PHP Form Validation

For some reason my form is not carrying the user inputted information over when it reloads.

This is the page: http://www.searchtransparencysem.com/projects/hennigan/auto-insurance-quote.php

This is the php:


<?php
session_start();
/* Subject and Email Variables */

	$subject = 'Insurance Quote Request';
	$to = 'samuel@searchtransparencysem.com';
	//samuel@searchtransparencysem.com
	//aaa@aaa.com
	
/* Gathering Data Variables */	

	$name = $_POST['name'];
	$phone = $_POST['phone'];
	$email = $_POST['email'];
	$street = $_POST['street'];
	$city = $_POST['city'];
	$state = $_POST['state'];
	$zip = $_POST['zip'];
	$city_garaged = $_POST['city_garaged'];
	$license_number = $_POST['license_number'];
	$dob = $_POST['dob'];
	$first_license = $_POST['first_license'];
	$vin_number = $_POST['vin_number'];
	$vehicle_make = $_POST['vehicle_make'];
	$vehicle_model = $_POST['vehicle_model'];
	$vehicle_year = $_POST['vehicle_year'];
	$uninsured_motorist = $_POST['uninsured_motorist'];
	$property_damage = $_POST['property_damage'];
	$bodily_injury = $_POST['bodily_injury'];
	$medical_payments = $_POST['medical_payments'];
	$collision_deductible = $_POST['collision_deductible'];
	$limited_collision_deductible = $_POST['limited_collision_deductible'];
	$comprehensive_deductible = $_POST['comprehensive_deductible'];
	$substitute_transportation = $_POST['substitute_transportation'];
	$towing_and_labor = $_POST['towing_and_labor'];
	$underinsured_motorist = $_POST['underinsured_motorist'];
	$mileage = $_POST['mileage'];
	$alarm = $_POST['alarm'];
	$airbags = $_POST['airbags'];
	$guidepoint = $_POST['guidepoint'];
	$lojack = $_POST['lojack'];
	$onstar = $_POST['onstar'];
	$auto_remarks = $_POST['auto_remarks'];
	$limited_collision_deductible = $_POST['limited_collision_deductible'];
	$body = "
<br><hr><br>
<h1>Auto Quote Request</h1>
<h2>Personal Information</h2>
Name: $name <br>
SSN: $ssn <br>
Phone: $phone <br>
Email: $email <br>
Street: $street <br>
City: $city <br>
State: $state <br>
Zip: $zip <br>
<h2>Driver Information</h2>
License number: $license_number <br>
D.O.B.: $dob <br>
Year you received your first license: $first_license <br><br>
<h2>Vehicle Information</h2>
VIN number: $vin_number <br>
Make: $vehicle_make <br>
Model: $vehicle_model <br>
Year: $vehicle_year <br>
<h2>Coverages</h2>
Uninsured Motorist: $uninsured_motorist <br>
Property Damage: $property_damage <br>
Bodily Injury: $bodily_injury <br>
Medical Payments: $medical_payments <br>
Collision Deductible: $collision_deductible <br>
Limitied Collision Deductible: $limited_collision_deductible <br>
Comprehensive Deductible: $comprehensive_deductible <br>
Substitute Transportation: $substitute_transportation <br>
Towing and Labor: $towing_and_labor <br>
Underinsured Motorist: $underinsured_motorist <br>
Mileage: $mileage <br>
What city is the vehicle garaged in?: $city_garaged <br><br>
<h3>Options that your vehicle is equipped with</h3>
Alarm: $alarm <br>
Airbags: $airbags <br>
GuidePoint: $guidepoint <br>
LoJack: $lojack <br>
OnStar: $onstar <br>
Remarks: $auto_remarks <br>
";
$flag = true;
if (isset($_POST['Submit'])) {
 if(!$name || !$phone || !$email || !$street || !$city || !$state || !$zip || !$license_number || !$dob || !$first_license || !$vin_number || !$vehicle_make || !$vehicle_model ||
!$vehicle_year || !$uninsured_motorist || !$property_damage || !$bodily_injury || !$city_garaged || !$mileage || !$underinsured_motorist) 
	{
		$flag = false;
	}
}

if($_POST && $flag == true && (isset($_POST['Submit']))) {

	$headers = "From: $email\\r\
";
	$headers = "Content-type: text/html\\r\
";

mail($to,$subject,$body,$headers);

