How to Make a Lead Capture Page

From About Amalaki

This method requires that you have a web server that understands PHP code. Many hosting companies have PHP as a standard option. If you are not sure, then please contact them.

Step One: You need to add the FORM code to your index.html or index.php page. This is where the customer fills in there name and phone number. Copy and past the code below and place it in the area you want the form to display.

<form METHOD=POST ACTION=call_me.php>
<center>
<table>
  <tr>
    <td><b>Name:   </b></td><td><input type=text name=name value=></td>
  </tr>
  <tr>
    <td><b>Phone Number:   </b></td><td><input type=text name=phone value=></td>
  <tr>
    <td><b>Email:   </b></td><td><input type=text name=email value=></td><td>Optional</td>
  </tr>
  <tr>
    <td colspan=3 align=center>
      <input type=SUBMIT value=" I'm Interested - Call Me! ">
    </td>
  </tr>
</table>
</center>
</form>

Step Two: Create a file named "call_me.php". This file will send you an email and become the "Thank You" page. Put the code below at the TOP of the call_me.php file.
PS, Don't for get to replace the text PUT YOUR EMAIL ADDRESS HERE, with your own email address. Leave the qoutes.

<?php

$message= "Name: " . $_REQUEST['name'] . "\n" . "Phone: " . $_REQUEST['phone'] . "\n" . "Email: " . $_REQUEST['email'] . "\n";
$to= "PUT YOUR EMAIL ADDRESS HERE";
$subject= "Zrii Lead";

mail($to, $subject, $message);

?>

Step Three: Add your "Thank You" message below the PHP code using standard HTML format.