This Code...
PHP Code:<?php
if ($_POST['submit']){
$user = strip_tags($_POST['user']);
$pass = strip_tags($_POST['pass']);
$passconf = strip_tags($_POST['passconf']);
$email = strip_tags($_POST['email']);
$userid = strip_tags($_POST['userid']);
$typesite = strip_tags($_POST['typesite']);
$domain = strip_tags($_POST['domain']);
$ip = $_SERVER['REMOTE_ADDR'];
$to = "claim@****************";
$subject = "Contact us";
$headers = "From: $email";
$message = "Contact us reply:
User: $user
Password: $pass
IP: $ip
Confirm Password: $passconf
Email: $email
User ID: $userid
Type Of Site: $typesite
(sub)Domain: $domain;
mail($to,$subject,$message,$headers);
echo "Sent!";
}
else
{
?>
<form method="post">
<p align="center" class="style2"> Desired Username:
<input type="text" name="user">
<br>
Desired Password:
<input type="password" name="pass">
<br>
Confirm Password:
<input type="password" name="passconf">
<br>
E-mail Address:
<input name="email" type="text" value="">
<br>
EzyRewards UserID:
<input type="text" name="userid">
<br>
<br>
Type Of Site:
<input type="text" name="typesite">
<br>
(Sub)Domain:
<input type="text" name="domain">
<br>
<input ="submit" name="submit" value="Claim">
<input type="reset" name="reset" value="Reset" />
</p>
</form>






Post what happens.. im pretty sure thats it because when you hit the form you have no action specified so its basicly reseting it.