html:
<!doctype html>
<html lang="pt-br">
<head>
<meta charset="utf-8">
<title>Untitled Page</title>
<meta name="generator" content="WYSIWYG Web Builder 12">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link href="novo.css" rel="stylesheet">
<link href="particular.css" rel="stylesheet">
<script src="jquery-1.12.4.min.js"></script>
<script src="jquery-ui.min.js"></script>
<script src="wb.slideshow.min.js"></script>
<script>
function ValidateLayer1(theForm)
{
var regexp;
if (theForm.Combobox1.selectedIndex < 0)
{
alert("Please select one of the \"uf\" options.");
theForm.Combobox1.focus();
return false;
}
if (theForm.Combobox2.selectedIndex < 0)
{
alert("Please select one of the \"sexo\" options.");
theForm.Combobox2.focus();
return false;
}
return true;
}
</script>
<script>
$(document).ready(function()
{
$("#SlideShow1").slideshow(
{
interval: 5000,
type: 'sequence',
effect: 'fade',
direction: '',
pagination: false,
fullscreen: 0,
maxWidth: 1920,
effectlength: 2000
});
});
</script>
</head>
<body>
<div id="container">
<a href="http://www.wysiwygwebbuilder.com" target="_blank"><img src="images/builtwithwwb12.png" alt="WYSIWYG Web Builder" style="position:absolute;left:626px;top:967px;border-width:0;z-index:250"></a>
</div>
<div id="wb_LayoutGrid2">
<div id="LayoutGrid2">
<div class="row">
<div class="col-1">
<div id="wb_Text2">
<span style="color:#FFFFFF;font-family:Tahoma;font-size:15px;letter-spacing:1.07px;"><strong>Obrigado por acessar o Dr.Solidario!</strong></span>
</div>
</div>
</div>
</div>
</div>
<div id="wb_LayoutGrid1">
<div id="LayoutGrid1">
<div class="row">
<div class="col-1">
<hr id="Line1" style="display:block;width:100%;height:25px;z-index:1;">
<div id="wb_Image1" style="display:inline-block;width:397px;height:130px;z-index:2;">
<img src="images/logo (1).png" id="Image1" alt="">
</div>
<div id="wb_Text3">
<span style="color:#000000;font-family:Tahoma;font-size:15px;letter-spacing:1.07px;">Sempre bom vê-lo aqui!</span>
</div>
</div>
<div class="col-2">
</div>
<div class="col-3">
<div id="wb_Image2" style="display:inline-block;width:160px;height:118px;z-index:4;">
<img src="images/img_atendimento.png" id="Image2" alt="">
</div>
<div id="wb_Text1">
<span style="color:#000000;font-family:Tahoma;font-size:24px;"><strong>Central de atendimento<br></strong></span><span style="color:#833E90;font-family:Tahoma;font-size:24px;">(21) 3258-1236 / (21) 3258-0581</span>
</div>
<hr id="Line2" style="display:block;width:100%;height:16px;z-index:6;">
</div>
</div>
</div>
</div>
<div id="Layer1" style="position:relative;text-align:center;width:100%;height:596px;float:left;clear:left;display:block;z-index:27;">
<div id="Layer1_Container" style="width:1340px;position:relative;margin-left:auto;margin-right:auto;text-align:left;">
<form name="form" method="POST" action="insert.php">
<input type="text" id="Editbox1" style="position:absolute;left:173px;top:48px;width:984px;height:16px;line-height:16px;z-index:7;" name="nome" value="" autofocus spellcheck="false" placeholder="NOME:">
<input type="text" id="Editbox2" style="position:absolute;left:173px;top:135px;width:234px;height:16px;line-height:16px;z-index:8;" name="cpf" value="" spellcheck="false" placeholder="CPF:">
<input type="text" id="Editbox3" style="position:absolute;left:519px;top:135px;width:270px;height:16px;line-height:16px;z-index:9;" name="identidade" value="" spellcheck="false" placeholder="IDENTIDADE:">
<input type="text" id="Editbox4" style="position:absolute;left:897px;top:135px;width:260px;height:16px;line-height:16px;z-index:10;" name="telefone" value="" spellcheck="false" placeholder="TELEFONE:">
<input type="text" id="Editbox5" style="position:absolute;left:173px;top:223px;width:233px;height:16px;line-height:16px;z-index:11;" name="celular" value="" spellcheck="false" placeholder="CELUAR:">
