<style type="text/css">

textarea, .form { border: 1px solid #555555; }
</style>


<?  


// Enter your email address here
$adminaddress = "kumanprx@o2.pl";

// Enter the address of your website here MUST include [url=http://www]http://www[/url].
$siteaddress ="http://www.web-effect.tym.pl";

// Enter your company name or site name here
$sitename = "Web-EFFECT";



// Unless you know better I advise that you don't touch anything below here!
// Don't touch this it grabs the date and time from your server
$date = date("m/d/Y H:i:s");
$vers = "kumanMAIL";
$traceroute = "<a href=\"http://www.above.net/cgi-bin/trace?$REMOTE_ADDR\">";

if ($REMOTE_ADDR == "") $ip = "<i> no ip </i>";
else $ip = getHostByAddr($REMOTE_ADDR);

IF ($action==""):
?>

<center>

<FORM name=validation METHOD=POST ACTION="<? echo "$PHP_SELF"; ?>" onSubmit="return checkbae()">

<table border ="0" cellspacing="10" >
  <tbody>
    <tr>
      <td><font size="1">Nazwisko:</font></td>
      <td><INPUT TYPE="text" NAME="fname" size="30" style="border: 1px solid #555555;"></td>
    </tr>
    <tr>
      <td><font size="1">E-mail:</font></td>
      <td><INPUT TYPE="text" NAME="vemail" size="30" style="border: 1px solid #555555;"></td>
    </tr>
    <tr>
      <td><font size="1">Telefon:</font></td>
      <td><INPUT TYPE="text" NAME="telno" size="30" style="border: 1px solid #555555;"></td>
    </tr>
    <tr>
      <td valign="top"><br><font size="1">Wiadomość:</font></td>
      <td valign="top"><br><TEXTAREA NAME="comments" ROWS="3" COLS="30 style="border: 1px solid #555555;"></TEXTAREA></td>
    </tr>
   <tr>
      <td></td>
      <td><FORM><center><INPUT type=image NAME="action" VALUE="Wyślij" src="image/smal_ico/wyslij_button.gif" ></center></FORM></td>
    </tr>


</tbody>
</table>





<script language="JavaScript1.2">

var testresults

function checkemail(){

var str=document.validation.vemail.value

var filter=/^.+@.+\..{2,3}$/

if (filter.test(str))

testresults=true

else{

alert("Please input a valid email address!")

testresults=false

}



return (testresults)

}

</script>
<script>

function checkbae(){

if (document.layers||document.all)

return checkemail()

else

return true

}

</script>

<?
//This grabs the form data and formats it and sends it in an email to you

exit;
ELSEIF ($action="Send"):
mail("$adminaddress","Info Request", "FAO: Admin @ $sitename \n
First Name: $fname
Last Name: $lname
Email: $vemail
Company: $cname
Telephone: $telno\n
The visitor commented:
------------------------------
$comments
------------------------------

Logged Info :
------------------------------
Mailer: $vers
Using: $HTTP_USER_AGENT
Hostname: $ip
IP address: $REMOTE_ADDR
Date/Time:  $date","FROM:$adminaddress");

//This grabs the form data and sends a confirmation to your visitor

mail("$vemail","Thank You for visiting $sitename", "Hi $fname,\n
Thank you for your interest in $sitename!
We will read your comments as soon as we can and act accordingly.
You can expect a response within 48hrs.\n
Best regards,
$sitename
$siteaddress","FROM:$adminaddress");


PRINT "Dziękujemy za kontakt.<BR><BR>";
PRINT "<font face=\"$font\" color=\"$fcolor\">Skontaktujemy się z Tobą na podany adres : <b> $vemail </b>, lub telefonicznie: <b> $telno </b> w ciągu 48 godzin.<br>";
ENDIF;
?>