I've set the configuration to "My Template", and I just get an empty email with my IP at the bottom.
Here's my form code:
Email Template
Please help!
Here's my form code:
<table width="100%" border="0">
<tr>
<td>Respondent</td>
<td><input name="respondent" type="text" id="respondent" /></td>
</tr>
<tr>
<td>Email</td>
<td><input name="email" type="text" id="email" /></td>
</tr>
<tr>
<td>Phone</td>
<td><input name="phone" type="text" id="phone" /></td>
</tr>
<tr>
<td>Agency Name </td>
<td><input name="agency" type="text" id="agency" /></td>
</tr>
<tr>
<td>City, State </td>
<td><input name="city" type="text" id="city" /></td>
</tr>
</table>
<p>Ryan White CARE Act funding (Select all that apply):<br />
<label>
<input name="ryan1" type="checkbox" id="na" value="Not Applicable" />
Not Applicable</label>
<input name="ryan2" type="checkbox" id="iii" value="Title III" />
Title III
<input name="ryan3" type="checkbox" id="iv" value="Title IV" />
TitleIV</p>
<ol>
<li>What is you profession/discipline? (Select one)
<p>
<label>
<input type="radio" name="RadioGroup1" value="Case Manager" />
Case Manager</label>
<br />
<label>
<input type="radio" name="RadioGroup1" value="Health Educator" />
Health Educator</label>
<br />
<label>
<input type="radio" name="RadioGroup1" value="Substance Abuse Counselor" />
Substance Abuse Counselor</label>
<br />
<label>
<input type="radio" name="RadioGroup1" value="Mental Health Counselor" />
Mental Health Counselor</label>
<br />
<label>
<input type="radio" name="RadioGroup1" value="Other" />
Other (specify)</label> <input name="othertext1" type="text" />
<br />
</p>
</li>
<li>In the past 12 months, have you worked with patients or clients in the following populations: (Select all that apply)
<p>
<label>
<input type="checkbox" name="ques2[]" value="HIV positive without AIDS diagnosis" />
HIV positive without AIDS diagnosis</label>
<br />
<label>
<input type="checkbox" name="ques2[]" value="HIV positive with AIDS diagnosis" />
HIV positive with AIDS diagnosis</label>
<br />
<label>
<input type="checkbox" name="ques2[]" value="Had an STD" />
Had an STD</label>
<br />
</p>
</li>
<li>What length of time do you prefer for continuing professional education/training programs? (Indicate longest duration)
<p>
<label>
<input type="radio" name="ques3" value="No preference" />
No preference</label>
<br />
<label>
<input type="radio" name="ques3" value="Less than half's day" />
Less than half's day</label>
<br />
<label>
<input type="radio" name="ques3" value="Half day" />
Half day</label>
<br />
<label>
<input type="radio" name="ques3" value="Full day" />
Full day</label>
<br />
<label>
<input type="radio" name="ques3" value="2-3 days" />
2-3 days</label>
<br />
</p>
</li>
<li>How far are you willing to travel to receive education/training? (Indicate farthest distance)
<p>
<label>
<input type="radio" name="ques4" value="No preference" />
No preference</label>
<br />
<label>
<input type="radio" name="ques4" value="On-site location" />
On-site location</label>
<br />
<label>
<input type="radio" name="ques4" value="City in which you work" />
City in which you work</label>
<br />
<label>
<input type="radio" name="ques4" value="State in which you work" />
State in which you work</label>
<br />
<label>
<input type="radio" name="ques4" value="Other" />
Other</label>
<br />
</p></li>
<li>In the past 2 years, approximately how many different professional education/training programs have you participated in that included HIV/AIDS-related topics? (Select one)
<p>
<label>
<input type="radio" name="ques5" value="None" />
None</label>
<br />
<label>
<input type="radio" name="ques5" value="1 - 2 events" />
1 - 2 events</label>
<br />
<label>
<input type="radio" name="ques5" value="3 - 5 events" />
3 - 5 events</label>
<br />
<label>
<input type="radio" name="ques5" value="6 - 10 events" />
6 - 10 events</label>
<br />
<label>
<input type="radio" name="ques5" value="More than 10 events" />
More than 10 events</label>
<br />
</p></li>
<li>Please tell us about other ways the NC AIDS Education Center can assist you to deliver optimum care to people living with HIV.
<p><textarea style="width: 80%;" name="comments" cols="" rows=""></textarea></p>
</li>
</ol>
<input name="submit" type="submit" value="Send Evaluation Results" />
Email Template
<p>A Evaluation has been done by {respondent}. Here are the results.</p>
<table width="100%" border="0">
<tr>
<td>Email</td>
<td>{email}</td>
</tr>
<tr>
<td>Phone</td>
<td>{phone}</td>
</tr>
<tr>
<td>Agency Name </td>
<td>{agency}</td>
</tr>
<tr>
<td>City, State </td>
<td>{city}</td>
</tr>
<tr>
<td><p>Ryan White CARE Act funding (Select <strong>all</strong> that apply)</p></td>
<td>{ryan1}{ryan2}{ryan3}</td>
</tr>
<tr>
<td>What is your <strong>profession/discipline</strong>? </td>
<td>{RadioGroup1}{othertext1}</td>
</tr>
<tr>
<td>In the <strong>past 12 months</strong>, have you worked with patients or clients in the following populations: </td>
<td>{ques2}</td>
</tr>
<tr>
<td>What <strong>length of time</strong> do you prefer for continuing professional education/training programs</td>
<td>{ques3}</td>
</tr>
<tr>
<td>How <strong>far</strong> are you willing to travel to receive education/training</td>
<td>{ques4}</td>
</tr>
<tr>
<td>In the <strong>past 2 years</strong>, approximately how many different <strong>professional education/training programs</strong> have you participated in that included <strong>HIV/AIDS</strong>-related topics? </td>
<td>{ques5}</td>
</tr>
<tr>
<td>Please tell us about<strong> other ways </strong>the NC HIV Training Center can <strong>assist </strong>you to deliver<strong> optimum care</strong> to <strong>people living with HIV</strong>.</td>
<td>{comments}</td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
</table>
<p> </p>
Please help!