Passing Multiple Variables Through Form

I have a form that is almost completely done.
The Mail and everything works, along with the first 4 products, but when any products below the first row are selected it doesn't pass them through correctly.

URGENT, PLEASE HELP!
<?php
if( !empty($_POST['Name']) && !empty($_POST['Email']) && !empty($_POST['Site']) )
{
	header("Content-type: text/plain");
 
	$RegionalManager=array();
	$RegionalManager['A']="PersonA@company.com";
	$RegionalManager['B']="PersonB@company.com";
	$RegionalManager['C']="PersonC@company.com";
	$RegionalManager['D']="PersonD@company.com";
	$RegionalManager['E']="PersonE@company.com";
	$RegionalManager['F']="PersonF@company.com";
 
	
      $submittedData="";
	 
      $submittedData.="\nName:" . $_POST['Name'];
      $submittedData.="\nEmail:" . $_POST['Email'];
      $submittedData.="\nSite:" . $_POST['Site'];
      $submittedData.="\nRegional Manager:" . $_POST['regional_manager'];
	 
	 $fields=array('Standard_Supplies','No_Worries_Flyers','No_Worries_Posters','No_Worries_Banners','No_Worries_Postcards');
	foreach($fields as $arrName)
	{
		 if(isset($_POST[$arrName]))
		 {
			 $submittedData.="\n\n" . str_replace("_"," ",$arrName);
		      foreach($_POST['Standard_Supplies'] as $value)
		      {
		            $k=$value."_quantity";
		            if(!empty($_POST[$k]))
		                  $submittedData .= "\n\t".str_replace("_"," ",$value) . ": " . $_POST[$k];
		      }
		 }
	}
	 $headers="CC:". $RegionalManager[ $_POST['regional_manager'] ];
      if(!empty($submittedData))
      {
            mail("natalie@company.com","Order details",$submittedData,$headers);
		 //echo $submittedData;
            echo "\n\nThank you!";
      }
      exit;
}
?>
 
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
 "http://www.w3.org/TR/html4/loose.dtd">
 
<html>
<head>
<title></title>
<style type="text/css">
.row1{float:left;width:24%;}
.row2{float:left;width:20%;}
fieldset{padding:5px;}
fieldset div select{display:block;}
legend{font-weight:bold;background-color:white;}
fieldset fieldset{border:0px; border-top:1px dashed black;margin-top:1em;}
</style>
 
</head>
<body>
<form id="form1" name="form1" method="post" action="<?=$_SERVER['PHP_SELF']?>">
  <label><strong>* Name:</strong></label>
  <input name="Name" type="text" id="Name" size="27">
  <br><br>
  <label><strong>* Email:</strong></label>
  <input name="Email" type="text" id="Email" size="27">
  <br><br>
<label><strong>* Site:</strong></label>
<input name="Site" type="text" id="Site" size="29">
<br>
<br>
<label>Regional Manager
<select name="regional_manager" id="regional_manager">
  <option  value="">-</option>
  <option value="A">Person A</option>
  <option value="B">Person B</option>
  <option value="C">Person C</option>
  <option value="D">Person D</option>
  <option value="E">Person E</option>
  <option value="F">Person F</option>
</select>
</label>
<br>
<br>
  <fieldset><legend>Standard Supplies</legend>
 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="RateSheet" />Ratesheet <select name="RateSheet_quantity"><option value="0"  >-</option>
		  <option value="500">500</option>
		  <option value="1000">1000</option>
		  <option value="1500">1500</option>
		  <option value="2000">2000</option>
            <option value="2500">2500</option>
            <option value="3000">3000</option>
            <option value="3500">3500</option>
            <option value="4000">4000</option>
            <option value="4500">4500</option>
            <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Table_Drape" />Table Drape <select name="Table_Drape_quantity"><option value="0"  >-</option>
                <option value="1 - 6 ft.">1 - 6 ft.</option>
                <option value="2 - 6 ft.">2 - 6 ft.</option>
                <option value="3 - 6 ft.">3 - 6 ft.</option>
                <option value="1 - 8 ft.">1 - 8 ft.</option>
                <option value="2 - 8 ft.">2 - 8 ft.</option>
                <option value="3 - 8 ft.">3 - 8 ft.</option>
            </select></div>
 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Banner_Stands" />Banner Stands <select name="Banner_Stands_quantity"><option value="0" >-</option>
                <option value="1">1</option>
                <option value="2">2</option>
                <option value="3">3</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="T_Shirts" />T-Shirts <select name="T_Shirts_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Flyers</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ClassFlyer" />Class In Ten Minutes? <select name="ClassFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ApartmentFlyer" />Apartment Hunting? <select name="ApartmentFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RoommateFlyer" />Roommate Hasn't Paid Up? <select name="RoommateFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RentsFlyer" />'Rents Cramping Your Style? <select name="RentsFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Posters</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ClassPoster" />Class In Ten Minutes? <select name="ClassPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ApartmentPoster" />Apartment Hunting? <select name="ApartmentPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RoommatePoster" />Roommate Hasn't Paid Up? <select name="RoommatePoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RentsPoster" />'Rents Cramping Your Style? <select name="RentsPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Banners</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ClassBanner" />Class In Ten Minutes? <select name="ClassBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ApartmentBanner" />Apartment Hunting? <select name="ApartmentBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RoommateBanner" />Roommate Hasn't Paid Up? <select name="RoommateBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RentsBanner" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Postcards</legend>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ClassPostcard" />Class In Ten Minutes? <select name="ClassPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ApartmentPostcard" />Apartment Hunting? <select name="ApartmentPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RoommatePostcard" />Roommate Hasn't Paid Up? <select name="RoommatePostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RentsPostcard" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ForeignPostcard" />Foreign City?<select name="ForeignPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
<br>
<input type="submit" name="Submit" id="Submit" value="Submit">
 