$_SESSION['success'] = '1';
header('Location: sent.html');
exit;
}

?>


<?php
if ( isset($_POST['Submit']))

{
	
	$errorstring = "";

if (!$name)
	$errorstring = $errorstring."Name<br>";

if (!$phone)
 	$errorstring = $errorstring."Phone #<br>";

if (!$email)
 	$errorstring = $errorstring."Email<br>";
	
if (!$street)
 	$errorstring = $errorstring."Street<br>";
		
if (!$city)
 	$errorstring = $errorstring."City<br>";
		
if (!$state)
 	$errorstring = $errorstring."State<br>";
		
if (!$zip)
 	$errorstring = $errorstring."Zip<br>";
	
if (!$license_number)
	$errorstring = $errorstring."License Number<br>";

if (!$dob)
 	$errorstring = $errorstring."D.O.B.<br>";
	
if (!$first_license)
 	$errorstring = $errorstring."Year you received your first license<br>";
	
if (!$vin_number)
 	$errorstring = $errorstring."VIN Number<br>";
	
if (!$vehicle_make)
	$errorstring = $errorstring."Vehicle Make<br>";

if (!$vehicle_model)
 	$errorstring = $errorstring."Vehicle Model<br>";
	
if (!$vehicle_year)
 	$errorstring = $errorstring."Vehicle Year<br>";
	
 if (!$uninsured_motorist)
 	$errorstring = $errorstring."Uninsured Motorist<br>";
	
if (!$property_damage)
 	$errorstring = $errorstring."Property Damage<br>";
	
if (!$bodily_injury)
 	$errorstring = $errorstring."Bodily Injury<br>";

if (!$underinsured_motorist)
 	$errorstring = $errorstring."Underinsured Motorist<br>";
	
if (!$mileage)
 	$errorstring = $errorstring."Mileage<br>";
	
if (!$city_garaged)
 	$errorstring = $errorstring."What city is the vehicle garaged in?t<br>";

if ($errorstring!="") {
	echo "<h3>Please fill out the following Auto form fields</h3>$errorstring<br>";
}
  else
  {
  //run code
  echo "<h3>Thank you. Your auto quote request has been sent.</h3>";
  }
}

if($errorstring != '') {
 $options = array( 	 	
 	array('option'=>'uninsured_motorist','value'=>$uninsured_motorist), 	
 	array('option'=>'property_damage','value'=>$property_damage), 	
 	array('option'=>'bodily_injury','value'=>$bodily_injury), 	
 	array('option'=>'medical_payments','value'=>$medical_payments), 	
 	array('option'=>'collision_deductible','value'=>$collision_deductible), 	
 	array('option'=>'limited_collison_deductible','value'=>$limited_collison_deductible), 	
 	array('option'=>'comprehensive_deductible','value'=>$comprehensive_deductible), 
 	array('option'=>'substitute_transportation','value'=>$substitute_transportation), 	
 	array('option'=>'towing_and_labor','value'=>$towing_and_labor), 	
 	array('option'=>'underinsured_motorist','value'=>$underinsured_motorist), 	
 	array('option'=>'alarm','value'=>$alarm), 	
 	array('option'=>'airbags','value'=>$airbags), 	
 	array('option'=>'guidepoint','value'=>$guidepoint), 	
 	array('option'=>'lojack','value'=>$lojack), 	
 	array('option'=>'onstar','value'=>$onstar),
 );
} 
?>

I’ll work on your codes tomorrow…cheers.

