report.php

   1 <?php
   2
   3 echo '
   4 <html>
   5 <title>Problem Report Form</title>
   6 <body>
   7 <center><h2>Problem Report Form</h2></center>
   8 <p>If you find a problem with content on this site, please fill out the form and we will have a look ASAP.</p>
   9 <p>Your Name and E-mail address are optional and will only be used to notify you of the status of the request.</p>
  10 <p>There is also no account signup needed to use this service.</p>
  11
  12 <center>
  13 <table>
  14         <tr><td>Name (optional):</td><td><input name="name" type="text"></td></tr>
  15         <tr><td>E-mail (optional):</td><td><input name="email" type="text"></td></tr>
  16         <tr><td>Type of Problem:</td><td><select><option></option><option>Bad Link</option><option>Factual</option><option>Grammar</option><option>Spelling</option></select></td></tr>
  17 </table>
  18
  19 <textarea name=comment  rows="15" cols="60" </textarea><br><br>
  20
  21 <button name="submit"><img src="http://opentextbook.info/icons/16x16/tick.png"> Submit</button>
  22 <button name="reset" type="reset"><img src="http://opentextbook.info/icons/16x16/cross.png"> Reset</button>
  23 </center>
  24 </body>
  25 </html>
  26 ';
  27
  28 ?>