/home/mip/mip/public/img/credit/datatables/request_form.php.tar
home/mip/public_html_/old-website/request_form.php 0000644 00000015111 15152061674 0016372 0 ustar 00 <?php
require_once("func_proc.php");
require_once("func_select.php");
require_once("func_select_codes.php");
require_once("func_data_validation.php");
do_header("Manpower Request");
do_menu();
$formname="thisonly";
$inputname= array("Business_Name","Address","Telephone","Email_Address","Nature","agency_email","email_employer");
$displayname= array("Business Name","Business Address","Telephone","Email Address","Nature of Business");
JS_CheckRequired($formname,$inputname,$displayname,"","");
$config = getdata_one("*","config","1",1);
?>
<script language="javascript">
var currcount = 3;
function AddInput(){
if(currcount>=15) return false;
currcount++;
var el = document.getElementById('fileInput'+currcount);
el.style.display = '';
if(currcount >= 15) document.getElementById("attachMoreLink").style.display = "none";
}
</script>
<!--call do_leftContent-->
<table width="100%" border="0" cellspacing="0" cellpadding="0">
<tr>
<td height="3px"></td>
</tr>
<!-- <tr>
<td height="1" background="images/pixel.gif"><img src="images/pixel.gif" width="1" height="1"></td>
</tr>-->
<tr>
<td style="padding:10px;">
<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr>
<td width="150" class="header_white" style="padding-top:3;padding-left:5px;"><img src="images/form.gif" />
</td>
<td>
</td>
</tr>
<tr height="5" >
<td colspan="2"></td>
</tr>
</table><br />
<table width="100%" cellpadding="0" cellspacing="0" border="0">
<tr><form action="sendregistrationform.php" method="post" name="<?=$formname?>" onSubmit="return CheckRequired()">
<td align="center" valign="middle" class="style4">
Please fill-up all required fields (<font color="#FF0000">*</font>)
<table border="0" cellpadding="0" cellspacing="0" style="border-collapse:collapse">
<tr>
<td height="15" colspan="4"></td>
</tr>
<tr>
<td height="22" align="left"><strong>Business Name</strong></td>
<td align="left"><input name="Business_Name" type="text" size="35"></td>
<td align="left" valign="top"><font color="#FF0000">*</font></td>
</tr>
<tr>
<td height="22" valign="top" align="left"><strong>Business Address</strong></td>
<td align="left"><textarea name="Address" rows="2"></textarea></td>
<td align="left" valign="top"><font color="#FF0000">*</font></td>
</tr>
<tr>
<td height="22" align="left"><strong>Telephone Number</strong></td>
<td align="left"><input name="Telephone" type="text" size="35"></td>
<td align="left" valign="top"><font color="#FF0000">*</font></td>
</tr>
<tr>
<td height="22" align="left"><strong>Fax Number</strong></td>
<td align="left"><input name="Fax" type="text" size="35"></td>
<td align="center"> </td>
</tr>
<tr>
<td height="22" align="left"><strong>Email Address</strong><input type=hidden name="agency_email" size=50 value="<?=$company['agency_email']?>"></td>
<td align="left"><input name="Email_Address" type="text" size="35"></td>
<td align="center"><font color="#FF0000">*</font></td>
</tr>
<tr>
<td height="22" align="left"><strong>Website</strong></td>
<td align="left"><input name="Website" type="text" size="35"></td>
<td align="center"> </td>
</tr>
<tr>
<td height="15"></td>
<td height="15"></td>
<td height="15"></td>
</tr>
<tr>
<td height="22" align="left"><strong>Contact Person</strong></td>
<td align="left"><input name="Contact_Person" type="text" size="35"></td>
<td align="center"> </td>
</tr>
<tr>
<td height="22" align="left"><strong>Position</strong></td>
<td align="left"><input name="Position" type="text" size="35"></td>
<td align="center"> </td>
</tr>
<tr>
<td height="22" align="left" style="padding-left:2px"><strong>Business License Number</strong></td>
<td align="left"><input name="License_Number" type="text" size="35"></td>
<td align="center"> </td>
</tr>
<tr>
<td height="22" align="left"><strong>Nature of Business</strong></td>
<td align="left"><input name="Nature" type="text" size="35"></td>
<td align="center"><font color="#FF0000">*</font> </td>
</tr>
<tr>
<td height="15" colspan="4"></td>
</tr>
</table>
<br />
<table border="0" cellpadding="0" cellspacing="0">
<tr>
<td height="29" align="center" valign="top"><strong>Position</strong></td>
<td align="center" valign="top" ><strong>Number Required</strong></td>
<td align="center" valign="top"><strong>Job Description (Qualification, age limit..etc)</strong></td>
</tr>
<tr id="fileInput1">
<td valign="top"><input name="Position1" type="text"></td>
<td align="center" valign="top"><input name="Number1" type="text" maxlength="10" size="5"></td>
<td><textarea name="Description1" rows="2"></textarea></td>
</tr>
<tr id="fileInput2">
<td valign="top"><input name="Position2" type="text"></td>
<td align="center" valign="top"><input name="Number2" type="text" size="5"></td>
<td><textarea name="Description2" rows="2"></textarea></td>
</tr>
<tr id="fileInput3">
<td valign="top"><input name="Position3" type="text"></td>
<td valign="top" align="center"><input name="Number3" type="text" size="5"></td>
<td><textarea name="Description3" rows="2"></textarea></td>
</tr>
<? $row = 15;
for ($b=4; $b<=$row; $b++) {
echo "<tr style=display:none id=fileInput".$b.">
<td valign=top><input name=Position".$b." type=text></td>
<td valign=top align=center><input name=Number".$b." type=text size=5></td>
<td><textarea name=Description".$b." rows=2></textarea></td>
</tr>";
}
?>
<tr>
<td colspan="3" class="style3" align="left"><p id="attachMoreLink"><a href="javascript:AddInput();">Add More</a></p></td>
</tr>
<tr>
<td colspan="3"> </td>
</tr>
<tr>
<td colspan="3" align="center"><input name="Send" type="submit" id="Send2" value=" Submit ">
<input type="hidden" name="email_employer" size="35" value='<?=$config["email_employer"]?>' />
<input name="clear" type="reset" value="Clear All">
<input name="cancel" type="button" id="cancel2" value="Cancel" onClick="javascript:history.back();"></td>
</tr>
<tr>
<td colspan="3"> </td>
</tr>
</table>
</form>
</td></tr></table></td>
</tr>
</table>
<? do_footer(); ?>
