Форма:
<form class="form" action="feedback.php" metod="POST">
<p class="name">
<input type="text" name="name" id="name" />
<label for="name">Имя</label>
</p><br />
<p class="email">
<input type="text" name="email" id="email" />
<label for="email">E-mail</label>
</p><br />
<p class="phone">
<input type="text" name="phone" id="phone" />
<label for="phone">Телефон</label>
</p><br />
<p class="datepicker">
<input type="text" id="datepicker"/>
<label for="datepicker">Дата</label>
</p><br />
<p class="time">
<select name="time" size="1">
<option>09:00</option>
<option>10:00</option>
<option>11:00</option>
<option>12:00</option>
<option>13:00</option>
<option>14:00</option>
<option>15:00</option>
<option>16:00</option>
<option>17:00</option>
<option>18:00</option>
<option>19:00</option>
</select>
<label for="time">Время</label>
</p><br />
<p class="text">
<textarea name="text">Здравствуйте,</textarea>
</p><br />
<p class="submit">
<input type="submit" value="Отправить" />
</p>
</form>
Обработчик:
<?php
if(isset($_POST['submit'])) {
if(trim($_POST['name']) == '') {$hasError = true;}
else {$name = trim($_POST['name']);}
if(trim($_POST['email']) == '') {$hasError = true;}
else if (!eregi("^[A-Z0-9._%-]+@[A-Z0-9._%-]+\.[A-Z]{2,4}$", trim($_POST['email']))) {$hasError = true;}
else {$email = trim($_POST['email']);}
else {$phone = trim($_POST['phone']);}
else {$datepicker = trim($_POST['datepicker']);}
else {$time = trim($_POST['time'])}
if(!isset($hasError)) {
$emailTo = '56-semeynaja-mira56@rambler.ru';
$body = "Name: $name \n\nEmail: $email \n\nComments:\n $comments";
$headers = 'From: My Site <'.$emailTo.'>' . "\r\n" . 'Reply-To: ' . $email;
mail($emailTo, $subject, $body, $headers);
$emailSent = true;
}
}
?>
<p>Собщение успешно отправленно нажмите <a href="contact.php">ВЕРНУТЬСЯ,</a> что бы перейти в контакты.