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  1. #1
    Member
    Join Date
    May 2011
    Posts
    33
    Member #
    27718

    Question Need a php processing file for this bootstrap form

    Hello Guys, I am not that good working around with PHP. Please i would like someone to please help out with the possible PHP scripts that could connect with this form validate, obtain data and send data to a dedicated email. I know is simple, but i cannot just get it done.

    Here is the code for the form i have:

    <form method="post" action="#">
    <div class= "form">
    <div class="input-group margin-bottom-sm col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <input class="form-control" type="text" placeholder="Full Name *" required>
    </div>
    <div class="input-group margin-bottom-sm col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <input class="form-control" type="text" placeholder="Email Address *" required>
    </div>
    <div class="input-group margin-bottom-sm col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <input class="form-control" type="text" placeholder="Appointment Date *" required>
    </div>
    <div class="input-group margin-bottom-sm col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <input class="form-control" type="text" placeholder="Mobile Number *" required>
    </div>
    </div>
    <div class="input-group margin-bottom-sm col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <textarea class="form-control" rows="6" placeholder="Your Problem *" required></textarea>
    </div>
    <div class="col-md-8 col-md-offset-2 col-sm-8 col-sm-offset-2 col-xs-10 col-xs-offset-1">
    <div class="captcha-container">
    <label>Are you human? </label><br/>
    <img src="http://inspirythemesdemo.com/healthpress/wp-content/themes/healthpress-theme/captcha/captcha.php" alt="">
    <input type="text" class="captcha required" name="captcha" maxlength="5" title=" Please enter the code characters displayed in image!">
    </div>
    <input class="btn btn-primary send" type="submit" value="Send">
    </div>
    </form>


    Please help me out on this. Thanks!

  2.  


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