<!doctype html>
<html>
<head>
<meta charset="utf-8">
<title>Form</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.5.0/css/font-awesome.min.css">
<link href="https://fonts.googleapis.com/css?family=Roboto" rel="stylesheet">
<link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/bootstrap/4.1.3/css/bootstrap.min.css" integrity="sha384-MCw98/SFnGE8fJT3GXwEOngsV7Zt27NXFoaoApmYm81iuXoPkFOJwJ8ERdknLPMO" crossorigin="anonymous">
<link href="style.css" rel="stylesheet" type="text/css">
</head>
<body>
<div class="row">
<div class="col-md-6">
<header class = "logo">
<img src="logoMaieutica-01.png" class="rounded float-left" alt="...">
<div class="p-3 mb-2 bg-primary text-white">
<h1><center>Checklist - Materiais de Comunicação</center></h1>
</div>
</header>
</div>
</div>
<form method="post" action="process.php">
<div class="form-group">
<label for="desscription">Descrição</label>
<input type="text" name="eventDescription" class="form-control" placeholder="Nome completo do Evento">
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label for="date">Data do Pedido</label>
<input type="date" name="askDate" class="form-control" placeholder="date">
</div>
<div class="form-group col-md-6">
<label for="dataDoEvento">Data do Evento</label>
<input type="date" name="eventDate" class="form-control" placeholder="date2">
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label for="service">Serviço/Centro/Gabinete/Departamento</label>
<input type="text" name="gabinete" class="form-control" placeholder="Serviço/Centro/Gabinete/Departamento">
</div>
<div class="form-group col-md-6">
<label for="ask">Pedido por</label>
<input type="text" name="asked" class="form-control" placeholder="Pedido por">
</div>
</div>
<small class="form-text text-muted">Preencha devidamente os campos indicados.</small>
<div class="p-3 mb-2 bg-warning text-white">
<p>Design/Impressão</p>
</div>
<div class ="form-row">
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Tamanho do Cartaz</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" name="tamanhoCartaz[]" value="Cartaz A0" id="customCheck1">
<label class="custom-control-label" for="customCheck1">Cartaz A0</label>
<input type="text" name="quant[]" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" name="tamanhoCartaz[]" value="Cartaz A1" id="customCheck2">
<label class="custom-control-label" for="customCheck2">Cartaz A1</label>
<input type="text" name="quant[]" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" name="tamanhoCartaz[]" value="Cartaz A2" id="customCheck3">
<label class="custom-control-label" for="customCheck3">Cartaz A2</label>
<input type="text" name="quant[]" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" name="tamanhoCartaz[]" value="Cartaz A3" id="customCheck4">
<label class="custom-control-label" for="customCheck4">Cartaz A3</label>
<input type="text" name="quant[]" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" name="tamanhoCartaz[]" value="Cartaz A4" id="customCheck5">
<label class="custom-control-label" for="customCheck5">Cartaz A4</label>
<input type="text" name="quant[]" class="form-control" placeholder="Quantidade">
</div>
</div>
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Tipo de Programa</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="Fa4" id="customCheck6">
<label class="custom-control-label" for="customCheck6">Formato A4</label>
<input type="text" name="fa4quant" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="Fa5" id="customCheck7">
<label class="custom-control-label" for="customCheck7">Formato A5</label>
<input type="text" name="fa5quant" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="BS" id="customCheck8">
<label class="custom-control-label" for="customCheck8">Booklet Simples</label>
<small class="form-text text-muted">A4 dobrdo a meio, 4 páginas A5</small>
<input type="text" name="bookletSimples" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="BE" id="customCheck9">
<label class="custom-control-label" for="customCheck9">Booklet Extenso</label>
<small class="form-text text-muted">Biografias, Fotografias dos intervenientes, etc.</small>
<input type="text" name="bookletExtended" class="form-control" placeholder="Quantidade">
</div>
</div>
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Flyers</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="FFa4" id="customCheck10">
<label class="custom-control-label" for="customCheck10">Formato A4</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="FFa5" id="customCheck11">
<label class="custom-control-label" for="customCheck11">Formato A5</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
</div>
</div>
<div class ="form-row">
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Convites/Cartas</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="VI" id="customCheck12">
