Untitled

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
<title>Untitled Document</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
</head>

<body>
<form name="form1" method="post" action="">
  <table width="50%" border="0">
    <tr>
      <td>Ime i Prezime </td>
      <td><input type="text" name="imep"></td>
    </tr>
    <tr>
      <td>Email </td>
      <td><input type="text" name="email"></td>
    </tr>
    <tr>
      <td>Kupovina </td>
      <td><select name="kupovina">
          <option value="admin">admin</option>
          <option value="slot">slot</option>
          <option value="redirekcija">redirekcija</option>
        </select></td>
    </tr>
    <tr>
      <td>Server </td>
      <td><select name="server">
          <option value="dublic">Public</option>
          <option value="deathrun">Deathrun</option>
          <option value="zombie">Zombie</option>
          <option value="public2">Public #2</option>
          <option value="paintball">Paintball</option>
          <option value="gungame">GunGame</option>
          <option value="dmhs">DM+HS</option>
          <option value="surf">Surf</option>
        </select></td>
    </tr>
    <tr>
      <td>Username </td>
      <td><input type="text" name="user"></td>
    </tr>
    <tr>
      <td>Password </td>
      <td><input type="text" name="pass"></td>
    </tr>
    <tr>
      <td colspan="2"><input type="submit" name="Submit" value="Posalji"></td>
    </tr>
  </table>
</form>
Script by A1r*M4x<br>
<?php

if($_POST['Submit']){
$imep = $_POST['imep'];
$email = $_POST['email'];
$kupovina = $_POST['kupovina'];
$server = $_POST['server'];
$username = $_POST['user'];
$password = $_POST['pass'];

if($imep == "") echo "Moras uneti ime i prezime";
if($email== "") echo "Moras uneti email";
if($username == "") echo "Moras unetu username";
if($password == "") echo "Moras uneti password";
else
	{
	$to      = 'razzer-sight@hotmail.com';
	$subject = 'Porudzbina';
	$message = "Ime i Prezime: ".$imep."\nEmail: ".$email."\nKupovina: ".$kupovina."\nServer: ".$server."\nUsername: ".$username."\nPassword: ".$password;
	$headers = 'From: narudzbine@blabla.net' . "\r\n" .
    'Reply-To: narudzbine@blabla.net' . "\r\n";
	echo "<strong>USPESNO STE PORUCILI</strong>"

mail($to, $subject, $message, $headers);
	}

}

?>
</body>
</html>