</form>
</body>
</html>
 
 
<?php
exit;
 
if( !empty($_POST['action']) )
{
	header("Content-type: text/plain");
	$submittedData="";
	foreach($_POST['Standard_Supplies'] as $value)
	{
		$k=$value."_quantity";
		if(!empty($_POST[$k]))
			$submittedData .= "\n".str_replace("_"," ",$value) . ": " . $_POST[$k];
	}
	$submittedData .="\nNo Worries Campaign";
	$submittedData .="\n\tQuantity: " . $_POST['NWC_quantity'];
	$nwc=array('Flyers','Posters','Banners','Post_Cards');
	foreach($nwc as $chk)
	{
		if( !empty($_POST[$chk]) )
		{
			$submittedData .= "\n\t" . $chk.":";
			foreach($_POST[$chk] as $value)
			{
				$submittedData .= "\n\t\t".str_replace("_"," ",$value);
			}
		}
	}
	if(!empty($submittedData))
	{
		//mail("you@yourcompany.com","Order details",$submittedData);
		echo $submittedData;
		echo "\n\nThank you!";
	}
	exit;
}
?>
 
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
 "http://www.w3.org/TR/html4/loose.dtd">
 
<html>
<head>
<title></title>
<style type="text/css">
<!--
.row1{float:left;width:25%;}
.col1{float:left;width:49%;}
fieldset{padding:5px;}
fieldset div select{display:block;}
legend{font-weight:bold;background-color:white;}
fieldset fieldset{border:0px; border-top:1px dashed black;margin-top:1em;}
-->
</style>
 
</head>
<body>
<form id="form1" name="form1" method="post" action="<?=$_SERVER['PHP_SELF']?>">
	<fieldset><legend>Standard Supplies</legend>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="RateSheet" />Ratesheet <select name="RateSheet_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Table_Drape" />Table Drape <select name="Table_Drape_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Banner_Stands" />Banner Stands <select name="Banner_Stands_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div><input type="checkbox" name="Standard_Supplies[]" value="T_Shirts" />T-Shirts <select name="T_Shirts_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
	</fieldset>
 
	<fieldset><legend>No Worries Campaign</legend>
		<div>Quantity: <input type="text" name="NWC_quantity"/></div>
		<fieldset><legend>Flyers</legend>
			<div class="col1"><input type="checkbox" name="Flyers[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Flyers[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Flyers[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Flyers[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Posters</legend>
			<div class="col1"><input type="checkbox" name="Posters[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Posters[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Posters[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Posters[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Banners</legend>
			<div class="col1"><input type="checkbox" name="Banners[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Banners[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Banners[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Banners[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Post Cards</legend>
			<div class="col1"><input type="checkbox" name="Post_Cards[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Post_Cards[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Post_Cards[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Post_Cards[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
	</fieldset>
	<div><input type="submit" name="action" value="Submit"/></div>
</form>
</body>
</html>

Open in new window

natsullyAsked:
Who is Participating?
 
