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<html> <head> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <title>Email Form </title> </head> <body> <form method="post" action="sendeail.php"> <!-- DO NOT change ANY of the php sections --> <?php $ipi = getenv("REMOTE_ADDR"); $httprefi = getenv ("HTTP_REFERER"); $httpagenti = getenv ("HTTP_USER_AGENT"); ?> <input type="hidden" name="ip" value="<?php echo $ipi ?>" /> <input type="hidden" name="httpref" value="<?php echo $httprefi ?>" /> <input type="hidden" name="httpagent" value="<?php echo $httpagenti ?>" /> Your Name: <br /> <input type="text" name="visitor" size="35" /> <br /> Your Email:<br /> <input type="text" name="visitormail" size="35" /> <br /> <br /> <br /> Attention:<br /> <select name="attn" size="1"> <option value=" Sales n Billing ">Sales n Billing </option> <option value=" General Support ">General Support </option> <option value=" Technical Support ">Technical Support </option> <option value=" Webmaster ">Webmaster </option> </select> <br /><br /> Mail Message: <br /> <textarea name="notes" rows="4" cols="40"></textarea> <br /> <input type="submit" value="Send Mail" /> <br /> <a href="http://www.ibdhost.com/contact/"></a> </form> </body> </html>