The Eagles Nest Web Design

EMail Registration Sample Page

The following is a sample email capture page. This form just asks for the name and email address, but it can be modified to ask for as much (or as little) information as you need.

The form will check to make sure any required fields are filled out, and make sure the fields are correctly filled out (EMail, phone number, etc). When you enter the information, a check will be made to ensure the email address hasn't already been registered. If the address has been registered or is being registered for the first time, an EMail will be sent to the address provided to allow them to confirm the registration.

When the registration has been confirmed by clicking the link in the email, another email will be sent to let the user know that the registration has been completed.

This can easily be incorporated into any page that requires a user to register, such as a mailing list, a message board system, or any number of other sites. If you have any questions, or would like to include a form like this on your page, email me at

Try the sample below and let me know if you have any questions!!

Email Sample

Email Address:
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