<?php
session_start();
/* Subject and Email Variables */

	$subject = 'Homeowners Insurance Quote Request';
	$to = 'samuel@searchtransparencysem.com';
	//samuel@searchtransparencysem.com
	//aaa@aaa.com
	
/* Gathering Data Variables */	

	$type_of_insurance = $_POST['type_of_insurance'];
	$name = $_POST['name'];
	$ssn = $_POST['ssn'];
	$phone = $_POST['phone'];
	$email = $_POST['email'];
	$street = $_POST['street'];
	$city = $_POST['city'];
	$state = $_POST['state'];
	$zip = $_POST['zip'];
	$number_of_units = $_POST['number_of_units'];
	$square_footage = $_POST['square_footage'];
	$year_built = $_POST['year_built'];
	$pets = $_POST['pets'];
	$updates = $_POST['updates'];
	$current_insurance_company = $_POST['current_insurance_company'];
	$why_was_policy_cancelled = $_POST['why_was_policy_cancelled'];
	$paid_losses = $_POST['paid_losses'];
	$amount_requested = $_POST['amount_requested'];
	$amps = $_POST['amps'];
	$does_owner_live_on_property = $_POST['does_owner_live_on_property'];
	$new_or_existing_residence = $_POST['new_or_existing_residence'];
	$type_of_structure = $_POST['type_of_structure'];
	$heating_source = $_POST['heating_source'];
	$coverage_cancelled = $_POST['coverage_cancelled'];
	$property_damage = $_POST['property_damage'];
	$home_remarks = $_POST['home_remarks'];
	$body = "
<br><hr><br>
<h1>Homeowners/Renters Quote Request</h1><br>
<h2>Personal Information</h2>
Name: $name <br>
SSN: $ssn <br>
Phone: $phone <br>
Email: $email <br>
Street: $street <br>
City: $city <br>
State: $state <br>
Zip: $zip <br>
<h2>Residence</h2>
Type of insurance: $type_of_insurance <br>
Number of units: $number_of_units <br>
Square footage: $square_footage <br>
Year built: $year_built <br>
Pets: $pets <br>
Updates: $updates <br>
Current insurance company: $current_insurance_company <br>
If policy was cancelled, why?: $why_was_policy_cancelled <br>
Paid losses: $paid_losses <br>
Amount Requested: $amount_requested <br>
I verify that the electrical system is circuit breakers and at least 100 amps: $amps <br>
Does the owner live on the property?: $does_owner_live_on_property <br>
New or existing property?: $new_or_existing_residence <br>
Type of structure: $type_of_structure <br>
Heating source: $heating_source <br>
Has your coverage been cancelled in the last three years?: $coverage_cancelled <br>
Remarks: $home_remarks <br>
";
$flag = true;
if ( isset($_POST['Submit'])) {
	if(!$name || !$phone || !$email || !$street || !$city || !$state || !$zip || !$type_of_insurance || !$number_of_units || !$square_footage || !$year_built || 
	!$current_insurance_company || !$amps || !$does_owner_live_on_property || !$new_or_existing_residence || !$type_of_structure || !$amount_requested || !$heating_source || 
	!$coverage_cancelled) 
	{
		$flag = false;
	}
}

if($_POST && $flag == true && (isset($_POST['Submit']))) {

	$headers = "From: $email\\r\
";
	$headers = "Content-type: text/html\\r\
";

mail($to,$subject,$body,$headers);

$_SESSION['success'] = '1';
header('Location: sent.html');
exit;
}

?>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<link rel="icon" type="image/ico" href="images/favicon.ico">
<title>Home Insurance quotes | Renters Insurance quotes | West Roxbury, MA</title>
<meta name="description" content="James W Hennigan Insurance is a Greater Boston insurance agency offering competitive homeowner insurance and renters insurance rates .Visit us for a free home insurance quote." />
<link href="css/wrapper.css" rel="stylesheet" type="text/css" />
<script type="text/javascript">
<!--
function MM_swapImgRestore() { //v3.0
  var i,x,a=document.MM_sr; for(i=0;a&&i<a.length&&(x=a[i])&&x.oSrc;i++) x.src=x.oSrc;
}
function MM_preloadImages() { //v3.0
  var d=document; if(d.images){ if(!d.MM_p) d.MM_p=new Array();
    var i,j=d.MM_p.length,a=MM_preloadImages.arguments; for(i=0; i<a.length; i++)
    if (a[i].indexOf("#")!=0){ d.MM_p[j]=new Image; d.MM_p[j++].src=a[i];}}
}

