<form name="contactform" method="post" action="form1.php">
 
<table width="600px">
 
<tr>
 
 <td valign="top">
 
  <label for="name">Name </label>
 
 </td>
 
 <td valign="top">
 
  <input  type="text" name="name" maxlength="50" size="30" required>
 
 </td>
 
</tr>
<tr>
 
 <td valign="top">
 
  <label for="Affiliation"> Affiliation </label>
 
 </td>
 
 <td valign="top">
 
  <input  type="text" name="Affiliation" maxlength="30" size="30" required>
 
 </td>
 
</tr>
<tr>
 
 <td valign="top">
 
  <label for="Designation">Designation </label>
 
 </td>
 
 <td valign="top">
 
  <input  type="text" name="Designation" maxlength="30" size="30" required>
 
 </td>
 
</tr>
<tr>
 
 <td valign="top"">
 
  <label for="address" > Correspondence Address</label>
 
 </td>
 
 <td valign="top">
 
  <textarea  type="text" name="address" maxlength="50" size="30" required>
  </textarea>
 </td>
</tr> 
<tr>
<tr>
 
 <td valign="top">
 
  <label for="telephone">Telephone/ Mobile</label>
 
 </td>
 
 <td valign="top">
 
  <input  type="text" name="telephone" maxlength="10" size="30" required>
 
 </td>
 
</tr>
 
<tr>
 
<tr>
 
 <td valign="top">
 
  <label for="email">Email ID </label>
 
 </td>
 
 <td valign="top">
  <input  type="text" name="email" maxlength="80" size="30" required>
 </td>
 </tr>
<tr>
<td>
Registration Type 
<td> <select name="Regtype">
<option value="Indian Participants">Indian Participants</option>
<option value="Institutional/Corporate Delegates">Institutional/Corporate Delegates </option>
<option value="Research Scholars and Participants from DU">Research Scholars and Participants from DU</option>
<option value="Foreign Delegates">Foreign Delegates</option>  
</select>
</td> 
 </tr>
 <tr><td>Presenting Paper</td>
 <td><input type="radio" name="paper" value="Yes">Yes</input>
 <input type="radio" name="paper" value="No">No</input></td>
 </tr>
 </tr>
 <tr>
<td>
Theme for Research Paper: 
<td> <select name="themeforResearch" value = "themeforResearch">
<option value="Smart Cities and Urban Infrastructure">Smart Cities and Urban Infrastructure</option>
<option value="Urban Environment and Micro-climate Change">Urban Environment and Micro-climate Change</option>
<option value="Urban Housing and Slums">Urban Housing and Slums</option>
<option value="Disaster Risk Reduction and Urban Sustainable Planning">Disaster Risk Reduction and Urban Sustainable Planning</option>
<option value="Mega Cities: Problems and Prospects">Mega Cities: Problems and Prospects</option>
<option value="Marginalized Spaces in Urban System">Marginalized Spaces in Urban System</option>
<option value="Urban Governance and Policies">Urban Governance and Policies</option>  
<option value="Urban Health and Well-being">Urban Health and Well-being</option>
<option value="Human Health and Well-being">Human Health and Well-being</option>  
<option value="Geospatial Techniques and Urban Planning">Geospatial Techniques and Urban Planning</option>  
<option value="Sustainable Urban Economy">Sustainable Urban Economy</option>  
</select>
</td> 
<tr><td>Abstract</td>
<td><textarea name ="Abstract" size = "30"></textarea></td></tr>

<tr>
 
 <td colspan="2" style="text-align:center">
 
  <input type="submit" value="Submit" name="cc">
 
 </td>
 
</tr>
 
</table>
 
</form>

<?php



if(isset($_POST['email'])) 
{
    // EDIT THE 2 LINES BELOW AS REQUIRED
 
    $email_to = "jitendra@bagwarsoftwares.com";
 
    $email_subject = "Enquiry";

    function died($error) {
 
        // your error code can go here
 
        echo "We are very sorry, but there were error(s) found with the form you submitted. ";
 
        //echo "These errors appear below.<br /><br />";
 
        echo $error."<br /><br />";
 
        //echo "Please go back and fix these errors.<br /><br />";
 
        die();
 
