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Custom web form coding

Hello Freelancers.

We have a special problem we want fixed with our webform.

I want to be able to capture a IP address, and Location from the webform and have it submit the information to a hidden field that is a custom tag for my email and marketing management system.

Let me outline it.

Name

Email

Phone number

And I also want a hidden field that captures location, IP and submits it to a hidden custom field.

Here is the CODE minus my API key - I will work with you to get this done:

This is a PHP sidebar that is called to each of my webpages:

<script type="text/javascript">

// <![CDATA[

function CheckMultiple20(frm, name) {

for (var i=0; i < [url removed, login to view]; i++)

{

fldObj = [url removed, login to view][i];

fldId = [url removed, login to view];

if (fldId) {

var fieldnamecheck=[url removed, login to view](name);

if (fieldnamecheck != -1) {

if ([url removed, login to view]) {

return true;

}

}

}

}

return false;

}

function CheckForm20(f) {

var email_re = /[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*@(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?/i;

if (![url removed, login to view]([url removed, login to view])) {

alert("Please enter your email address.");

[url removed, login to view]();

return false;

}

return true;

}

// ]]>

</script>

<td width="13px">

<!--- spacer --->

</td>

<!--- right sidebar --->

<td valign="top" width="291px" align="right">

<table cellpadding="0px" cellspacing="0px" border="0" width="291px"><!--- sidebar --->

<tr>

<td style="background-image:url(images/[url removed, login to view]); background-repeat:no-repeat; background-position:right top;" valign="middle" align="center" height="279px">

<!--- form --->

<center>

<form method="post" action="[url removed, login to view]" id="MY API KEY HERE" onsubmit="return CheckForm20(this);">

<span style="color:#eb1d21; font-size:14px;">Sign up to see the <br /><strong>Six Easy Steps for making <br />9% on your money starting now!</strong></span>

<input type="text" name="CustomFields[2]" id="CustomFields_2_20" value="Enter Your First Name" onfocus="if ([url removed, login to view] == 'Enter Your First Name') {[url removed, login to view] = '';}" onblur="if ([url removed, login to view] == '') {[url removed, login to view] = 'Enter Your First Name';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/>

<br/>

<input type="text" name="email" value="Enter Your Email" onfocus="if ([url removed, login to view] == 'Enter Your Email') {[url removed, login to view] = '';}" onblur="if ([url removed, login to view] == '') {[url removed, login to view] = 'Enter Your Email';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/>

<br/>

<input type="text" name="CustomFields[5]" id="CustomFields_5_20" value="Enter Your Mobile Number" onfocus="if ([url removed, login to view] == 'Enter Your Mobile Number') {[url removed, login to view] = '';}" onblur="if ([url removed, login to view] == '') {[url removed, login to view] = 'Enter Your Mobile Number';}" style="width:200px; margin-bottom:12px; font-size:16px; color:#333; padding:3px;"/>

<div style="font-size:12px;color:#999;margin:5px 0;">

<p>By signing up you are granting permission for us to call about our program and email you materials.</p>

</div>

<div align="center" style="height:45px; width:265px;">

<input type="image" name="submit" height="40" width="264" src="[url removed, login to view]" />

</div>

<input type="hidden" name="format" value="h" />

</form>

</center>

<!--- end form --->

<div style="margin-top:10px;"></div>

</td>

</tr>

<tr>

<td height="10px">

Kemahiran: HTML, Javascript, PHP

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Tentang Majikan:
( 21 ulasan ) Newberg, United States

ID Projek: #1573337

2 pekerja bebas membida secara purata $30 untuk pekerjaan ini

acesolution

Lets do it now.....Thanks

$30 USD dalam 0 hari
(125 Ulasan)
6.7
pollux1er

Very easy to do. I am free to do it!

$30 USD dalam 0 hari
(26 Ulasan)
4.7