hieloConnect With a Mentor Commented:
>>What is going on after line 279? Is this one or two html pages?
If you look at line 286, the script will stop there. I pasted all that by mistake. I started a sample page yesterday (because I didn't like what the the poster supplied ) then kept on building on it. I forgot to get rid of it.My apologies for the confusion. It should have just been:
<?php
if( !empty($_POST['Name']) && !empty($_POST['Email']) && !empty($_POST['Site']) )
{
	header("Content-type: text/plain"); 
	//if you set this to false you will get "No Worries Posters". 
	//When true, you just get "Posters"
	$RemoveNoWorriesPrefix=true; 
	//list or regional managers to be cc
	$RegionalManager=array();
	$RegionalManager['A']="PersonA@company.com";
	$RegionalManager['B']="PersonB@company.com";
	$RegionalManager['C']="PersonC@company.com";
	$RegionalManager['D']="PersonD@company.com";
	$RegionalManager['E']="PersonE@company.com";
	$RegionalManager['F']="PersonF@company.com"; 
	
      $submittedData="";
	 
      $submittedData.="\nName:" . $_POST['Name'];
      $submittedData.="\nEmail:" . $_POST['Email'];
      $submittedData.="\nSite:" . $_POST['Site'];
      $submittedData.="\nRegional Manager:" . $_POST['regional_manager'];
	 
	 $fields=array('Standard_Supplies','No_Worries_Flyers','No_Worries_Posters','No_Worries_Banners','No_Worries_Postcards');
	foreach($fields as $arrName)
	{
		 if(isset($_POST[$arrName]))
		 {
		 	if($RemoveNoWorriesPrefix)
				$submittedData.="\n\n" . str_replace("No Worries ","",str_replace("_"," ",$arrName));
			else
				$submittedData.="\n\n" . str_replace("_"," ",$arrName); 
		      foreach($_POST[$arrName] as $value)
		      {
		            $k=$value."_quantity";
		            if(!empty($_POST[$k]))
		                  $submittedData .= "\n\t".str_replace("_"," ",$value) . ": " . $_POST[$k];
		      }
		 }
	}
	 $headers="";
	 if(!empty($_POST['regional_manager']))
	 	$headers="CC:". $RegionalManager[ $_POST['regional_manager'] ];
      if(!empty($submittedData))
      {
            //mail("natalie.teinert@company.com","Order details",$submittedData,$headers);
		 echo $submittedData;
            echo "\n\nThank you!";
      }
      exit;
}
?>
 
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
 "http://www.w3.org/TR/html4/loose.dtd">
 
<html>
<head>
<title></title>
<style type="text/css">
.row1{float:left;width:24%;}
.row2{float:left;width:20%;}
fieldset{padding:5px;}
fieldset div select{display:block;}
legend{font-weight:bold;background-color:white;}
fieldset fieldset{border:0px; border-top:1px dashed black;margin-top:1em;}
</style>
 
</head>
<body>
<form id="form1" name="form1" method="post" action="<?=$_SERVER['PHP_SELF']?>">
  <label><strong>* Name:</strong></label>
  <input name="Name" type="text" id="Name" size="27">
  <br><br>
  <label><strong>* Email:</strong></label>
  <input name="Email" type="text" id="Email" size="27">
  <br><br>
<label><strong>* Site:</strong></label>
<input name="Site" type="text" id="Site" size="29">
<br>
<br>
<label>Regional Manager
<select name="regional_manager" id="regional_manager">
  <option  value="">-</option>
  <option value="A">Person A</option>
  <option value="B">Person B</option>
  <option value="C">Person C</option>
  <option value="D">Person D</option>
  <option value="E">Person E</option>
  <option value="F">Person F</option>
</select>
</label>
<br>
<br>
  <fieldset><legend>Standard Supplies</legend> 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="RateSheet" />Ratesheet <select name="RateSheet_quantity"><option value="0"  >-</option>
		  <option value="500">500</option>
		  <option value="1000">1000</option>
		  <option value="1500">1500</option>
		  <option value="2000">2000</option>
            <option value="2500">2500</option>
            <option value="3000">3000</option>
            <option value="3500">3500</option>
            <option value="4000">4000</option>
            <option value="4500">4500</option>
            <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Table_Drape" />Table Drape <select name="Table_Drape_quantity"><option value="0"  >-</option>
                <option value="1 - 6 ft.">1 - 6 ft.</option>
                <option value="2 - 6 ft.">2 - 6 ft.</option>
                <option value="3 - 6 ft.">3 - 6 ft.</option>
                <option value="1 - 8 ft.">1 - 8 ft.</option>
                <option value="2 - 8 ft.">2 - 8 ft.</option>
                <option value="3 - 8 ft.">3 - 8 ft.</option>
            </select></div> 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Banner_Stands" />Banner Stands <select name="Banner_Stands_quantity"><option value="0" >-</option>
                <option value="1">1</option>
                <option value="2">2</option>
                <option value="3">3</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="T_Shirts" />T-Shirts <select name="T_Shirts_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Flyers</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ClassFlyer" />Class In Ten Minutes? <select name="ClassFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ApartmentFlyer" />Apartment Hunting? <select name="ApartmentFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RoommateFlyer" />Roommate Hasn't Paid Up? <select name="RoommateFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RentsFlyer" />'Rents Cramping Your Style? <select name="RentsFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Posters</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ClassPoster" />Class In Ten Minutes? <select name="ClassPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ApartmentPoster" />Apartment Hunting? <select name="ApartmentPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RoommatePoster" />Roommate Hasn't Paid Up? <select name="RoommatePoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RentsPoster" />'Rents Cramping Your Style? <select name="RentsPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Banners</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ClassBanner" />Class In Ten Minutes? <select name="ClassBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ApartmentBanner" />Apartment Hunting? <select name="ApartmentBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RoommateBanner" />Roommate Hasn't Paid Up? <select name="RoommateBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RentsBanner" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Postcards</legend>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ClassPostcard" />Class In Ten Minutes? <select name="ClassPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ApartmentPostcard" />Apartment Hunting? <select name="ApartmentPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RoommatePostcard" />Roommate Hasn't Paid Up? <select name="RoommatePostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RentsPostcard" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ForeignPostcard" />Foreign City?<select name="ForeignPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
<br>
<input type="submit" name="Submit" id="Submit" value="Submit"> 
</form>
</body>
</html> 

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0
 
hieloCommented:
copy and paste this:
<?php
if( !empty($_POST['Name']) && !empty($_POST['Email']) && !empty($_POST['Site']) )
{
	header("Content-type: text/plain"); 
	//if you set this to false you will get "No Worries Posters". 
	//When true, you just get "Posters"
	$RemoveNoWorriesPrefix=true; 
	//list or regional managers to be cc
	$RegionalManager=array();
	$RegionalManager['A']="PersonA@company.com";
	$RegionalManager['B']="PersonB@company.com";
	$RegionalManager['C']="PersonC@company.com";
	$RegionalManager['D']="PersonD@company.com";
	$RegionalManager['E']="PersonE@company.com";
	$RegionalManager['F']="PersonF@company.com"; 
	
      $submittedData="";
	 
      $submittedData.="\nName:" . $_POST['Name'];
      $submittedData.="\nEmail:" . $_POST['Email'];
      $submittedData.="\nSite:" . $_POST['Site'];
      $submittedData.="\nRegional Manager:" . $_POST['regional_manager'];
	 
	 $fields=array('Standard_Supplies','No_Worries_Flyers','No_Worries_Posters','No_Worries_Banners','No_Worries_Postcards');
	foreach($fields as $arrName)
	{
		 if(isset($_POST[$arrName]))
		 {
		 	if($RemoveNoWorriesPrefix)
				$submittedData.="\n\n" . str_replace("No Worries ","",str_replace("_"," ",$arrName));
			else
				$submittedData.="\n\n" . str_replace("_"," ",$arrName); 
		      foreach($_POST[$arrName] as $value)
		      {
		            $k=$value."_quantity";
		            if(!empty($_POST[$k]))
		                  $submittedData .= "\n\t".str_replace("_"," ",$value) . ": " . $_POST[$k];
		      }
		 }
	}
	 $headers="";
	 if(!empty($_POST['regional_manager']))
	 	$headers="CC:". $RegionalManager[ $_POST['regional_manager'] ];
      if(!empty($submittedData))
      {
            //mail("natalie.teinert@company.com","Order details",$submittedData,$headers);
		 echo $submittedData;
            echo "\n\nThank you!";
      }
      exit;
}
?>
 
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
 "http://www.w3.org/TR/html4/loose.dtd">
 
<html>
<head>
<title></title>
<style type="text/css">
.row1{float:left;width:24%;}
.row2{float:left;width:20%;}
fieldset{padding:5px;}
fieldset div select{display:block;}
legend{font-weight:bold;background-color:white;}
fieldset fieldset{border:0px; border-top:1px dashed black;margin-top:1em;}
</style>
 
