I love chrono forms! Thank you so much for this service. But I'm having some issues here.
I wrote the code by hand (after reading up on how to make forms), yet when the user submits the application to us we only recieve half of the information:
A TEST (this is what shows for the users information)
{Last Name}*:=
{Address}:
869 congress st
state:
costa mesa
state
CA
zip
92627
{email}
[email]oddball13@hotmail.com[/email]
{Phone Number}:
{Which time should we contact you?}:
{Which courses will you be attending?}:
{Suggest Course}:
{Will you be needing tuition assistance?}:
Submit
Send Application
_______
So only the address information shows up, but none of the other information. I will paste the code here, and someone PLEASE help me figure out why the name and course information for this online school wont show up. Thank you!!!
<b>Request for information</b>:
<br>
<br>
Please fill out the form below and we will get in contact with you as soon as possible. Normally within one business day. The * sign means that field is required.
<br>
<br>
<tr>
<td height="50" colspan="2" align="left" valign="top" style="padding-top:16px; padding-left:11px; "><span class="body_text"><strong>Personal Information<br/>
</strong></span>
<table width="400" height="1" border="0" cellpadding="0" cellspacing="0" class="row_div_bg">
<tr>
<td></td>
</tr>
</table>
<span class="body_text"><strong> </strong></span></td>
</tr>
<tr>
<td width="155" align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">First Name*:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<input name="{First Name}*:" type="text" class="form" style="width:170px; " value="">
</span></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">Last Name:</span></td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<input name="{Last Name}*:="text" class="form" style="width:170px; " value="">
</span></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">Address*:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<input name="{Address}:" type="text" class="form" style="width:170px; " value="">
</span></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text">City/State/zip*:</td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text"><input name="state:" type="text" class="form" style="width:120px; ">
<select name="state" class="form" id="select" style="width:50px; ">
<option value="N/A" selected>N/A</option>
<option value="AL">AL</option>
<option value="AK">AK</option>
<option value="AZ">AZ</option>
<option value="AR">AR</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="DE">DE</option>
<option value="DC">DC</option>
<option value="FL">FL</option>
<option value="GA">GA</option>
<option value="HI">HI</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="IA">IA</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="ME">ME</option>
<option value="MD">MD</option>
<option value="MA">MA</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MS">MS</option>
<option value="MO">MO</option>
<option value="MT">MT</option>
<option value="NE">NE</option>
<option value="NV">NV</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NY">NY</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VT">VT</option>
<option value="VA">VA</option>
<option value="WA">WA</option>
<option value="WV">WV</option>
<option value="WI">WI</option>
<option value="WY">WY</option>
</select>
<input name="zip" type="text" class="form" style="width:50px; " maxlength="9"></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text">Email Address:</td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text"><span class="body2_bg">
<input id="{email}" name="{email}" type="text" class="form" style="width:170px; ">
</span></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">
Phone Number:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<input name="{Phone Number}:" type="text" class="form" style="width:170px; " value="">
</span></td>
</tr>
<br>
<br>
<tr>
<td height="50" colspan="2" align="left" valign="top" style="padding-top:16px; padding-left:11px; "><span class="body_text"><strong>Questions Regarding PCS<br/>
</strong></span>
<table width="400" height="1" border="0" cellpadding="0" cellspacing="0" class="row_div_bg">
<tr>
<td></td>
</tr>
</table>
<span class="body_text"><strong> </strong></span></td>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">
What is the best time to contact you?:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<select name="{Which time should we contact you?}:" class="form" id="select" style="width:100px; ">
<option value="Morning">Morning</option>
<option value="Noon">Noon</option>
<option value="Evening">Evening</option>
</select>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">
Which courses will you be attending?:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<select name="{Which courses will you be attending?}:" class="form" id="select" style="width:140px; ">
<option value="Medical Billing">Medical Billing</option>
<option value="Medical Coding">Medical Coding</option>
<option value="Medical Transcription"> Medical Transcription</option>
<option value="Pharmacy Technician">Pharmacy Technician</option>
<option value="HIPAA">HIPAA</option>
<option value="Medical Terminology">Medical Terminology</option>
</select>
</tr>
<tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">
Suggest a course which you're interested in:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<input name="{Suggest Course}:" type="text" class="form" style="width:170px; " value="">
</span></td>
</tr>
<tr>
</tr>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body_text">
Will you be needing tuition assistance?:</span> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; "><span class="body2_bg">
<select name="{Will you be needing tuition assistance?}:" class="form" id="select" style="width:70px; ">
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</tr>
</td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text"> </td>
<td align="left" valign="top" style="padding-top:6px; padding-left:11px; " class="body_text"><input name="Submit" type="submit" onclick="checkIfOkToSubmit();" class="button" value="Send Application"></td>
</tr>
<tr>
</td>
</span></td>
</tr>