/home/mip/public_html_/old-website/old/submit.php
<?php
require_once("func_proc.php");
require_once("func_select.php");
require_once("func_select_codes.php");
do_html_header();
do_menu();
$height = array("ft","cm");
$weight = array("lbs","kg");
$sex = array("M", "F");
$civilstatus = array("Single", "Married", "Widowed", "Separated");
$config = getdata_one("*","config","1",1);
$job1 = getdata_one("*","webjobs","webjobid",$webjobid);
//$positions = getdata("select position from webjobs order by position");
?>
<style type="text/css">
<!--
.style1 {
color: #FFFFFF;
font-family: Arial, Helvetica, sans-serif;
font-weight:bold;
}
-->
</style>
<table border="0" cellpadding="0" cellspacing="0" width="100%" background="images/bckgrnd_style.jpg" style="background-position:top " id="middle">
<tr>
<td valign="top" colspan="2">
<form method=post action='send_application.php' name='form_applicant' onSubmit="return checkrequired(this)" enctype="MULTIPART/FORM-DATA" >
<input type=hidden name="webjobid" value="<?=$job1[webjobid]?>">
<table align=center cellpadding='0' cellspacing='0' border="0" width="100%"><br>
<tr>
<td align=center><img src="images/apply_online.gif" width="180" height="29" align="left" />
<br />
<br />
<table border="0" cellpadding='0' cellspacing='0' width="200" class="jobs">
<tr class=jobs align=left bgcolor=#ca8c02>
<td class="style11" height="22"><b> <span class="style1">POSITION APPLIED FOR</span></b></td>
<td class="style4" colspan=3>: <input type=text name="position" size=30 value="<?=$job1[position]?>"></td>
</tr>
<tr align=left>
<td height="22" class="style4"><b>COUNTRY APPLIED FOR</b></td>
<td colspan=3>: <input type=text name="country" size=30 value="<?=$job1[country]?>"></td>
</tr>
<tr>
<td colspan="4" height="10"></td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Insert Picture</b></td>
<td class="style4">: <input type=file name=picture size=30> </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Last Name</b></td>
<td class="style4" colspan=3>: <input type=text name="requiredlastname" size=30 maxlength=30 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>First Name</b></td>
<td colspan=3 class="style4">: <input type=text name="requiredfirstname" size=30 maxlength=30 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Middle</b></td>
<td class="style4" colspan=3>: <input type=text name=mname size=30 maxlength=30 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Email Address</b></td>
<td class="style4"colspan=3>: <input type=text name=email size=30> </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>City Address</b></td>
<td class="style4" colspan=3>: <input type=text name=address1 size=30 maxlength=70 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Tel. No.</b></td>
<td class="style4" colspan=3>: <input type=text name=telephone1 size=30 maxlength=30 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Mobile No.</b></td>
<td class="style4" colspan=3>: <input type=text name=mobileno size=30 maxlength=30 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Provincial Address</b></td>
<td class="style4" colspan=3>: <input type=text name=address2 size=30 maxlength=70 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Date of Birth</b></td>
<td class="style4" colspan=3>: <? list ($bday_year, $bday_month, $bday_day) = split ('[-]', $applicant[birthdate]); ?>
<?echo dateselect("bday_month","month","$bday_month",0,0);?>
<?echo dateselect("bday_day","day","$bday_day",0,0);?>
<?echo dateselect("bday_year","year","$bday_year",60,0);?> </td>
</tr>
<tr align=left>
<td class="style4"><b>Place</b></td>
<td class="style4" colspan=3>: <input type=text name=birthplace size=30 maxlength=60 > </td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Sex</b></td>
<td class="style4" colspan=3>:
<select name="sex">
<?selectcode2($sex,"")?>
</select></td>
</tr>
<tr align=left>
<td class="style4"><b>Civil Status</b></td>
<td class="style4" colspan=3>: <select name="civil_status">
<?selectcode2($civilstatus,"")?>
</select></td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Height</b></td>
<td colspan=3 align="left" class="style4">: <input type=text name=height1 size=4 maxlength=4 onclick="select()">
<select name="height2">
<?selectcode2($height,$applicant[height2])?>
</select></td>
</tr>
<tr>
<td align="left" class="style4"><b>Weight</b></td>
<td colspan=3 align="left" class="style4">:
<input type=text name=weight1 size=4 maxlength=4 onclick="select()">
<select name="weight2">
<?selectcode2($weight,"")?>
</select></td>
</tr>
<tr class=black align=left>
<td class="style4"><b>Nationality</b></td>
<td class="style4" colspan=3>: <input type=text name=nationality size=30 maxlength=30> </td>
</tr>
<tr>
<td align="left" class="style4"><b>Religion</b></td>
<td colspan=3 align="left" class="style4">: <input type=text name=religion size=30 maxlength=30> </td>
</tr>
<tr>
<td colspan="4" height="10"></td>
</tr>
<tr align=left height=25 bgcolor=#f9ea8d>
<td colspan=4 class="style11" bgcolor=#ca8c02><b> <span class="style1">EDUCATIONAL ATTAINMENT</span></td>
