| Current File : /home/inlingua/www/icentex/in-centre/ingl_admission.form.php |
<?php
// Created on: 16-02-2013
// Include header
include "header_in.php";
?>
<h3>
<span class='pa-nor-navbar'>Add in-center</span>
</h3>
<?php
echo $succFailMesg;
// Show result of a form submission?
if ($showResult == "Y")
{ echo "<br><a href='ingl_admission.select.php'>Back</a><br>";
// Include footer
include "footer_in.php";
return;
}
?>
<script type="text/javascript" src="js/jquery.validate.min.js"></script>
<script language="javascript">
<!--
function validate1()
{
var mailformat = /^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,3})+$/;
var inputText=document.getElementById('email');
var Email=inputText.value.match(mailformat) ;
if (document.form.firstName.value=="")
{ alert("First Name cannot be blank. Please enter it.");
document.form.firstName.focus(); return false;
}
if (document.form.Nationality.value=="")
{ alert("Nationality cannot be blank. Please enter it.");
document.form.Nationality.focus(); return false;
}
if (document.form.address.value=="")
{ alert("address cannot be blank. Please enter it.");
document.form.address.focus(); return false;
}
if(Email==null)
{
alert("You have entered an invalid email address!");
document.form.email.focus();
return false;
}
if(document.getElementById('mobile').value.length!=10)
{
alert("Please enter a valid mobile no.");
document.form.mobile.focus();
return false;
}
//debugger;
var radios = document.getElementsByName('preffered_slot');
var radiossat = document.getElementsByName('preffered_slot_sat');
var value;
var istrue=false;
for (var i = 0; i < radios.length; i++) {
//alert(radios.length);
if (radios[i].checked) {
//alert(true);
istrue=true;
}
}
debugger;
for (var i = 0; i < radiossat.length; i++) {
//alert(radios.length);
if (radiossat[i].checked) {
//alert(true);
istrue=true;
}
}
if(!istrue)
{
alert(' Please Prefered Time Slot')
return false;
}
if (document.form.recNo.value=="")
{ alert("recNo cannot be blank. Please enter it.");
document.form.recNo.focus(); return false;
}
return true;
}
-->
</script>
<form id='aForm' name="form" method='post' action='ingl_admission.main.php' onsubmit="return validate1()">
<input type='hidden' name='recNo' class='required' value="<?php echo $dbObject->getDbField('recNo');?>">
<input type='hidden' name='kV' value="<?php echo $_REQUEST['kV'];?>">
<input type='hidden' name='ref_No' value="<?php echo $dbObject->getDbField('ref_No');?>" size='20' maxlength='250'>
<table><tr><td>
Center :
</td><td>
<select id="center_no" name="center_no" class="required" style="width:200px;">
<?php
$queryB="select * from timesheet_location where status='1' && location='".$_SESSION['branch']."' order by location";
$resultB=mysqli_query($conn,$queryB);
while($numB=mysqli_fetch_array($resultB))
{
if($numB['location']=="S.Extn")
{
$showL="South Extension";
}
else
{
$showL=$numB['location'];
}
echo"<option value='".$numB[recNo]."'";
if($dbObject->getDbField('center_no')==$numB[recNo]) echo"selected";
echo">".$showL."</option>";
}
?>
</select>
</td></tr>
<tr><td>
Test Type :
</td><td>
<select id="test_category" name="test_category" class="required" style="width:200px;">
<?php
$queryB="select * from ingl_test_category";
$resultB=mysqli_query($conn,$queryB);
while($numB=mysqli_fetch_array($resultB))
{
echo"<option value='".$numB['recNo']."'";
if($dbObject->getDbField('test_category')==$numB['recNo'])
{
echo"selected";
}
echo" >".$numB['category']."</option>";
}
?>
</select>
</td></tr>
<tr><td>Date</td><td>