    }
 
    // validation expected data exists
 
    if(!isset($_POST['name']) ||
 
        !isset($_POST['address']) ||

        !isset($_POST['Designation']) ||
    
        !isset($_POST['Affiliation']) ||
 
        !isset($_POST['email']) ||
 
        !isset($_POST['telephone'])||

        !isset($_POST['Regtype'])||

        !isset($_POST['themeforResearch'])||

    
        
        !isset($_POST['Abstract'])) 
     {
      died('\nWe are sorry, but there appears to be a problem with the form you submitted.');       
 
    }
 
    $first_name = isset($_POST['name']); // required 
    $Affiliation = isset($_POST['Affiliation']); //  required
    $Designation = isset($_POST['Designation']); // required
    $address = isset($_POST['address']); // required
    $email_from = isset($_POST['email']); // required 
    $telephone = isset($_POST['telephone']); // not required
    $Regtype = isset($_POST['Regtype']); // required
    $ppa = isset($_POST['paper']); // required
    $themeforResearch = isset($_POST['themeforResearch']); //required
    $Abstract = isset($_POST['Abstract']); //required
 
   /* $error_message = "";
 
    $email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/';
 
  if(!preg_match($email_exp,$email_from)) {
 
    $error_message .= 'The Email Address you entered does not appear to be valid.<br />';
 
  }
 
    $string_exp = "/^[A-Za-z .'-]+$/";
 
  if(!preg_match($string_exp,$first_name)) {
 
    $error_message .= 'The Name you entered does not appear to be valid.<br />';
 
  }
 
  if(!preg_match($string_exp,$address)) {
 
    $error_message .= 'The Address you entered does not appear to be valid.<br />';
 
  }
 
  if($Regtype == '') {
 
    $error_message .= 'You did not Select Your Registration Type:.<br />';
 
  }
 
  if(strlen($error_message) > 0) {
 
    died($error_message);
 
  }*/

    $email_message = "Form details below.\n\n";
 
    function clean_string($string) {
 
      $bad = array("content-type","bcc:","to:","cc:","href");
 
      return str_replace($bad,"",$string);
 
    } 
    $email_message .= "Name : ".clean_string($_POST['name'])."\n";
    $email_message .= "Address : ".clean_string($_POST['address'])."\n";
    $email_message .= "Affiliation   : ".clean_string($_POST['Affiliation'])."\n";
    $email_message .= "Designation   : ".clean_string($_POST['Designation'])."\n";
    $email_message .= "Mobile  : ".clean_string($_POST['telephone'])."\n";
    $email_message .= "Email   : ".clean_string($_POST['email'])."\n";
    $email_message .= "Registration Type : ".clean_string($_POST['Regtype'])."\n";
    $email_message .= "Presenting Paper : ".clean_string($_POST['paper'])."\n";
    $email_message .= "Theme For Research Paper: ".clean_string($_POST['themeforResearch'])."\n";
    $email_message .= "Abstract : ".clean_string($_POST['Abstract'])."\n";



    if($_SERVER['REQUEST_METHOD'] == 'POST'){ 
 $con = mysql_connect("localhost","sbsc_register","sbsc@123");
if (!$con)
  {
  die('Could not connect: ' . mysql_error());
  }
mysql_select_db("sbsc_register", $con);
$sql = "INSERT INTO `college`(`name`, `address`, `affiliation`, `Designation`, `Mobile`, `email`, `Registype`, `prespapr`,`themeforresearch`,`Abstract`) VALUES 
('$_POST[name]','$_POST[address]','$_POST[Affiliation]','$_POST[Designation]','$_POST[telephone]','$_POST[email]','$_POST[Regtype]','$_POST[paper]','$_POST[themeforResearch]','$_POST[Abstract]')";
if (!mysql_query($sql,$con))
  {
  die('Error: ' . mysql_error());
  }
echo "Your Information has Successfully Posted";
mysql_close($con);
     }
 
// create email headers
 
$headers = 'From: '.$_POST['email']."\r\n".
 
'Reply-To: '.$_POST['email']."\r\n" .
 
'X-Mailer: PHP/' . phpversion();
 
@mail($email_to, $email_subject, $email_message, $headers);  
 

?>
 
 
 
<!-- include your own success html here -->
 
 
 
Thank you for contacting us. We will be in touch with you very soon.
 
 
 
<?php
 
}

?>