Help with Form
Posted: Sun Oct 13, 2002 11:34 am
<html>
<head>
<title>application</title>
</head><center><img src="images/KCTCS.JPG"></center>
<body><body bgcolor="EBC79E"></body>
<FORM METHOD="POST" ACTION="application4.php">
<h1>Application For Employment</h1>
<table>
<p align="right">Date of Application: <input type="text" Date="Date" size="12"></p>
<p>Position applied for: <input type="text" Name="Name" size="73"> Salary
Desired: <input type="text" name="T3" size="11"> Minimum Accepted Salary:
<input type="text" Name="name" size="11"></p>
<p>How did you hear about us: <select size="1" name="D1" multiple>
<option>Radio</option>
<option>TV</option>
<option>Newspaper</option>
<option>Other</option>
</select></p>
<p> </p>
<p> </p>
<tr>
<td><b>Last name:</b></td>
<td><INPUT TYPE="TEXT" NAME="Lastname[]" size="20"></td>
</tr>
<br>
<tr>
<td><b>First name:</b></td>
<td><INPUT TYPE="TEXT" NAME="Firstname[]" size="20"></td>
</tr>
<tr>
<td><b>Middle name:</b></td>
<td><INPUT TYPE="TEXT" NAME="Middlename[]" size="20"></td>
</tr>
<tr>
<td><b>Maiden name:</b></td>
<td><INPUT TYPE="TEXT" NAME="maidenname" size="20"></td>
</tr>
<tr>
<td><b>Primary Email:</b></td>
<td><INPUT TYPE="TEXT" NAME="email[]" size="20"></td>
<td WIDTH="20"> </td>
<td>Secondary Email:</td>
<td><INPUT TYPE="TEXT" NAME="secondaryemail" size="20"></td>
</tr>
<tr>
<td>Home Address:</td>
<td><INPUT TYPE="TEXT" NAME="homeaddress1"></td>
</tr>
<tr>
<td></td>
<td><INPUT TYPE="TEXT" NAME="homeaddress2"></td>
</tr>
<tr>
<td>City:</td>
<td><INPUT TYPE="TEXT" NAME="homecity"></td>
</tr>
<tr>
<td>County:</td>
<td><INPUT TYPE="TEXT" NAME="homecounty"></td>
</TR>
<tr>
<td>State:</td>
<td><INPUT TYPE="TEXT" NAME="homestate"></td>
</tr>
<tr>
<td>Postal</td>
<td><INPUT TYPE="TEXT" NAME="homepostal"></td>
</tr>
</table>
<br>
<br>
<br>
<INPUT TYPE= "SUBMIT" VALUE="Submit">
<br>
<br>
<INPUT TYPE= "RESET" VALUE="Clear the form">
</form>
</body>
</html>
<?php
foreach ($input as $index => $Lastname, $Firstname, Middlename,)
{
echo "<br>input[$index]= $Lastname, $Firstname, Middlename";
}
?>