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<?php

if (!empty($_POST["email"])) {

	$email_to = "jouw@email.com";
	
	
	$name = (!$_POST['name'] ? 'empty' : $_POST['name']);	
	$address = (!$_POST['address'] ? 'empty' : $_POST['address']);	
	$phone = (!$_POST['phone'] ? 'empty' : $_POST['phone']);	
	$email = (!$_POST['email'] ? 'empty' : $_POST['email']);	
	$message = (!$_POST['message'] ? 'empty' : $_POST['message']);	
	
	$name = mysql_real_escape_string($name);
	$email = mysql_real_escape_string($email);
	$message = mysql_real_escape_string($message);
	
	$name = htmlentities($name);
	$email = htmlentities($email);
	$message = htmlentities($message);
	
	$date = date("F j, Y, g:i a"); 
	
	$text = "NAME: $name<br>
	         EMAIL: $email<br>	 
	         MESSAGE: $message";
	$headers = "MIME-Version: 1.0" . "\r\n"; 
	$headers .= "Content-type:text/html; charset=utf-8" . "\r\n"; 
	$headers .= "From: <$email>" . "\r\n";
	mail($email_to, "Message", $text, $headers);
	
	echo "success";
	
} else {

	echo "empty";
	
}

?>