Creating a form to email

HI guys! I thought I would try to take another look at this again. I don't know PHP and am learning it but on my website, I created a great contact form but am now in the process of having it authenticated. I am having issues with that. The code that I used to just call the information seems to work fine. When a user clicks the submit, it takes them to the thank you page, but I get no email from it because I need to have the authentication.
I contacted my server and I just became more confused if anything. They gave me a link to verify everything but I don't know how to integrate that into my code. I am hoping somebody here could help me with this. I will post my code that I am using. I did mask out personal information. My password, my email, my website. I put in fake ones but they are correct.
This first part is from their website. If I add this in with the required information it calls for, I end up getting an email that says test email via php from sender. I get no email from my actual form.
<html>
<head><title>Test email via php</title></head>
<body>
<?
require_once "Mail.php";
$from = "Sender <[email protected]>";
$to = "Recipient <[email protected]>";
$subject = "This is a test email sent via php";
$body = "This is a test email";
$host = "mail.domain.com";
$username = "[email protected]";
$password = "password";
$headers = array ('From' => $from,
'To' => $to,
'Subject' => $subject);
$smtp = Mail::factory('smtp',
array ('host' => $host,
'auth' => true,
'username' => $username,
'password' => $password));
$mail = $smtp->send($to, $headers, $body);
?>
</body>
</html>
This next part is my actual code that I used. If I use this, I either get a mail function error or it goes to the thank you page, but I get no email from it.
<?php
// This function checks for email injection. Specifically, it checks for carriage returns - typically used by spammers to inject a CC list.
function isInjected($str) {
$injections = array('(\n+)',
'(\r+)',
'(\t+)',
'(%0A+)',
'(%0D+)',
'(%08+)',
'(%09+)'
$inject = join('|', $injections);
$inject = "/$inject/i";
if(preg_match($inject,$str)) {
return true;
else {
return false;
// Load form field data into variables.
$first_name= $_REQUEST['first_name'] ;
$last_name = $_REQUEST['last_name'] ;
$email = $_REQUEST['email'] ;
$comments = $_REQUEST['comments'] ;
// If the user tries to access this script directly, redirect them to feedback form,
if (!isset($_REQUEST['email'])) {
header( "Location: contact.html" );
// If the form fields are empty, redirect to the error page.
elseif (empty($email) || empty($comments)) {
header( "Location: error_message.html" );
// If email injection is detected, redirect to the error page.
elseif ( isInjected($email) ) {
header( "Location: error_message.html" );
// If we passed all previous tests, send the email!
else {
mail( "[email protected]", "Email from website",
$comments, "From: $email" );
header( "Location: thank_you.html" );
?>

Can we first establish if your SERVER really DOES requie the authentication or not.
Copy the below and paste it into a new DW document and save it as - form_submit.php
Change [email protected] in the code below to the recipient email address. Upload to your server fill out the fields and see if any results are sent. If not then authentication is required, if yes it's not required and you are free to use a simpler solution.
<?php
if (isset($_POST['submit'])) {
    // get name
$name = trim($_POST['name']);
// get email address
$email = trim($_POST['email']);
// get comments
$comments = stripslashes(trim($_POST['comments']));
// check antiSpam field
$antiSpam = trim($_POST['antiSpam']);
if (!empty($antiSpam)) {
    exit;
$to = "[email protected]";
$subject   = "Comments from website";
$headers = "From: $email\r\n";
$headers .= "Reply-To: $email\r\n";
$message = "Name: $name\n\n";
$message .= "Email Address: $email\n\n";
$message .= "Comments: $comments\n\n";
mail($to, $subject, $message, $headers);
$sent = "Mail was sent successfully";
?>
<!DOCTYPE HTML>
<html>
<head>
<meta charset="UTF-8">
<title>Website Form</title>
<script>
$(document).ready(function() {
$('#submit').click(function()
    var name = $('#name').val();
if (name == null || name == "" ) {
    alert('Please provide your name');
    return false;
// check for valid email address
var email = document.getElementById('email');
var filter = /^([a-zA-Z0-9_\.\-])+\@(([a-zA-Z0-9\-])+\.)+([a-zA-Z0-9]{2,4})+$/;
if (!filter.test(email.value)) {
alert('Please provide a valid email address');
email.focus;
return false;
    var comments = $('#comments').val();
if (comments == null || comments == "" ) {
    alert('Please provide your comments');
    return false;
</script>
<style>
#antiSpam {
    display: none;
</style>
<script src="http://code.jquery.com/jquery-1.10.2.min.js"></script>
</head>
<body>
<?php
if(isset($sent)) {
    echo "<h3>$sent</h3>";
echo "    <script>
alert('Your message has been sent!');
</script>";
    ?>
<form id="maiForm" method="post" action="form_submit.php">
<p>
<label for="name">Name</label><br>
<input type="text" id="name" name="name">
</p>
<p>
<label for="email">Email Address</label><br>
<input type="text" id="email" name="email">
</p>
<p>
<label for="comments">Comments</label><br>
<textarea id="comments" name="comments"></textarea>
</p>
<input type="text" id="antiSpam" name="antiSpam">
<input type="submit" name="submit" id="submit" value="submit">
</form>
</body>
</html>

