[insert_php] $to = “icnoka@gmail.com”;
$subject = “HTML email”;

$message = ”

//

“;

// Always set content-type when sending HTML email
$headers = “MIME-Version: 1.0” . “\r\n”;
$headers .= “Content-type:text/html;charset=UTF-8” . “\r\n”;

// More headers
$headers .= ‘From: ‘ . “\r\n”;
$headers .= ‘Cc: myboss@example.com’ . “\r\n”;

mail($to,$subject,$message,$headers);
[/insert_php]

Request Form

DISTRIUBTOR NAME

CONTACT

PHONE NUMBER

EMAIL

ASI NO.

PPAI NO.

SOCKS	TIES	BOW TIES	SCARVES	POCKET SQUARES
MENS WOMANS UNISEX SPORT/DRESS ANKLE CREW OTHER	SILK POLY	PRE TIED TO BE TIED SILK POLY	SILK POLY SIZE 10X60 20X60 (MOST POPULAR) 26X26 30X30 36X36 24X72 TWILLY OTHER	SILK POLY SIZE 12X12 14X14 (MOST POPULAR)

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PMS COLOR 1

PMS COLOR 2

PMS COLOR 3

PMS COLOR 4

PMS COLOR 5

PMS COLOR 6

PMS COLOR 7

PMS COLOR 8

DELIVERY DATE

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