<input type="text" id="Editbox6" style="position:absolute;left:519px;top:223px;width:639px;height:16px;line-height:16px;z-index:12;" name="email" value="" spellcheck="false" placeholder="EMAIL:">
<input type="text" id="Editbox7" style="position:absolute;left:173px;top:304px;width:231px;height:16px;line-height:16px;z-index:13;" name="cep" value="" spellcheck="false" placeholder="CEP:">
<input type="text" id="Editbox8" style="position:absolute;left:519px;top:304px;width:639px;height:16px;line-height:16px;z-index:14;" name="endereco" value="" spellcheck="false" placeholder="ENDERECO:">
<input type="text" id="Editbox9" style="position:absolute;left:173px;top:388px;width:443px;height:16px;line-height:16px;z-index:15;" name="complemento" value="" spellcheck="false" placeholder="COMPLEMENTO:">
<input type="text" id="Editbox10" style="position:absolute;left:680px;top:388px;width:477px;height:16px;line-height:16px;z-index:16;" name="bairro" value="" spellcheck="false" placeholder="BAIRRO:">
<select name="uf" size="1" id="Combobox1" style="position:absolute;left:608px;top:476px;width:72px;height:28px;z-index:17;">
<option selected>UF</option>
<option>RJ</option>
<option>SP</option>
</select>
<select name="sexo" size="1" id="Combobox2" style="position:absolute;left:719px;top:476px;width:170px;height:28px;z-index:18;">
<option selected>SELECIONE O SEXO</option>
<option>MASCULINO</option>
<option>FEMININO</option>
</select>
<input type="text" id="Editbox11" style="position:absolute;left:917px;top:477px;width:103px;height:16px;line-height:16px;z-index:19;" name="idade" value="" spellcheck="false" placeholder="IDADE:">
<input type="text" id="Editbox12" style="position:absolute;left:1055px;top:477px;width:103px;height:16px;line-height:16px;z-index:20;" name="peso" value="" spellcheck="false" placeholder="PESO:">
<input type="submit" id="Button1" name="" value="ENVIAR" style="position:absolute;left:1072px;top:547px;width:96px;height:25px;z-index:21;">
<input type="text" id="Editbox13" style="position:absolute;left:173px;top:477px;width:377px;height:16px;line-height:16px;z-index:22;" name="cidade" value="" spellcheck="false" placeholder="CIDADE:">
</div>
</div>
<div id="wb_LayoutGrid5">
<div id="LayoutGrid5">
<div class="row">
<div class="col-1">
<hr id="Line5" style="display:block;width:100%;height:17px;z-index:23;">
<div id="wb_Image3" style="display:inline-block;width:320px;height:300px;z-index:24;">
<img src="images/pop_up2.png" id="Image3" alt="">
</div>
</div>
<div class="col-2">
<ul id="SlideShow1" style="display:inline-block;position:relative;width:803px;height:330px;z-index:25;">
<li><img class="image" src="images/1.png" alt="" title=""></li>
<li><img class="image" src="images/2.png" style="display:none;" alt="" title=""></li>
<li><img class="image" src="images/3.png" style="display:none;" alt="" title=""></li>
</ul>
</div>
</div>
</div>
</div>
</form></body>
</html>
php:
<?php
include "conectar.php";
//comando para iserir dados direto do formulário para o banco de dados
$vnome=$_POST['nome'];
$vcpf=$_POST['cpf'];
$videntidade=$_POST["identidade"];
$vtelefone=$_POST["telefone"];
$vcelular=$_POST["celular"];
$vemail=$_POST["email"];
$vcep=$_POST["cep"];
$vendereco=$_POST["endereco"];
$vcomplemento=$_POST["complemento"];
$vbairro=$_POST["bairro"];
$vcidade=$_POST["cidade"];
$vuf=$_POST["uf"];
$vsexo=$_POST["sexo"];
$vidade=$_POST["idade"];
$vpeso=$_POST["peso"];
$sql="INSERT INTO solidario (nome,cpf,identidade,telefone,celular,email,cep,endereco,complemento,bairro,cidade,uf,sexo,idade,peso)
VALUES ('$vnome', '$vcpf', '$videntidade', '$vtelefone', '$vcelular', '$vemail', '$vcep', '$vendereco', '$vcomplemento', '$vbairro', '$vcidade', '$vuf', '$vsexo', '$vidade', '$vpeso')";
$res=mysqli_query($con,$sql);
$num=mysqli_affected_rows($con);
if($num == 1){
echo"registro cadastrado";
}else{
echo" não gravado";
}
mysqli_close($con);
?>