<html>
<head>
<title>Freelance - Contact Form</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">

</head>
    <?php
   /* error_reporting(0);*/
 
    echo '<pre>';
    //var_dump($_POST);
    echo '</pre>';
    
    
    foreach ($_POST as $key=>$value){
        if ($key == 'send'){
            continue;
        }
        if (is_array($value)){
          echo '<strong>'.ucfirst($key).'</strong> : ';
            foreach ($value as $indvalue){
                echo $indvalue.'<br>';
            }
        }
        else {
            if ($key == 'email'){
            $value = '<a href="tel:'.$value.'">'.$value.'</a>';
            }
            
        echo '<strong>'.ucfirst($key).'</strong> : '.$value.'<br>';
        }
     }
    
    
   ?>
<body bgcolor="#FFFFFF">
  <p>
  <form action="<?php echo $_SERVER['PHP_SELF'];?>" name = "myForm"
     method="post" onSubmit="return validatecheck();">

  <p align="center">
  <font face="Verdana, Arial, Helvetica" size=2 color = "white"> </font> 
  <table border = 0 width = 600 cellpadding = 10 align="center">
    <tr> 
      <td colspan="4" height="111"> 
        <div align="center">Logo Here</div>
      </td>
    </tr>
    <tr bgcolor="#CC0000"> 
      <td colspan="4"> 
        <div align="center"><font face="Verdana, Arial, Helvetica" size=2 color = "white"> 
          <font size="1">TELL US ABOUT YOURSELF</font></font></div>
      </td>
    </tr>
    <tr> 
      <td align = right valign=middle width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1"> NAME:</font></font></td>
      <td align = center valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="name" id="name" size=20 maxlength=40 >
        </font></td>
      <td align = right valign=middle width="89" bgcolor="#999999"><font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">COMPANY:</font></font></td>
      <td align = center valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="company" id="company" size=20 maxlength="40">
        </font></td>
    </tr>
    <tr> 
      <td align = right valign=middle width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1"> EMAIL:</font></font></td>
      <td align = center valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="email" id="email" size=20 maxlength=40 >
        </font></td>
      <td align = right valign=middle width="89" bgcolor="#999999"><font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">PHONE:</font></font></td>
      <td align = center valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="phone" id="phone" size=20 maxlength="40">
        </font></td>
    </tr>
    <tr> 
      <td align = right valign=middle width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1"> YOUR URL:</font></font></td>
      <td align = center valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="URL" size=20 maxlength=40 >
        </font></td>
      <td align = right valign=middle width="89" bgcolor="#999999"><font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">CITY:</font></font></td>
      <td align = center valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="city" id="city" size=20 maxlength="40">
        </font></td>
    </tr>
    <tr align="left" valign="middle"> 
      <td align="right" width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1"> STATE/<br>
        COUNTRY:</font></font></td>
      <td width="156" align="center" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="state" type="text" id="state" size="20" maxlength="200">
        </font></td>
      <td align="right" width="89" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1"> BEST WAY TO CONTACT YOU:</font></font></td>
      <td width="204" align="center" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="contact_by" type="radio" id="contact_by" value="Contact Phone">
        <font size="1"> PHONE</font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="radio" name="contact_by" value="Contact Email">
        <font size="1">EMAIL</font><font face="Verdana, Arial, Helvetica" size=2></font></font></font></td>
    </tr>
    <tr bgcolor="#CC0000"> 
      <td colspan=4> 
        <div align="center"><font face="Verdana, Arial, Helvetica" size=2 color = "white"> 
          <font size="1">WHAT SORT OF SERVICES DO YOU NEED?</font></font></div>
      </td>
    </tr>
    <tr> 
      <td align = right valign=top width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">WEBSITE:</font></font></td>
      <td align = left valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="web[]" value="Site Design">
        <font size="1">SITE DESIGN</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="web[]" value="Redesign">
        <font size="1">SITE REDESIGN</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="web[]" value="Store">
        <font size="1">ONLINE STORE<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="web[]" value="Marketing">