<input type='text' name='createDate' value="<?php echo date("Y-m-d",strtotime($dbObject->getDbField('createDate')));?>" size='28' maxlength='250' id="datepicker1" class="required">
</td></tr>
<tr>
<td>in-center Source</td><td>
<select name="incenter_source" style="width:200px;">
<option value="Retail wing" <?php if($dbObject->getDbField('incenter_source')=="Retail wing") echo "selected"; ?> >Retail wing</option>
<option value="Corporate" <?php if($dbObject->getDbField('incenter_source')=="Corporate") echo "selected"; ?>>Corporate</option>
<option value="Marketing" <?php if($dbObject->getDbField('incenter_source')=="Marketing") echo "selected"; ?>>Marketing</option>
<option value="Call center" <?php if($dbObject->getDbField('incenter_source')=="Call center") echo "selected"; ?>>Call center</option>
<option value="Other" <?php if($dbObject->getDbField('incenter_source')=="Other") echo "selected"; ?>>Other</option>
</select>
</td></tr>
<tr><td>Customer detailing</td><td>
<?php echo getInstructor($conn,$dbObject->getDbField('customer_detailing')) ?></td></tr>
</table>
<table border="0">
<tr>
<td colspan="4" style="background-color:#cccccc;">A.PERSONAL INFORMATION</td>
</tr>
<tr><td>First Name</td><td><input type='text' name='firstName' value="<?php echo $dbObject->getDbField('firstName');?>" size='70' maxlength='250'></td>
<td>Last Name</td><td><input type='text' name='lastName' value="<?php echo $dbObject->getDbField('lastName');?>" size='40' maxlength='250'>
</tr>
<tr>
<td>Nationality</td><td><input type='text' name='Nationality' id="Nationality" value="<?php echo $dbObject->getDbField('Nationality');?>" size='20' maxlength='250'>
<td>Gender</td><td>
<?php
$gender_selected=$dbObject->getDbField('gender');
$gender_array=array("Male"=>"Male","Female"=>"Female");
echo radio_buttons($gender_array,"gender",$gender_selected,"",2);
?>
</td>
<tr>
<td valign="top">Age Group</td>
<td>
<?php
$age_selected=$dbObject->getDbField('age_group');
$age_group=array("Below 15"=>"Below 15","16 to 18"=>"16 to 18","19 to 23"=>"19 to 23","24 to 27"=>"24 to 27","27 to 30"=>"27 to 30","30 & above"=>"30 & above");
echo radio_buttons($age_group,"age_group",$age_selected,"",3);
?>
</td>
</tr>
</tr>
</table>
<br>
<table width="100%" >
<tr><td style="background-color:#cccccc;" colspan="6">B.CONTACT INFORMATION</td></tr>
<tr><td valign="top" >Address:</td><td colspan="5"><textarea wrap='virtual' rows='1' cols='100' name='address'><?php echo $dbObject->getDbField('address');?></textarea></td></tr>
<tr>
<td>City</td><td><input type='text' name='city' value="<?php echo $dbObject->getDbField('city');?>" size='20' maxlength='250'></td>
<td>District</td><td><input type='text' name='district' value="<?php echo $dbObject->getDbField('district');?>" size='20' maxlength='250'></td>
<td>State</td><td><input type='text' name='state' value="<?php echo $dbObject->getDbField('state');?>" size='20' maxlength='250'></td>
</tr>
<tr valign='top'><td >Pincode:</td><td><input type='text' name='pincode' value="<?php echo $dbObject->getDbField('pincode');?>" size='20' maxlength='250'></td>
<td >Country:</td><td colspan="3"><input type='text' name='country' value="<?php echo $dbObject->getDbField('country');?>" size='20' maxlength='250'></td>
</tr>
<tr>
<td>Telephone</td><td><input type='text' name='telephone' value="<?php echo $dbObject->getDbField('telephone');?>" size='20' maxlength='250'></td>
<td>Mobile</td><td><input type='text' id="mobile" name='mobile' value="<?php echo $dbObject->getDbField('mobile');?>" size='20' maxlength='250'></td>