</head>
<body>
<form id="form1" name="form1" method="post" action="<?=$_SERVER['PHP_SELF']?>">
  <label><strong>* Name:</strong></label>
  <input name="Name" type="text" id="Name" size="27">
  <br><br>
  <label><strong>* Email:</strong></label>
  <input name="Email" type="text" id="Email" size="27">
  <br><br>
<label><strong>* Site:</strong></label>
<input name="Site" type="text" id="Site" size="29">
<br>
<br>
<label>Regional Manager
<select name="regional_manager" id="regional_manager">
  <option  value="">-</option>
  <option value="A">Person A</option>
  <option value="B">Person B</option>
  <option value="C">Person C</option>
  <option value="D">Person D</option>
  <option value="E">Person E</option>
  <option value="F">Person F</option>
</select>
</label>
<br>
<br>
  <fieldset><legend>Standard Supplies</legend> 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="RateSheet" />Ratesheet <select name="RateSheet_quantity"><option value="0"  >-</option>
		  <option value="500">500</option>
		  <option value="1000">1000</option>
		  <option value="1500">1500</option>
		  <option value="2000">2000</option>
            <option value="2500">2500</option>
            <option value="3000">3000</option>
            <option value="3500">3500</option>
            <option value="4000">4000</option>
            <option value="4500">4500</option>
            <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Table_Drape" />Table Drape <select name="Table_Drape_quantity"><option value="0"  >-</option>
                <option value="1 - 6 ft.">1 - 6 ft.</option>
                <option value="2 - 6 ft.">2 - 6 ft.</option>
                <option value="3 - 6 ft.">3 - 6 ft.</option>
                <option value="1 - 8 ft.">1 - 8 ft.</option>
                <option value="2 - 8 ft.">2 - 8 ft.</option>
                <option value="3 - 8 ft.">3 - 8 ft.</option>
            </select></div> 
            <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Banner_Stands" />Banner Stands <select name="Banner_Stands_quantity"><option value="0" >-</option>
                <option value="1">1</option>
                <option value="2">2</option>
                <option value="3">3</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="T_Shirts" />T-Shirts <select name="T_Shirts_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Flyers</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ClassFlyer" />Class In Ten Minutes? <select name="ClassFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="ApartmentFlyer" />Apartment Hunting? <select name="ApartmentFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RoommateFlyer" />Roommate Hasn't Paid Up? <select name="RoommateFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Flyers[]" value="RentsFlyer" />'Rents Cramping Your Style? <select name="RentsFlyer_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Posters</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ClassPoster" />Class In Ten Minutes? <select name="ClassPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="ApartmentPoster" />Apartment Hunting? <select name="ApartmentPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RoommatePoster" />Roommate Hasn't Paid Up? <select name="RoommatePoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Posters[]" value="RentsPoster" />'Rents Cramping Your Style? <select name="RentsPoster_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Banners</legend>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ClassBanner" />Class In Ten Minutes? <select name="ClassBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="ApartmentBanner" />Apartment Hunting? <select name="ApartmentBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RoommateBanner" />Roommate Hasn't Paid Up? <select name="RoommateBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row1"><input type="checkbox" name="No_Worries_Banners[]" value="RentsBanner" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
   <fieldset><legend>No Worries - Postcards</legend>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ClassPostcard" />Class In Ten Minutes? <select name="ClassPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ApartmentPostcard" />Apartment Hunting? <select name="ApartmentPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
            <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RoommatePostcard" />Roommate Hasn't Paid Up? <select name="RoommatePostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
                <option value="2500">2500</option>
                <option value="3000">3000</option>
                <option value="3500">3500</option>
                <option value="4000">4000</option>
                <option value="4500">4500</option>
                <option value="5000">5000</option>
            </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="RentsPostcard" />'Rents Cramping Your Style? <select name="RentsBanner_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  <div class="row2"><input type="checkbox" name="No_Worries_Postcards[]" value="ForeignPostcard" />Foreign City?<select name="ForeignPostcard_quantity"><option value="0" >-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option>
      <option value="2500">2500</option>
      <option value="3000">3000</option>
      <option value="3500">3500</option>
      <option value="4000">4000</option>
      <option value="4500">4500</option>
      <option value="5000">5000</option>
  </select></div>
  </fieldset>
<br>
<br>
<input type="submit" name="Submit" id="Submit" value="Submit"> 
</form>
</body>
</html> 