function MM_findObj(n, d) { //v4.01
  var p,i,x;  if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
    d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
  if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n];
  for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document);
  if(!x && d.getElementById) x=d.getElementById(n); return x;
}

function MM_swapImage() { //v3.0
  var i,j=0,x,a=MM_swapImage.arguments; document.MM_sr=new Array; for(i=0;i<(a.length-2);i+=3)
   if ((x=MM_findObj(a[i]))!=null){document.MM_sr[j++]=x; if(!x.oSrc) x.oSrc=x.src; x.src=a[i+2];}
}
//-->
</script></head>
<body onload="MM_preloadImages('images/rollover-box-home-insurance.jpg','images/rollover-box-business-insurance.jpg','images/rollover-box-auto-insurance.jpg','images/rollover-home.jpg','images/rollover-about-us.jpg','images/rollover-services.jpg','images/original-contact-us.jpg')">
<div id="wrapper">

	<div id="top">

		<div id="top-left"><a href="index.html" target="_self"><img src="images/logo.jpg" alt="Boston Insurance Agency" border="0"></a></div>

		<div id="top-right"><img src="images/phone.jpg" width="111" height="14" alt="Phone Number" /></div>

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		<div id="navigation">

	<div style="margin: 0pt auto; z-index: 100; height: auto; position: relative width: 711px;"><ul id="nav">

	<li><a href="index.html" target="_self" onMouseOver="MM_swapImage('home','','images/rollover-home.jpg',1)" onMouseOut="MM_swapImgRestore()"><img name="home" border="0" src="images/original-home.jpg" alt="Home" width="195"height="36" id="home"></a></li>

	<li><a href="#" target="_self" onMouseOver="MM_swapImage('about us','','images/rollover-about-us.jpg',1)" onMouseOut="MM_swapImgRestore()"><img name="about us" border="0" src="images/original-about-us.jpg" alt="About Us" width="186" height="36" id="about us"></a>
	<ul>
	<li><a href="about-us.html" title="About Us" target="_self">About Us</a></li>
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	<ul>
	<li><a href="homeowners-insurance.html" title="Homeowners Insurance" target="_self">Homeowners Insurance</a></li>
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	<div id="spacer-950x15"></div>

	

	<div id="right-side"><a href="homeowners-insurance.html" target="_self" title="Homeowners Insurance"><img name="home insurance" border="0" src="images/original-box-home-insurance.jpg" alt="Homeowners Insurance" width="318" height="164" id="home insurance"></a><a href="business-insurance.html" target="_self" title="Business Insurance"><img name="business insurance" border="0" src="images/original-box-business-insurance.jpg" alt="Business Insurance" width="318" height="170" id="business insurance"></a><a href="auto-insurance.html" target="_self" title="Auto Insurance"><img name="auto insurance" border="0" src="images/original-box-auto-insurance.jpg" alt="Auto Insurance" width="318" height="164" id="auto insurance"></a></div>

<div id="main-content-form">
	
<h1>Homeowners Insurance Quote Request</h1>

<div id="validation">

<?php
if ( isset($_POST['Submit']))

{

$errorstring = "";

if (!$name)
	$errorstring = $errorstring."Name<br>";

if (!$phone)
 	$errorstring = $errorstring."Phone #<br>";

if (!$email)
 	$errorstring = $errorstring."Email<br>";
	
if (!$street)
 	$errorstring = $errorstring."Street<br>";
		
if (!$city)
 	$errorstring = $errorstring."City<br>";
		
if (!$state)
 	$errorstring = $errorstring."State<br>";
		
if (!$zip)
 	$errorstring = $errorstring."Zip<br>";
		
if (!$type_of_insurance)
	$errorstring = $errorstring."Type of insurance<br>";

if (!$number_of_units)
 	$errorstring = $errorstring."Number of units<br>";
	
if (!$square_footage)
 	$errorstring = $errorstring."Square footage<br>";
	
if (!$year_built)
 	$errorstring = $errorstring."Year built<br>";
	
if (!$current_insurance_company)
 	$errorstring = $errorstring."Current insurance company<br>";
	