<td>Email</td><td><input type='text' id="email" name='email' value="<?php echo $dbObject->getDbField('email');?>" size='20' maxlength='250'></td>
</tr>
</table>
<br>
<table width="100%" border="0" >
<tr><td colspan="4" style="background-color:#cccccc;">C.EDUCATION & OCCUPATION</td></tr>
<tr><td colspan="2">In which city have you done most of your schooling?</td><td colspan="2"><input type='text' name='city_school' value="<?php echo $dbObject->getDbField('city_school');?>" size='20' maxlength='250'></td></tr>
<tr><td colspan="2">What was the medium of instruction in your school?</td><td colspan="2">
<input type="checkbox" name="medium_school_english" value="1" <?php if($dbObject->getDbField('medium_school_english')=="1") echo "checked" ?>> English
<input type="checkbox" name="medium_school_hindi" value="1" <?php if($dbObject->getDbField('medium_school_hindi')=="1") echo "checked" ?>> Hindi
<input type="checkbox" name="medium_school_other" value="1" <?php if($dbObject->getDbField('medium_school_other')=="1") echo "checked" ?>> Other
</td></tr>
<tr><td width="20%">Are you currently a student?</td><td width="15%">
<?php
$student_selected=$dbObject->getDbField('student');
$student_array=array("No"=>"No","Yes"=>"Yes");
echo radio_buttons($student_array,"student",$student_selected,"",2);
?>
</td><td>Are you currently working?</td><td>
<?php
$working_selected=$dbObject->getDbField('working');
$working_array=array("No"=>"No","Yes"=>"Yes");
echo radio_buttons($working_array,"working",$working_selected,"",2);
?>
</td></tr>
</table><br>
<?php
$sources_array=array("No"=>"No","Yes"=>"Yes");
?>
<table width="100%" >
<tr><td colspan="4" style="background-color:#cccccc;">D.SOURCES OF INFORMATION ABOUT inlingua</td></tr>
<tr><td>Did you see or hear an ad for inlingua?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_ad",$dbObject->getDbField('inlingua_ad'),"",2);
?>
</td>
<td>Did you find us on the internet or through phone inquiry?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_internet_phone",$dbObject->getDbField('inlingua_internet_phone'),"",2);
?>
</td>
</tr>
<tr><td>Did you see signage or posters for inlingua?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_signage_posters",$dbObject->getDbField('inlingua_signage_posters'),"",2);
?>
</td>
<td>Were you cantacted by someone on behalf of inlingua?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_contacted",$dbObject->getDbField('inlingua_contacted'),"",2);
?>
</td>
</tr>
<tr><td>Did you receive a pamphlet of leaflet for inlingua?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_pamphlet_leaflet",$dbObject->getDbField('inlingua_pamphlet_leaflet'),"",2);
?>
</td>
<td>Any other source of information not listed above?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_above",$dbObject->getDbField('inlingua_above'),"",2);
?>
</td>
</tr>
<tr>
<td>Did someone recommend inlingua to you?</td><td>
<?php
echo radio_buttons($sources_array,"inlingua_recommend",$dbObject->getDbField('inlingua_recommend'),"",2);
?>
</td>
<td colspan="2"><input type='text' name='inlingua_other' value="<?php echo $dbObject->getDbField('inlingua_other');?>" size='20' maxlength='250'></td>
</tr>
</table><br>
<table width="100%">
<tr><td colspan="3" style="background-color:#cccccc;">E.PURPOSE OF VISIT</td></tr>
<tr>
<td>Is this your first visit to a language school?</td><td colspan="2">
<div style='float:left;width:100%;border:0px solid #cccccc;'>
