : ""; $htmlField .= "   "; $i++; } if (isset($error[$field[1]])) $htmlError .= "
".$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; case "select": preg_match_all("/\{(.*?)\}/", $field[3], $foo); $options = $foo[1]; $i=1; $htmlField .= "\n\n"; if (isset($error[$field[1]])) $htmlError .= "
".$errorPointer.$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; case "multiselect": preg_match_all("/\{(.*?)\}/", $field[3], $foo); $options = $foo[1]; $i=1; $htmlField .= "\n\n"; if (isset($error[$field[1]])) $htmlError .= "
".$errorPointer.$error[$field[1]]."
"; $html .= ($posError == "above") ? $htmlError.$htmlField : $htmlField.$htmlError; break; } $html .= "
  Algemene voorwaarden
  
 (**) Het BSN (Burger Service Nummer) kunt u terugvinden op uw id.kaart/paspoort/rijbewijs
 * $txtMandatory
 \n"; $html .= "
\n"; $html .= "
\n"; //$html .= "\n \n\n"; echo $html; } /* ######################### END Contact Form ########################## ##################################################################### */ ?>