if (!$amps)
 	$errorstring = $errorstring."I verify that the electrical system is circuit breakers and at least 100 amps<br>";
	
if (!$does_owner_live_on_property)
 	$errorstring = $errorstring."Does the owner live on the property?<br>";
	
if (!$new_or_existing_residence)
 	$errorstring = $errorstring."New or existing property?<br>";
	
if (!$type_of_structure)
	$errorstring = $errorstring."Type of structure<br>";

if (!$heating_source)
 	$errorstring = $errorstring."Heating source<br>";
	
if (!$coverage_cancelled)
 	$errorstring = $errorstring."Has your coverage been cancelled in the last three years?<br>";
	
if (!$amount_requested)
 	$errorstring = $errorstring."Amount of personal property insurance requested?<br>";

if ($errorstring!="") {
	echo "<h3>Please fill out the following fields</h3>$errorstring<br>";
}
  else
  {
  //run code
  echo "<h3>Thank you. Your homeowners quote request has been sent.</h3>";
  }
}


if($errorstring != '') {
 $options = array(
  array('option'=>'type_of_insurance','value'=>$type_of_insurance), 	
 	array('option'=>'coverage_cancelled','value'=>$coverage_cancelled),
 	array('option'=>'heating_source','value'=>$heating_source),
 	array('option'=>'type_of_structure','value'=>$type_of_structure),
 	array('option'=>'new_or_existing_residence','value'=>$new_or_existing_residence),
 	array('option'=>'does_owner_live_on_property','value'=>$does_owner_live_on_property),
 	array('option'=>'type_of_insurance','value'=>$type_of_insurance), 	 	 	 	
 	array('option'=>'amps','value'=>$amps),
 );
}  
?>

