Company Name:- $name

Contact Person:- $contactperson

Address:- $address

Email:- $email

Mobile:- $phone

City:- $city

Country:- $country

Product Interested:- $pi

Requirements:- $comments "; $headers = 'MIME-Version: 1.0' . "\r\n"; $headers .= 'Content-type: text/html; charset=iso-8859-1' . "\r\n"; $headers .= 'From:'. $email. "\r\n"; $mailStatus=mail($to, $subject, $message, $headers); } } ?>
(* represents compulsory fields)
    Company Name:
 
 * Contact Person:
 
    Address:
 
 * E-mail:
 
 * Mobile:
  
 * City/State:
 
 * Country:
 
     Product Interested:
 
       Requirements: