<?php defined('C5_EXECUTE') or die(_("Access Denied.")); ?>
<?php
$output = '';

$required = array('email', 'first_name', 'last_name');

$disclaimer = (' <div class="disclaimer"> If you are interested in receiving Brix updates and special offers by snail mail, please complete the following: </div> ');

$errors = array();

if (! empty($_POST)) {
    foreach ($required as $field) {
        if ( empty($_REQUEST[$field])) {
            $errors[$field] = 'this is required';
        }
    }
    if (count($errors) < 1) {
        //        Send an email
        if ($_POST) {
            if (get_magic_quotes_gpc()) {
                foreach ($_POST as $key=>$value) {
                    $temp = stripslashes($value);
                    $_POST[$key] = $temp;
                }
            }
            $to = $_POST['to']; // emailsubmissions@siteowner.com
            $subject = $_POST['Posted From Website']."\n";

            $message .= "Email: ".$_POST['email']."\n";
            $message .= "First Name: ".$_POST['first_name']."\n";
            $message .= "Last Name: ".$_POST['last_name']."\n";
            $message .= "Address: ".$_POST['address']."\n";
            $message .= "City: ".$_POST['city']."\n";
            $message .= "State: ".$_POST['state']."\n";
            $message .= "Country: ".$_POST['country']."\n";
            $message .= "Zip: ".$_POST['zip']."\n";
            $message .= "Phone Number: ".$_POST['phone_number']."\n";
            $message .= "Message: ".$_POST['message']."\n";
            $headers = "From: marypatc@turnpost.com\n"; // from address on the email to the site owner
            $headers .= "Content-type: text/plain; charset=UTF-8";
            $sent = mail($to, $subject, $message, $headers);
           // echo $message;

        }
        $output .= '<p style="padding-bottom:20px;">';
        $output .= '<strong>Email Sent!</strong> Thank you for contacting us. Click <a style="color:#830024;" href="/index.php">Here</a> to return.';
        $output .= '</p>';
        echo $output;
        return;

    } else {
        echo '<span class="error">Please fill in the following fields...</span><ul>';

    foreach ($errors as $error => $value) {

     echo '<li class="newerror">'.ucwords(str_replace('_',' ',$error)).' - '.$value.'</li>';

    }

    echo '</ul>';

    }
}

$output .= '<form method="post" id="contactform" name="contactform" action="'.$_SERVER['PHP_SELF'].'">';
$output .= '<table class="clearfix">';



$fields = array( 'to'=>'dropdown', 'email'=>'text', 'first_name'=>'text', 'last_name'=>'text' );

    echo $disclaimer;

$fields = array( 'address'=>'text', 'city'=>'text', 'state'=>'text', 'country'=>'text', 'zip'=>'text', 'phone_number'=>'text', 'message'=>'textarea' );


$drops = array('Book a meeting or event'=>'hospitality@brixomaha.com', 'Stay In Touch'=>'info@brixomaha.com');

foreach ($fields as $field=>$type) {

    if ($type != 'hidden') {
        $output .= '<tr><td><label for="'.$field.'" id="'.$field.'_label">';
        $output .= ucwords(str_replace('_',' ',$field));


    if (isset($errors[$field])) {
            $output .= ' <strong class="error"> *</strong>';
        }

        	$output .= ': </label></td>';
    	}


    switch ($type) {

        case 'textarea':
            $output .= '<td class="text"><textarea name="'.$field.'" id="'.$field.'" cols="30" rows="10">';
            if (isset($_REQUEST[$field])) {
                $output .= htmlspecialchars($_REQUEST[$field]);
            }

            $output .= '</textarea></td></tr>';
            break;



        case 'hidden';
        $output .= '<input type="hidden" name="'.$field.'" id="'.$field.'" value=""';
        if (isset($_REQUEST[$field])) {
            $output .= ' value="'.htmlspecialchars($_REQUEST[$field]).'"';
        }

        $output .= ' />';
        break;



    	case 'dropdown';
   		$output .= '<td><select name="'.$field.'" id="'.$field.'">';
    	foreach ($drops as $option=>$address) {
       		 $output .= '<option value="'.$address.'">'.$option.'</option>';
   		}

    	$output .= '</select></td></tr>';
    	break;



		default:
    	$output .= '<td><input type="text" name="'.$field.'" id="'.$field.'"';
    	if (isset($_REQUEST[$field])) {
       		$output .= ' value="'.htmlspecialchars($_REQUEST[$field]).'"';
   		}


    	$output .= ' /></td></tr>';
    	break;

		}
}

$output .= '

</table>

<input class="submit" type="submit" name="submit" value="Submit" />

</form>

';

echo $output;