        <font size="1">MARKETING<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="web[]" value="Maintenance">
        <font size="1">MAINTENANCE</font></font></font></font></font></font></td>
      <td align = right valign=top width="89" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">PROGRAMMING:</font></font></td>
      <td align = left valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="programming[]" value="HTML/DHTML">
        <font size="1">HTML/DHTML</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="programming[]" value="PERL/CGI">
        <font size="1">CGI/PERL/C/C++</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="programming[]" value="Java">
        <font size="1">JAVA<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="programming[]" value="ASP">
        <font size="1">ASP<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="programming[]" value="XML">
        <font size="1">XML</font></font></font></font></font><font size="1"> </font></font></td>
    </tr>
    <tr> 
      <td align = right valign=top width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">DATABASE:</font></font></td>
      <td align = left valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="database[]" value="Access">
        <font size="1">ACCESS</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="database[]" value="SQL">
        <font size="1">SQL</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="database[]" value="Sybase">
        <font size="1">SYBASE<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="database[]" value="Oracle">
        <font size="1">ORACLE</font></font></font></font><font size="1"> </font></font></td>
      <td align = right valign=top width="89" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">MULTIMEDIA:</font></font></td>
      <td align = left valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="multimedia[]" value="Flash">
        <font size="1">FLASH</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="multimedia[]" value="Quicktime">
        <font size="1">QUICKTIME</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="multimedia[]" value="Media Player">
        <font size="1">MEDIA PLAYER<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="multimedia[]" value="Real">
        <font size="1">REAL</font></font></font></font><font size="1"> </font></font></td>
    </tr>
    <tr> 
      <td align = right valign=top width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">CORPORATE DESIGN:</font></font></td>
      <td align = left valign=middle width="156" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="corporate[]" value="Marketing Collateral">
        <font size="1">MARKETING </font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="corporate[]" value="Logos">
        <font size="1">LOGOS</font><font face="Verdana, Arial, Helvetica" size=2><br>
        <input type="checkbox" name="corporate[]" value="Packaging">
        <font size="1">PACKAGING<br>
        </font><font face="Verdana, Arial, Helvetica" size=2> 
        <input type="checkbox" name="corporate[]" value="Annual Reports">
        <font size="1">ANNUAL REPORTS</font></font></font></font><font size="1"> 
        </font></font></td>
      <td align = right valign=middle width="89" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#000000"> 
        <font size="1">OTHER:</font></font></td>
      <td align = left valign=middle width="204" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="other" id="other" size=20 maxlength="40">
        </font></td>
    </tr>
    <tr bgcolor="#CC0000"> 
      <td colspan="4"> 
        <div align="center"><font face="Verdana, Arial, Helvetica" size=2 color = "white"> 
          <font size="1">ADDITIONAL COMMENTS</font></font></div>
      </td>
    </tr>
    <tr> 
      <td align = right valign=middle width="72" bgcolor="#999999"> <font face="Verdana, Arial, Helvetica" size="2" color="#FFFFFF"> 
        <font size="1"> <font color="#000000">COMMENTS:</font></font></font></td>
      <td align = left valign=middle colspan="3" bgcolor="#CCCCCC"><font face="Verdana, Arial, Helvetica" size=2> 
        <input name="comments" id="comments" size=60 maxlength=100 >
        </font></td>
    </tr>
    <tr> 
      <td valign=middle colspan="3" align="right" bgcolor="#CC0000"> 
        <div align="center"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font> 
          <font face="Verdana, Arial, Helvetica, sans-serif" size="1" color="#FFFFFF">SUBMIT 
          FORM &gt;&gt;&gt;</font> </div>
      </td>
      <td valign=top align="right" bgcolor="#CC0000"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"> 
        <input name="send" type=submit id="send" value="SEND">
        <input type="reset" value="RESET" onClick=resetform() name="reset">
        </font></td>
    </tr>
  </table>
</form>


</body>
</html>