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I tried this original code and yes your right it really did mess up the side bar terribly.
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is my site wwwdotselfdefenseproshopdotcom
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Hi chuck,
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Regards,
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REPORT zenvoi_pdf_mail MESSAGE-ID ad.
TYPE-POOLS : abap .
DATA : data_for_update TYPE zdemopdf ,
       hexa            TYPE solix_tab.
DATA : fm_name   TYPE funcname ,
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EXPORTING
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IMPORTING
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CHANGING
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EXCEPTIONS
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EXPORTING
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IMPORTING
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EXCEPTIONS
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EXCEPTIONS
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EXPORTING
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TABLES
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** CLASS-DEFINITIONS
DATA: send_request       TYPE REF TO cl_bcs.
DATA: document           TYPE REF TO cl_document_bcs.
*DATA: sender             TYPE REF TO cl_sapuser_bcs.
data: sender            TYPE REF TO if_sender_bcs.
DATA: recipient          TYPE REF TO if_recipient_bcs.
** INTERNAL TABLES
DATA: l_mailtext TYPE soli_tab.
DATA: iaddsmtp   TYPE TABLE OF bapiadsmtp.
DATA: ireturn    TYPE TABLE OF bapiret2.
** VARIABLES
DATA: mail_line LIKE LINE OF l_mailtext.
DATA: bapiadsmtp         TYPE bapiadsmtp.
DATA: subject    TYPE so_obj_des.
DATA : att_subject TYPE so_obj_des.
DATA : w_except TYPE REF TO cx_root .
CONSTANTS : c_defmail TYPE ad_smtpadr VALUE
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FIELD-SYMBOLS : <smtp> TYPE bapiadsmtp.
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subject = 'Exemple de PDF interactif'.
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APPEND mail_line TO l_mailtext .
att_subject = 'Template du PDF'.
TRY.
* Create persistent send request
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* Get sender object
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*    sender =
*      cl_cam_address_bcs=>create_internet_address( '[email protected]' ) .
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      EXPORTING
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* Read the E-Mail address for the user
*    CALL FUNCTION 'BAPI_USER_GET_DETAIL'
*      EXPORTING
*        username = sy-uname
*      TABLES
*        return   = ireturn
*        addsmtp = iaddsmtp.
*    LOOP AT iaddsmtp ASSIGNING <smtp> WHERE std_no = 'X'.
*      CLEAR bapiadsmtp.
*      MOVE <smtp> TO bapiadsmtp.
*    ENDLOOP.
*    CASE bapiadsmtp-e_mail.
*      WHEN space.
        recipient =
     cl_cam_address_bcs=>create_internet_address( c_defmail ).
*      WHEN OTHERS.
*        recipient =
*     cl_cam_address_bcs=>create_internet_address( bapiadsmtp-e_mail ).
*    ENDCASE.
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    CALL METHOD send_request->add_recipient
      EXPORTING
        i_recipient = recipient
        i_express    = 'X'
        i_copy       = space
        i_blind_copy = space
        i_no_forward = space.
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        i_status_mail      = 'E'.
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    document = cl_document_bcs=>create_document(
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                        i_text    = l_mailtext
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        i_att_content_hex    = hexa.
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CATCH cx_send_req_bcs INTO w_except.
CATCH cx_address_bcs INTO w_except.
CATCH cx_document_bcs INTO w_except.
ENDTRY.
Hope this help you .
Best regards

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Since Acrobat 3 the form could be submitted to a scripted web page and have the web server perform the tasks necessary to return the data to you.
Since Acrobat 6 the creator could add special "Extended Form Rights" to the form so users with Reader version 5 or better could save the form and email the form.
For mobile devices the app the user will be using will determine how or if the form can be returned.
Do not allow users to use Apple's Preview application on the Macintosh. It will corrupt the form in many ways.

Creating a form to email

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