<?php
exit; 
if( !empty($_POST['action']) )
{
	header("Content-type: text/plain");
	$submittedData="";
	foreach($_POST['Standard_Supplies'] as $value)
	{
		$k=$value."_quantity";
		if(!empty($_POST[$k]))
			$submittedData .= "\n".str_replace("_"," ",$value) . ": " . $_POST[$k];
	}
	$submittedData .="\nNo Worries Campaign";
	$submittedData .="\n\tQuantity: " . $_POST['NWC_quantity'];
	$nwc=array('Flyers','Posters','Banners','Post_Cards');
	foreach($nwc as $chk)
	{
		if( !empty($_POST[$chk]) )
		{
			$submittedData .= "\n\t" . $chk.":";
			foreach($_POST[$chk] as $value)
			{
				$submittedData .= "\n\t\t".str_replace("_"," ",$value);
			}
		}
	}
	if(!empty($submittedData))
	{
		//mail("you@yourcompany.com","Order details",$submittedData);
		echo $submittedData;
		echo "\n\nThank you!";
	}
	exit;
}
?> 
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
 "http://www.w3.org/TR/html4/loose.dtd">
 
<html>
<head>
<title></title>
<style type="text/css">
<!--
.row1{float:left;width:25%;}
.col1{float:left;width:49%;}
fieldset{padding:5px;}
fieldset div select{display:block;}
legend{font-weight:bold;background-color:white;}
fieldset fieldset{border:0px; border-top:1px dashed black;margin-top:1em;}
-->
</style>
 
</head>
<body>
<form id="form1" name="form1" method="post" action="<?=$_SERVER['PHP_SELF']?>">
	<fieldset><legend>Standard Supplies</legend>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="RateSheet" />Ratesheet <select name="RateSheet_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Table_Drape" />Table Drape <select name="Table_Drape_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div class="row1"><input type="checkbox" name="Standard_Supplies[]" value="Banner_Stands" />Banner Stands <select name="Banner_Stands_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
		<div><input type="checkbox" name="Standard_Supplies[]" value="T_Shirts" />T-Shirts <select name="T_Shirts_quantity"><option value="0">-</option><option value="500">500</option><option value="1000">1000</option><option value="1500">1500</option><option value="2000">2000</option></select></div>
	</fieldset>
 
	<fieldset><legend>No Worries Campaign</legend>
		<div>Quantity: <input type="text" name="NWC_quantity"/></div>
		<fieldset><legend>Flyers</legend>
			<div class="col1"><input type="checkbox" name="Flyers[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Flyers[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Flyers[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Flyers[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Posters</legend>
			<div class="col1"><input type="checkbox" name="Posters[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Posters[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Posters[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Posters[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Banners</legend>
			<div class="col1"><input type="checkbox" name="Banners[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Banners[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Banners[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Banners[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
 
		<fieldset><legend>Post Cards</legend>
			<div class="col1"><input type="checkbox" name="Post_Cards[]" value="Class In Ten Minutes?"/>Class In Ten Minutes?</div>
			<div><input type="checkbox" name="Post_Cards[]" value="Apartment Hunting?"/>Apartment Hunting?</div>
			<div class="col1"><input type="checkbox" name="Post_Cards[]" value="Roommate hasn't paid up?"/>Roommate hasn't paid up?</div>
			<div><input type="checkbox" name="Post_Cards[]" value="Olds Cramping Your Style?"/>Olds Cramping Your Style?</div>
		</fieldset>
	</fieldset>
	<div><input type="submit" name="action" value="Submit"/></div>
</form>
</body>
</html>

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0
 
hieloCommented:
NOTE: on this fragment:

      if(!empty($submittedData))
      {
            //mail("natalie.teinert@company.com","Order details",$submittedData,$headers);
             echo $submittedData;
            echo "\n\nThank you!";
      }

the mail is commented out so that you can see the output directly on the browser. Once it is resolved, change it to:

      if(!empty($submittedData))
      {
            mail("natalie.teinert@company.com","Order details",$submittedData,$headers);
             //echo $submittedData;
            echo "\n\nThank you!";
      }

so you get the email.
0
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Roger BaklundCommented:
What is going on after line 279? Is this one or two html pages?
0
 
natsullyAuthor Commented:
Thanks hielo!!
You've really helped me out!
Is there a way to message you when I have new open questions?
Thanks again!!
0
 
hieloCommented:
You are welcome. What other's have done in the past is start their question title with "Hielo:" and my filters will catch that. But that shouldn't be necessary. I'm an active contributor, so if I don't answer, I am most likely away from the computer.
0
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