Sample Pizza Order form

This is an example that uses text boxes, a drop down menu, check boxes and radio buttons. Feel free to download the source and use it as a starting point for your own form.

You will need to change the value for the recipient field, from "yourid@unlvm.unl.edu" to your actual e-mail address, and /cgi/null.pl to /cgi/formmail1.pl on the FORM METHOD line. Of course, you will also want to add the fields you need.

Please read all of the instructions (at least through the "useful fields" section) before proceeding - doing so will undoubtedly save you time.

Customer Information

Your name:

E-mail address:

Street address:

Pizza Preferences

Order Pizza From:

Check the toppings you want:
Pepperoni
Mushrooms
Onions
Anchovies
Ham
Bell Peppers

Deliver by:
Car
FedEx
UPS
U.S. Postal Service

Any message or note?

Note: Submit will not work on this example form, until the FORM METHOD is changed, as noted above.