Untitled

if(isset($_POST['submit'])) {

        $message =
        'Full Name: '.$_POST['name'].'<br />
        Email: '.$_POST['email'].'<br />
        Phone: '.$_POST['phoneNumber'].'<br />
        Service: '.$_POST['services'].'<br />
        Message: '.$_POST['messageArea'].'
        ';

        require "phpmailer/PHPMailerAutoload.php";

        $mail = new PHPMailer();

        $mail->IsSMTP();
        $mail->SMTPAuth = true;
        $mail->SMTPSecure = "ssl";
        $mail->Host = "smtp.gmail.com";
        $mail->Port = 465;
        $mail->Encoding = '7bit';

        $mail->Username = "xxxxxx@gmail.com";
        $mail->Password = "xxxxxxxxx";

        $mail->SetFrom($_POST['email'], $_POST['name']);
        $mail->AddReplyTo($_POST['email'], $_POST['name']);
        $mail->Subject = "Message from TheRejuviner.com";
        $mail->MsgHTML($message);

        $mail->AddAddress("xxxxxx@gmail.com", "xxxx");
        $result = $mail->Send();
        $message = $result ? 'Successfully Sent!' : 'Sending Failed';
        unset($mail);

    }

    ?>

    <!DOCTYPE html>
    <html lang="en">

    <body>
    <div>

    <!-- ######### MAIN CONTENT AREA######### -->
        <div>

            <div>
                <h1>Contact Form</h1>

                <form name="contact_form" method="post" action="" class="form_holder">

                    <div>
                        <!-- ###NAME LABEL AND FIELD### -->
                        <label for="name"><span class="star">&lowast;</span>Your Name&nbsp;:&nbsp;

                        <input name="name" type="text" id="name_field" placeholder="e.g. John Doe..." title="Enter your full name." autocomplete="off" autofocus>

                        </label>
                        <!-- ###END NAME LABEL AND FIELD### -->
                    </div>

                    <div>
                        <!-- ###EMAIL LABEL AND FIELD### -->
                        <label for="email"><span class="star">&lowast;</span>Your Email&nbsp;:&nbsp;&nbsp;

                        <input name="email" type="text" id="email_field" placeholder="e.g. johndoe@email.com..." title="Enter your email address." autocomplete="off" autofocus>
                        </label>
                        <!-- ###END EMAIL LABEL AND FIELD### -->
                    </div>

                    <div>
                        <!-- ###PHONE NUMBER LABEL AND FIELD### -->
                        <label for="phoneNumber"><span class="star">&lowast;</span>Your Phone&nbsp;:&nbsp;

                        <input name="phoneNumber" type="text" id="phone_number_field" placeholder="e.g. (777)333-4444..." title="Enter your phone number." autocomplete="off" autofocus>
                        </label>
                        <!-- ###END PHONE NUMBER LABEL AND FIELD### -->
                    </div>

                    <div class="contact_input">
                        <!-- ###SERVICES LABEL AND FIELD### -->
                        <label for="services"><span class="star">&lowast;</span>Select Service&nbsp;:&nbsp;

                            <select name="services" id="services" title="Select which service you are inquiring for" autofocus>
                                <option value="Empty">...</option>
                                <option value="Reiki">Reiki Session</option>
                                <option value="Holographic Memory Resolution">HMR Session</option>
                                <option value="Akashic Records">Akashic Records Session</option>
                                <option value="Full Package">Full Package Session</option>
                                <option value="None">None</option>

                            </select>

                        </label>
                        <!-- ###END SERVICES LABEL AND FIELD### -->
                    </div>

                    <div>
                        <!-- ###PHONE NUMBER LABEL AND FIELD### -->
                        <label for="message"><span class="star star_text">&lowast;</span>Your message&nbsp;:

                        <textarea id="message_area" name="messageArea" autofocus></textarea>
                        </label>
                        <!-- ###END PHONE NUMBER LABEL AND FIELD### -->
                    </div>

                        <!-- ###SUBMIT BUTTON### -->
                    <div>
                        <input type="submit" id="submit" name="submit" value="submit" autofocus required />
                    </div>
                        <!-- ###END SUBMIT BUTTON### -->

                </form>
            <p><?php if(!empty($message)) echo $message; ?></p>
            </div>


        </div>

    </div>


    </body>

    </html>