roropacific
IS-IT--Management
Here is the form
<html>
<head>
<title>Customer Service FeedBack Form</title>
</head>
<body>
<h1>Customer Service FeedBack Form</h1>
<hr>
<FORM method="post" action="doregister.cfm" name="Customer Service Feedback"> <ol> <li>
<table>
<tr>
<td ALIGN="right"><em>Service Agent</em></td>
<td><input TYPE="TEXT" NAME="user_name" SIZE="25"></td>
</tr>
</table>
<tr>
<td ALIGN="right"><em>Model Number</em></td>
<td><input TYPE="TEXT" NAME="Product_id" SIZE="25"></td>
</tr>
</table>
<li>
<p>Issue Title</p>
<p><TEXTAREA name=Summary cols=35></TEXTAREA><br>
</p>
<li>
<p>Issue Description</p>
<p><TEXTAREA name=Description rows=5 cols=35></TEXTAREA><br>
</p>
<li>
<p>Please provide the following contact information:</p>
<table>
<tr>
<td ALIGN="right"><em>First Name</em></td>
<td><input NAME="Contact_FirstName" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>Last Name</em></td>
<td><input NAME="Contact_LastName" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>Street Address</em></td>
<td><input NAME="Contact_StreetAddress" SIZE="25" ></td>
</tr>
<tr>
<td ALIGN="right"><em>Address (cont.)</em></td>
<td><input NAME="Contact_Address2" SIZE="25" ></td>
</tr>
<tr>
<td ALIGN="right"><em>City</em></td>
<td><input NAME="Contact_City" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>State/Province</em></td>
<td><input NAME="Contact_State" SIZE="2"></td>
</tr>
<tr>
<td ALIGN="right"><em>Zip/Postal Code</em></td>
<td><input NAME="Contact_ZipCode" SIZE="10" MAXLENGTH="10" ></td>
</tr>
<tr>
<td ALIGN="right"><em>Home Phone</em></td>
<td><input NAME="Contact_HomePhone" SIZE="12" MAXLENGTH="12" ></td>
</tr>
<tr>
<td ALIGN="right"><em>E-mail</em></td>
<td><input NAME="Contact_Email" SIZE="25"></td>
</tr>
</table>
<li>
<p>Enter the date of Purchase :</p>
<p><input NAME="purchaseDate" size="10" MAXLENGTH="10">
</p>
<li>
<p>Location of Purchase</p>
<p><input NAME="purchaseplace" SIZE="50" MAXLENGTH="50"><br>
<OL></OL>
<input type="SUBMIT" value="Add Customer" name="SUBMIT">
<input type=reset value="Reset Form">
<A href="menu1.htm"> View Reports</A>
<A href="search1.htm"> Search for Product ID</A>
<A href="search2.htm"> Search for Keyword</A>
</FORM></LI></body></HTML>
Here is the action file
<cfoutput>
<CFQUERY NAME="adduser" DATASOURCE="custsrvc">
INSERT INTO complaint
(product_id,
issue_summary,
issue_description,
DateofPurchase ,
LocationofPurchase,
custfirstname ,
custlastname ,
custaddress ,
custaddress2 ,
custcity,
custstate,
custzip,
custphone ,
custemail ,
currentdate,
username)
VALUES
('#form.product_model#',
'#form.summary#',
'#form.description#',
'#form.purchasedate#',
'#form.purchaseplace#',
'#form.contact_firstname#',
'#form.contact_lastname#',
'#form.cont_streetaddress#',
'#form.contact_address2#',
'#form.contact_city#',
'#form.contact_state#',
'#form.contact_zipcode#',
'#form.contact_homephone#',
'#form.contact_email#',
'#form.purchasedate#',
'#form.user_name#')
</CFQUERY>
Record added.
</cfoutput>
<html>
<head>
<title>Customer Service FeedBack Form</title>
</head>
<body>
<h1>Customer Service FeedBack Form</h1>
<hr>
<FORM method="post" action="doregister.cfm" name="Customer Service Feedback"> <ol> <li>
<table>
<tr>
<td ALIGN="right"><em>Service Agent</em></td>
<td><input TYPE="TEXT" NAME="user_name" SIZE="25"></td>
</tr>
</table>
<tr>
<td ALIGN="right"><em>Model Number</em></td>
<td><input TYPE="TEXT" NAME="Product_id" SIZE="25"></td>
</tr>
</table>
<li>
<p>Issue Title</p>
<p><TEXTAREA name=Summary cols=35></TEXTAREA><br>
</p>
<li>
<p>Issue Description</p>
<p><TEXTAREA name=Description rows=5 cols=35></TEXTAREA><br>
</p>
<li>
<p>Please provide the following contact information:</p>
<table>
<tr>
<td ALIGN="right"><em>First Name</em></td>
<td><input NAME="Contact_FirstName" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>Last Name</em></td>
<td><input NAME="Contact_LastName" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>Street Address</em></td>
<td><input NAME="Contact_StreetAddress" SIZE="25" ></td>
</tr>
<tr>
<td ALIGN="right"><em>Address (cont.)</em></td>
<td><input NAME="Contact_Address2" SIZE="25" ></td>
</tr>
<tr>
<td ALIGN="right"><em>City</em></td>
<td><input NAME="Contact_City" SIZE="25"></td>
</tr>
<tr>
<td ALIGN="right"><em>State/Province</em></td>
<td><input NAME="Contact_State" SIZE="2"></td>
</tr>
<tr>
<td ALIGN="right"><em>Zip/Postal Code</em></td>
<td><input NAME="Contact_ZipCode" SIZE="10" MAXLENGTH="10" ></td>
</tr>
<tr>
<td ALIGN="right"><em>Home Phone</em></td>
<td><input NAME="Contact_HomePhone" SIZE="12" MAXLENGTH="12" ></td>
</tr>
<tr>
<td ALIGN="right"><em>E-mail</em></td>
<td><input NAME="Contact_Email" SIZE="25"></td>
</tr>
</table>
<li>
<p>Enter the date of Purchase :</p>
<p><input NAME="purchaseDate" size="10" MAXLENGTH="10">
</p>
<li>
<p>Location of Purchase</p>
<p><input NAME="purchaseplace" SIZE="50" MAXLENGTH="50"><br>
<OL></OL>
<input type="SUBMIT" value="Add Customer" name="SUBMIT">
<input type=reset value="Reset Form">
<A href="menu1.htm"> View Reports</A>
<A href="search1.htm"> Search for Product ID</A>
<A href="search2.htm"> Search for Keyword</A>
</FORM></LI></body></HTML>
Here is the action file
<cfoutput>
<CFQUERY NAME="adduser" DATASOURCE="custsrvc">
INSERT INTO complaint
(product_id,
issue_summary,
issue_description,
DateofPurchase ,
LocationofPurchase,
custfirstname ,
custlastname ,
custaddress ,
custaddress2 ,
custcity,
custstate,
custzip,
custphone ,
custemail ,
currentdate,
username)
VALUES
('#form.product_model#',
'#form.summary#',
'#form.description#',
'#form.purchasedate#',
'#form.purchaseplace#',
'#form.contact_firstname#',
'#form.contact_lastname#',
'#form.cont_streetaddress#',
'#form.contact_address2#',
'#form.contact_city#',
'#form.contact_state#',
'#form.contact_zipcode#',
'#form.contact_homephone#',
'#form.contact_email#',
'#form.purchasedate#',
'#form.user_name#')
</CFQUERY>
Record added.
</cfoutput>