<label class="custom-control-label" for="customCheck12">Versão Impressa</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="DE" id="customCheck13">
<label class="custom-control-label" for="customCheck13">Digital para Email</label>
<small class="form-text text-muted">Enviado em formato JPG</small>
</div>
</div>
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Identificadores</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="prismas" id="customCheck14">
<label class="custom-control-label" for="customCheck14">Prismas</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="crachas" id="customCheck15">
<label class="custom-control-label" for="customCheck15">Crachás</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
</div>
<div class="form-group col-md-4">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Senhas</p>
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="agua" id="customCheck16">
<label class="custom-control-label" for="customCheck16">Água/Café</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox col-md-5">
<input type="checkbox" class="custom-control-input" value="outros" id="customCheck17">
<label class="custom-control-label" for="customCheck17">Outros</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Layout Formatos Digitais</p>
</div>
<div class="custom-control custom-checkbox custom-control-inline">
<input type="checkbox" class="custom-control-input" value="site" id="customCheck18">
<label class="custom-control-label" for="customCheck18">Site</label>
</div>
<div class="custom-control custom-checkbox custom-control-inline">
<input type="checkbox" class="custom-control-input" value="facebook" id="customCheck19">
<label class="custom-control-label" for="customCheck19">Facebook</label>
</div>
<div class="custom-control custom-checkbox custom-control-inline">
<input type="checkbox" class="custom-control-input" value="corptv" id="customCheck20">
<label class="custom-control-label" for="customCheck20">Corp TV</label>
</div>
<div class="custom-control custom-checkbox custom-control-inline">
<input type="checkbox" class="custom-control-input" value="wallpaper" id="customCheck21">
<label class="custom-control-label" for="customCheck21">Wallpaper Desktop</label>
</div>
</div>
<div class="form-group col-md-6">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Certificados</p>
</div>
<div class="custom-control custom-checkbox">
<input type="checkbox" class="custom-control-input" value="seNome" id="customCheck22">
<label class="custom-control-label" for="customCheck22">Sem Nome</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
</div>
<div class="custom-control custom-checkbox">
<input type="checkbox" class="custom-control-input" value="preenchido" id="customCheck23">
<label class="custom-control-label" for="customCheck23">Preenchido</label>
<input type="text" name="" class="form-control" placeholder="Quantidade">
<small class="form-text text-muted">Enviar Lista</small>
</div>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-12">
<div class="p-3 mb-2 bg-secondary text-white">
<p>Outros</p>
</div>
<label for="exampleFormControlTextarea1">Outros</label>
<textarea name="" class="form-control" id="exampleFormControlTextarea1" rows="3"></textarea>
</div>
</div>
<div class="form-row">
<button type="submit" value="submit" class="btn btn-primary">Submit</button>
</div>
</form>
</body>
</html>
And this PHP:
<?php
//process.php
if ($_SERVER["REQUEST_METHOD"] == "POST") {//Check it is comming from a form
$eventDescription = filter_var($_POST["eventDescription"], FILTER_SANITIZE_STRING); //set PHP variables like this so we can use them anywhere in code below
$askDate = filter_var($_POST["askDate"], FILTER_SANITIZE_STRING);
$eventDate = filter_var($_POST["eventDate"], FILTER_SANITIZE_STRING);
$gabinete = filter_var($_POST["gabinete"], FILTER_SANITIZE_STRING);
$asked = filter_var($_POST["asked"], FILTER_SANITIZE_STRING);
$quant = ($_POST["quant"]);
if (empty($eventDescription)){
die("Insira o nome completo do evento por favor!");
}
if (empty($askDate)) {
die("Insira uma data do pedido por favor!");
}
if (empty($eventDate)) {
die("Insira uma data do pedido por favor!");
}
if (empty($gabinete)) {
die("Insira o gabinete a quem se destina o pedido por favor!");
}
if (empty($asked)){
die("Insira o seu nome por favor!");
}
//print output text
print "O nome do evento é ". $eventDescription ."<br/>";
if(!empty($_POST['tamanhoCartaz'])) {
// Counting number of checked checkboxes.
$checked_count = count($_POST['tamanhoCartaz']);
print "Escolheu ".$checked_count. " Opções: <br/>";
// Loop to store and display values of individual checked checkbox.
foreach($_POST['tamanhoCartaz'] as $key => $selected) {
print "<p>Escolheu " .$quant[$key]. " impressões do tamanho ".$selected."</p>";
}
}
print "We will contact you very soon!";
}
?>