<div style='float:left;width:20%;border:0px solid #cccccc;'><input type="radio" name="first_visit" value="Yes" <?php if($dbObject->getDbField('first_visit')=="Yes") echo"checked" ?>> Yes</div>
<div style='float:left;width:79%;border:0px solid #cccccc;'>
<input type="radio" name="first_visit" value="No" <?php if($dbObject->getDbField('first_visit')=="No") echo"checked" ?>>No, I've been to <input type='text' name='first_visit_no' value="<?php echo $dbObject->getDbField('first_visit_no');?>" size='20' maxlength='250'>
</div>
</div>
</td>
</tr>
<tr>
<td>Are you interested in joining a course at inlingua?</td>
<td colspan="2">
<div style='float:left;width:100%;border:0px solid #cccccc;'>
<div style='float:left;width:20%;border:0px solid #cccccc;'><input type="radio" name="interested_joining" value="Yes" <?php if($dbObject->getDbField('interested_joining')=="Yes") echo"checked" ?>> Yes</div>
<div style='float:left;width:79%;border:0px solid #cccccc;'>
<input type="radio" name="interested_joining" value="No" <?php if($dbObject->getDbField('interested_joining')=="No") echo"checked" ?>>No,I'm just seeking information
</div>
</div>
</td>
</tr>
<tr>
<td colspan="3">If yes,which language or course are you interested in?</td>
</tr>
<tr>
<td><div style='float:left;width:100%;border:0px solid #cccccc;'><div style='float:left;width:46%;border:0px solid #cccccc;'>
<input type='checkbox' name='inlingua_language_english' value='1' <?php if($dbObject->getDbField('inlingua_language_english')=="1") echo"checked" ?>>English</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='inlingua_language_german' value='1' <?php if($dbObject->getDbField('inlingua_language_german')=="1") echo"checked" ?>>German</div>
<div style='float:left;width:20%;border:0px solid #cccccc;'><input type='checkbox' name='inlingua_language_spanish' value='1' <?php if($dbObject->getDbField('inlingua_language_spanish')=="1") echo"checked" ?>>Spanish</div></div> </td>
<td><div style='float:left;width:100%;border:0px solid #cccccc;'><div style='float:left;width:33%;border:0px solid #cccccc;'>
<input type='checkbox' name='inlingua_language_french' value='1' <?php if($dbObject->getDbField('inlingua_language_french')=="1") echo"checked" ?>>French</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='inlingua_language_hindi' value='1' <?php if($dbObject->getDbField('inlingua_language_hindi')=="1") echo"checked" ?>>Hindi</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='inlingua_language_customized' value='1' <?php if($dbObject->getDbField('inlingua_language_customized')=="1") echo"checked" ?>>Customized</div></div> </td>
<td><input type="checkbox" name="inlingua_language_other" value="1" <?php if($dbObject->getDbField('inlingua_language_other')=="1") echo"checked" ?>>Other<input type='text' name='inlinlingua_language_other_lang' value="<?php echo $dbObject->getDbField('inlinlingua_language_other_lang');?>" size='20' maxlength='250'></td>
</tr>
<tr>
<td colspan="3">What is your main objective for takng the course?</td>
</tr>
<tr>
<td><div style='float:left;width:100%;border:0px solid #cccccc;'><div style='float:left;width:46%;border:0px solid #cccccc;'>
<input type='checkbox' name='objective_course_career' value='1' <?php if($dbObject->getDbField('objective_course_career')=="1") echo"checked" ?>>Career/Growth</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='objective_course_studies' value='1' <?php if($dbObject->getDbField('objective_course_studies')=="1") echo"checked" ?>>Studies</div>