</tr>
<tr align=left height=25>
<td colspan=4 class=box>
<table>
<tr>
<td></td>
<td class="style4" align=center>Name of School/Address</td>
<td class="style4" align=center>Year Attended<br>From - To</td>
<td class="style4" align=center>Course Finished</td>
</tr>
<tr>
<td class="style4">College</td>
<td class="style4">: <input type=text name="college_school" size=20></td>
<td class="style4">: <input type=text name="college_from_year" size=4 maxlength=4> - : <input type=text name="college_to_year" size=4 size=4 maxlength=4></td>
<td class="style4">: <input type=text name="college_course" size=20></td>
</tr>
<tr>
<td class="style4">Secondary</td>
<td class="style4">: <input type=text name="secondary_school" size=20></td>
<td class="style4">: <input type=text name="secondary_from_year" size=4 size=4 maxlength=4> - : <input type=text name="secondary_to_year" size=4 size=4 maxlength=4></td>
<td class="style4">: <input type=text name="secondary_course" size=20></td>
</tr>
<tr>
<td class="style4">Primary</td>
<td class="style4">: <input type=text name="primary_school" size=20></td>
<td class="style4">: <input type=text name="primary_from_year" size=4 size=4 maxlength=4> - : <input type=text name="primary_to_year" size=4 size=4 maxlength=4></td>
<td class="style4">: <input type=text name="primary_course" size=20></td>
</tr>
<tr>
<td class="style4">Other</td>
<td class="style4">: <input type=text name="other_school" size=20></td>
<td class="style4">: <input type=text name="other_from_year" size=4 size=4 maxlength=4> - : <input type=text name="other_to_year" size=4 size=4 maxlength=4></td>
<td class="style4">: <input type=text name="other_course" size=20></td>
</tr>
</table> </td>
</tr>
<tr>
<td colspan="4" height="10"></td>
</tr>
<tr align=left height=25 bgcolor=f1f1f1>
<td colspan=4 class="style11" bgcolor=#ca8c02><b> <span class="style1">SEMINAR ATTENDED</span></td>
</tr>
<tr align=left height=25>
<td colspan=4 class="style4">
<table>
<tr class="style4">
<td align=center>Nature of Seminar</td>
<td align=center colspan=2>Inclusive Dates</td>
</tr>
<tr class="style4">
<td align=center></td>
<td align=center>From (mm/dd/yyyy)</td>
<td align=center>To (mm/dd/yyyy)</td>
</tr>
<? for($i=1;$i<=2;$i++){ ?>
<tr class="apply">
<td class="style4"><?=$i?>. <input type=text name="seminar<?=$i?>_nature" size=25></td>
<td class="style4">:<input type=text name="seminar<?=$i?>_from"></td>
<td class="style4">:<input type=text name="seminar<?=$i?>_to"></td>
</tr>
<?}?>
</table> </td>
</tr>
<tr>
<td colspan="4" height="10"></td>
</tr>
<tr align=left height=25 bgcolor=f1f1f1>
<td colspan=4 class="style11" bgcolor=#ca8c02><b> <span class="style1">WORK EXPERIENCES</span></td>
</tr>
<tr align=left height=25>
<td colspan=4 class=box><table border=0>
<tr class="style4">
<td align=center>Name of Company</td>
<td align=center>Position</td>
<td align=center>Period (mm/yyyy)</td>
</tr>
<? for($i=1;$i<=4;$i++){ ?>
<tr class="style4">
<td><?=$i?>
.
<input type=text name="company<?=$i?>" size=25 /></td>
<td>:
<input type=text name="company<?=$i?>_position" size=25 /></td>
<td>From
<input type=text name="company<?=$i?>_from" size=7 maxlength="7" /></td>
<td>To
<input type=text name="company<?=$i?>_to" size=7 maxlength="7" /></td>
</tr>
<tr class=black align=left>
<td colspan=4 class=box><table width=100% class="style4">
<tr>
<td class="box" valign="top">Duties & Responsibilities<br />
<textarea cols="31" rows="3" name="company<?=$i?>_duties"></textarea></td>
<td class="box" valign="top">Projects Undertaken<br />
<textarea cols="31" rows="3" name="company<?=$i?>_projects"></textarea></td>
</tr>
</table></td>
</tr>
<? } ?>
</table></td>
<tr class=black align=left>
<td colspan=4 class=box>
<table width=100%>
<tr>
<td class="style4"><b>Specialized Skill</b></td>
<td class="style4">: <input type=text name="specialized_skill" size=55 > </td>
</tr>
<tr>
<td class="style4"><b>Other Skill</b></td>
<td class="style4">: <input type=text name="other_skill" size=55 > </td>
</tr>
</table> </td>
</tr>
<tr>
<td colspan="4" height="10"></td>
</tr>
<tr align=left height=25 bgcolor=f1f1f1>
<td colspan=4 class="style11" bgcolor=#ca8c02><b> <span class="style1">REFERENCES</span></td>
</tr>
<tr align=left height=25>
<td colspan=4 class="style4">
<table class="style4">
<tr>
<td align=center>Names</td>
<td align=center>Address/Tel. No.</td>
<td align=center>Occupation/Relationship</td>
</tr>
<?for($i=1;$i<=2;$i++){?>
<tr class="style4">
<td><?=$i?>. <input type=text name="reference<?=$i?>" size=25></td>
<td>: <input type=text name="reference<?=$i?>_address" size=30></td>
<td>: <input type=text name="reference<?=$i?>_occupation" size=25></td>
</tr>
<?}?>
</table> </td>
</tr>
<tr class="style4" height=30>
<td colspan=4 align=center><input type=submit value=" Submit " name="user" class="button" onclick="return confirm('Are you sure you want to submit your application?')">
<input type="hidden" name="email_job" size="35" value='<?=$config["email_job"]?>' /></td>
</tr>
</table>
</td>
</tr>
</table>
</form>
</td>
</tr>
</table>
<? do_footer()?>