</div>

<h3>Owner/ Renter</h3>
<form action="homeowners-insurance-quote.php" method="post">
<label>Name*<br/>
<input name="name" type="text" class="text-field-home-narrow" id="name" value="<?php echo $name; ?>"/>
</label>
<br/>
<label>Street*<br/>
<input name="street" type="text" class="text-field-home-narrow" id="street" value="<?php echo $street; ?>"/>
</label>
<br/>
<label>City*<br/>
<input name="city" type="text" class="text-field-home-narrow" id="city" value="<?php echo $city; ?>"/>
</label>
<br/>
<label>State*<br/>
<input name="state" type="text" class="text-field-home-narrow" id="state" value="<?php echo $state; ?>"/>
</label>
<br/>
<label>Zip*<br/>
<input name="zip" type="text" class="text-field-home-narrow" id="zip" value="<?php echo $zip; ?>"/>
</label>
<br/><label>Phone #*<br/>
<input name="phone" type="text" class="text-field-home-narrow" id="phone" value="<?php echo $phone; ?>"/>
</label>
<br/>
<label>Email*<br/>
<input name="email" type="text" class="text-field-home-narrow" id="email" value="<?php echo $email; ?>"/>
</label>
<br/>
<label>Social Security # (optional) <div id="disclaimer">
<li>Disclaimer
<ul>
<li>To accurately quote your auto insurance a social security number is necessary. Insurance companies reserve the right to reject your policy due to bad credit.</li>
</ul>
</li>
<br/>
</div>
<input name="ssn" type="text" class="text-field-home-narrow" id="ssn" value="<?php echo $ssn; ?>"/>
</label>
<br/><br/>
<h3>Type of Insurance*</h3>
<label>
<input type="radio" name="type_of_insurance" value="Homeowners" id="type of insurance" />
Homeowners</label>
<br/>
<label>
<input type="radio" name="type_of_insurance" value="Condo" id="type of insurance" />
Condo</label>
<br/>
<label>
<input type="radio" name="type_of_insurance" value="Renters" id="type of insurance" />
Renters</label>
<br/>
<br/>
<label>Amount of personal property insurance requested? (minimum of $25,000 required)<br/>
<input name="amount_requested" type="text" class="text-field-home" id="amount requested" value="<?php echo $amount_requested; ?>" />
</label>
<br/>
<label>How many units are in the building?*<br/>
<input name="number_of_units" type="text" class="text-field-home-narrow" id="number of units" value="<?php echo $number_of_units; ?>"/>
</label>
<br/>
<label>Square footage?*<br/>
<input name="square_footage" type="text" class="text-field-home-narrow" id="square footage" value="<?php echo $square_footage; ?>"/>
</label>
<br/>
<label>Year built?*<br/>
<input name="year_built" type="text" class="text-field-home-narrow" id="year built" value="<?php echo $year_built; ?>"/>
</label>
<br/>
<label>Please list any pets and their breed:<br/>
<input name="pets" type="text" class="text-field-home" id="pets" value="<?php echo $pets; ?>"/>
</label>
<br/>
<label>Please list any update(s) to property including year of update: <br/>
( e.g. electric, roof, plumbing, heating)<br/>
<input name="updates" type="text" class="text-field-home" id="updates" value="<?php echo $updates; ?>"/>
</label>
<br/>
<label>Current insurance company?*<br/>
<input name="current_insurance_company" type="text" class="text-field-home" id="current insurance company" value="<?php echo $current_insurance_company; ?>"/>
</label>
<br/>
<label>If policy was cancelled, why?<br/>
<input name="why_was_policy_cancelled" type="text" class="text-field-home" id="why was policy cancelled" value="<?php echo $why_was_policy_cancelled; ?>"/>
</label>
<br/>
<label>Please list any and all paid losses within the last three years<br/>
<input name="paid_losses" type="text" class="text-field-home" id="paid losses" value="<?php echo $paid_losses; ?>"/>
</label>
<br/>
<br/>
<label>
<input type="checkbox" name="amps" value="Yes" id="amps" />
I verify that the electrical system is circuit breakers and at least 100 amps*</label>
<br/>
<br/>
<strong><br/>
Does the owner live on the property?</strong>*
<p>
<label>
<input type="radio" name="does_owner_live_on_property" value="Yes" id="does owner live on property" />
Yes</label>
<br />
<label>
<input type="radio" name="does_owner_live_on_property" value="No" id="does owner live on property" />
No</label>
<br />
</p>
<strong>Is this a new or existing residence?</strong>*
<p>
<label>
<input type="radio" name="new_or_existing_residence" value="New" id="new or existing residence" />
New</label>
<br />
<label>
<input type="radio" name="new_or_existing_residence" value="Existing" id="new or existing residence" />
Existing</label>
<br />
</p>
<strong>What type of structure?</strong>*
<p>
<label>
<input type="radio" name="type_of_structure" value="Wood" id="type of structure" />
Wood</label>
<br />
<label>
<input type="radio" name="type_of_structure" value="Brick" id="type of structure" />
Brick</label>
<br />
</p>
<strong>What is your heating source?</strong>*
<p>
<label>
<input type="radio" name="heating_source" value="Gas" id="heating source" />
Gas</label>
<br />
<label>
<input type="radio" name="heating_source" value="Oil" id="heating source" />
Oil</label>
<br />
</p>
<strong>Has your coverage been cancelled in the last three years?</strong>*
<p>
<label>
<input type="radio" name="coverage_cancelled" value="Yes" id="coverage cancelled" />
Yes</label>
<br />
<label>
<input type="radio" name="coverage_cancelled" value="No" id="coverage cancelled" />
No</label>
<br />
</p>
<label>Questions/Comments<br/>
<textarea name="home_remarks" id="home remarks" value="<?php echo $home_remarks; ?>" cols="45" rows="5"><?=$home_remarks?></textarea>
</label>
<br/>
<br/>
<input type="image" src="images/submit-button.jpg" name="Submit" id="submit" value="Submit" /></form><br/><br/><p class="aterick">All fields marked with * are required</p>

	
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Yes, I have everything in this one file.

Both those codes resides on single file? auto-insurance-quote.php

I didn’t write this script, as I am not very familiar with this language. Everything other than the radio buttons and checkbox get carried over on the reload. What are you saying the problem might be?

post the codes of that single file…here, thanks.

i noticed what if


$flag == false

what do you intend the script to do if it comes on that equation :slight_smile: write it