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11/09/2005 at 06:02PM PST, ID: 21625768
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5.0

HTML FORM HELP 500 Points

Asked by mdmcq5 in Hypertext Markup Language (HTML)

Tags: webbot

developing a form, that i thought would put the results into the _private folder as _private\formrslt.htm but nothing happens. am i missing something in my code?
whoever helps me get this form working gets 500 points!
<HTML>
<HEAD>
<meta HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=windows-1252">
<meta http-equiv="Content-Language" content="en-us">
<TITLE>Request Information</TITLE>
</HEAD>
<BODY>
<H1>Want More Information?</H1>
<HR>
<P>
Please fill out this form in order to obtain additional information...</P>
<FORM METHOD="POST" ACTION="--WEBBOT-SELF--" onSubmit="location.href='thankyou.htm';return false;" webbot-onSubmit>
<!--WEBBOT BOT=SaveResults
    U-File="_private\formrslt.htm"
    S-Format="HTML/DL"
    B-Label-Fields="TRUE" startspan
--><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" i-checksum="43374" endspan --><P>
Please provide the following contact information:</P>
<BLOCKQUOTE>
<TABLE>
<TR>
<TD ALIGN="right">
<EM>Name</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_FullName" SIZE=35>
</TD>
</TR>
<TR>
<TR>
<TD ALIGN="right">
<EM>Street Address</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_StreetAddress" SIZE=35>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Address (cont.)</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_Address2" SIZE=35>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>City</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_City" SIZE=35>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>State/Province</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_State" SIZE=35>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Zip/Postal Code</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_ZipCode" SIZE=12 MAXLENGTH=12>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Work Phone</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_WorkPhone" SIZE=25 MAXLENGTH=25>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Home Phone</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_HomePhone" SIZE=25 MAXLENGTH=25>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>E-mail</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Contact Information_Email" SIZE=25>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Desired form of payment</EM></TD>
<TD>
<INPUT TYPE=RADIO NAME="Personal Information_Insurance" VALUE="Insurance" CHECKED>
Insurance <INPUT TYPE=RADIO NAME="Personal Information_Insurance" VALUE="Cash Pay Patient">
Cash Pay Patient </TD>
</TR>

</TABLE>
</BLOCKQUOTE>
<P>
Please identify and describe yourself:</P>
<BLOCKQUOTE>
<TABLE>
<TR>
<TD ALIGN="right">
<EM>Date of Birth</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Personal Information_DateOfBirth" SIZE=8>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Sex</EM></TD>
<TD>
<INPUT TYPE=RADIO NAME="Personal Information_Sex" VALUE="Male" CHECKED>
Male <INPUT TYPE=RADIO NAME="Personal Information_Sex" VALUE="Female">
Female </TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Height</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Personal Information_Height" SIZE=6 MAXLENGTH=6>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>Weight</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Personal Information_Weight" SIZE=6 MAXLENGTH=6>
</TD>
</TR>
<TR>
<TD ALIGN="right">
<EM>BMI (Body Mass Index)</EM></TD>
<TD>
<INPUT TYPE=TEXT NAME="Personal Information_BMI" SIZE=6 MAXLENGTH=6>
</TD>
</TR>

</TABLE>
</BLOCKQUOTE>
<P>
Please ask questions or address concerns below:</P>
<BLOCKQUOTE>
<textarea rows="8" name="S1" cols="51"></textarea>
</BLOCKQUOTE>
<INPUT TYPE=SUBMIT VALUE="Submit Form">
<INPUT TYPE=RESET VALUE="Reset Form">
</FORM>
<HR>
<H5>
<BR>
Revised:
<!--WEBBOT BOT=TimeStamp
    S-Type="EDITED"
    S-Format="%m/%d/%y" startspan
-->11/09/05<!--WEBBOT BOT=TimeStamp endspan i-checksum="12991"
--></H5>
</BODY>
</HTML>
 
Keywords: HTML FORM HELP 500 Points
 
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About this solution

Zone: Hypertext Markup Language (HTML)
Tags: webbot
Sign Up Now!
Solution Provided By: ryancys
Participating Experts: 3
Solution Grade: A
 
 
 
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