<div style='float:left;width:20%;border:0px solid #cccccc;'><input type='checkbox' name='objective_course_job' value='1' <?php if($dbObject->getDbField('objective_course_job')=="1") echo"checked" ?>>Job</div></div> </td>
<td><div style='float:left;width:100%;border:0px solid #cccccc;'><div style='float:left;width:33%;border:0px solid #cccccc;'>
<input type='checkbox' name='objective_course_personality' value='1' <?php if($dbObject->getDbField('objective_course_personality')=="1") echo"checked" ?>>Personality Dev.</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='objective_course_abroad' value='1' <?php if($dbObject->getDbField('objective_course_abroad')=="1") echo"checked" ?>>Go Abroad</div>
<div style='float:left;width:33%;border:0px solid #cccccc;'><input type='checkbox' name='objective_course_social_reasons' value='1' <?php if($dbObject->getDbField('objective_course_social_reasons')=="1") echo"checked" ?>>Social Reasons</div></div> </td>
<td><input type="checkbox" name="objective_course_other" value="1" <?php if($dbObject->getDbField('objective_course_other')=="1") echo"checked" ?>> Other<input type='text' name='objective_course_other_list' value="<?php echo $dbObject->getDbField('objective_course_other_list');?>" size='20' maxlength='250'></td>
</tr>
<tr>
<td>When would you like to begin the course?</td>
<td>
<?php
$course_today_array=array("Right now"=>"Right now","In 2 weeks"=>"In 2 weeks","In 1 month"=>"In 1 month");
echo radio_buttons($course_today_array,"begin_course",$dbObject->getDbField('begin_course'),"",3);
?>
</td>
<td><input type="radio" name="begin_course" value="Later" <?php if($dbObject->getDbField('begin_course')=="Later") echo"checked" ?>> Later <input type='text' name='begin_course_later' value="<?php echo $dbObject->getDbField('begin_course_later');?>" size='20' maxlength='250'></td>
</tr>
<tr><td width="36%">Would you like to sit for assessment today?</td>
<td width="40%">
<?php
$assessment_array=array("Yes"=>"Yes","No, already taken"=>"No, already taken","No,will come on"=>"No,will come on");
echo radio_buttons($assessment_array,"assessment_today",$dbObject->getDbField('assessment_today'),"",3);
?>
</td>
<td style="padding-left: 65px;"><input type='text' name='assessment_today_no' value="<?php echo $dbObject->getDbField('assessment_today_no');?>" size='20' maxlength='250'></td>
</tr>
</table>
<table width="100%">
<tr>
<td style="background-color:#cccccc;" colspan="2">F.PREFERRED TIME SLOT </td></tr>
<tr>
<td valign="top">Mon-Thur</td><td>
<?php
$mtslots_array=array("7.30-9.00 am"=>"7.30-9.00 am","9.00-11.00 am"=>"9.00-11.00 am","11.00-01.00 pm"=>"11.00-01.00 pm","01.00-03.00 pm"=>"01.00-03.00 pm","03.00-05.00 pm"=>"03.00-05.00 pm","05.00-07.00 pm"=>"05.00-07.00 pm","07.00-08.30 pm"=>"07.00-08.30 pm");
echo radio_buttons($mtslots_array,"preffered_slot",$dbObject->getDbField('preffered_slot'),"",5);
?>
</td>
</tr>
<tr>
<td valign="top">Sat- Sun</td><td>
<?php
$ssslots_array=array("7.30-10.30 am"=>"7.30-10.30 am","11.00-14.00"=>"11.00-14.00");
echo radio_buttons($ssslots_array,"preffered_slot_sat",$dbObject->getDbField('preffered_slot_sat'),"",5);
?>
</td>
</tr>
</table>
<br>
<table width="100%">
<tr><td><input type='checkbox' name='tc' value='1'>
I Wish to receive promotional offers from Inlingua</td></tr>
<tr><td><input type='submit' name='aC' value='<?php echo $currentMode;?>'></td></tr>
</table>
</form>
<script>
$(function() {
$('#aForm').validate({
errorPlacement: function(error, element)
{ error.appendTo( element.parent("td").next("td") );
}
});
});
</script>
<?php
// Include footer
include "footer_in.php";
?>