<p><img src="images/sig.gif" align="left" width="37" height="69" style="margin-right: 5px;" alt="B/S Signature"/> <font
  class="head">Contact!</font><br/>

<form action="?page=mailer" method="post">
    <strong>*Name:</strong><br>
<input type="text" name="name" size="20">
<br>
    <strong>*E-mail Address:</strong><br>
<input type="text" name="email" size="45">
<br>
<strong>E-mail Subject:</strong><br>
<select type="subject" name="subject" value="subject" width="350"><br />
<option value=""></option>
<option value="Information Request">Information Request</option>
<option value="Quote Request">Quote Request</option>
</select><br><br />
<input name="human" type="checkbox" value="yes">
    Check if you are Human.*<br />
    (This is for your security)<br /><br />
    <strong>*Message/Comments:</strong><br>
<textarea rows="9" name="message" cols="30"></textarea>
<br>
<br>
<input type="submit" value="Submit" name="submit">
</form>
<br /><br />fields denoted with * are required.<br /><br />Your information will not be sold/given/other means of forwarding to anyone!</font>

<?php
// where the mail will be sent
$to = "EMAILADDRESSREMOVED";
//whos recieving this message
$subject = $_REQUEST["subject"];
//Subject of the message
$name_field = $_REQUEST["name"];
//senders name (if provided)
$email_field = $_REQUEST["email"];
//senders email
$message = $_REQUEST["message"];
//senders message
$human = $_REQUEST["human"];
//Sets what the answer to the first filter will be (kind-of)=
//this is for the check box, makes it required, and echos a reminder if forgotten
if($human =="") { echo "You forgot to check the human box or are a spambot! <br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br /><br />"; die;};

//makes sure that the senders name isn't blank
if($name_field=="") { echo "You forgot to fill out your name in the proper field!<br /><br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br /><br />"; die;};

//makes sure that the senders name isn't blank
if($email_field=="") { echo "You forgot to fill out your Email Address in the proper field!<br /><br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br /><br />"; die;};

//makes sure that the senders name isn't blank
if($message=="") { echo "You forgot to fill out any message/question(s)/or comment(s) in the proper field!<br /><br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br /><br />"; die;};

//Once they click submit and it passes the required checks it gets sent
if(isset($_POST['submit'])) {

//subject and body fields
$headers  = "From: $email_field\n";
$body = " From: $name_field\n E-Mail: $email_field\n Subject: $subject\n Message:\n $message";
//sent message

//A little thanks, echo'd after
echo "<br />Thank you for your interest, you information has been sent,<br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br />";
mail($to, $subject, $body, $headers);
//sends the email

} else {

echo "<br />Something was missing, please try again.<br /><a class='bodylink' href='java script:history.go(-1)'>click here to return to the previous page</a>.<br />";
// If something was wrong it tells them so, and then lets them go back and fix it
}
?>