/home/mip/public_html_/old-website/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="<?=$job1[webjobid]?>"> 
<table align=center cellpadding='0' cellspacing='0' border="0" width="100%"><br>
  <tr>
    <td align=center><img src="images/apply_online.gif" width="180" height="29" align="left" />
      <br />
      <br />
      <table border="0" cellpadding='0' cellspacing='0' width="200" class="jobs">
        <tr class=jobs align=left bgcolor=#ca8c02>
		  <td class="style11" height="22"><b>&nbsp;<span class="style1">POSITION APPLIED FOR</span></b></td>
		  <td class="style4" colspan=3>: <input type=text name="position"  size=30 value="<?=$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>&nbsp;</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);?>&nbsp; 
								 <?echo dateselect("bday_day","day","$bday_day",0,0);?>&nbsp;
						 		 <?echo dateselect("bday_year","year","$bday_year",60,0);?>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</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>&nbsp;<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>&nbsp;<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<?=$i?>_to"></td>				
			  </tr>		
				   <?}?>
			</table>		  </td>
		</tr>
		<tr>
		  <td colspan="4" height="10"></td>
		</tr>				
		<tr align=left height=25 bgcolor=f1f1f1>
		  <td colspan=4 class="style11" bgcolor=#ca8c02><b>&nbsp;<span class="style1">WORK EXPERIENCES</span></td>
		</tr>				
		<tr align=left height=25>
		  <td colspan=4 class=box><table border=0>
            <tr class="style4">
              <td align=center>Name of Company</td>
              <td align=center>Position</td>
              <td align=center>Period (mm/yyyy)</td>
            </tr>
            <? for($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>&nbsp;<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()?>

[D] brokerxxx
[D] css
[D] employer
[D] employerxxx
[D] images
[D] js
[D] old
[F] 404.shtml
[F] _config.php
[F] about_us.php
[F] ajax.js
[F] ajax_captcha.js
[F] announcements.php
[F] announcements_all.php
[F] announcements_allxx.php
[F] applicant_login.php
[F] apply.css
[F] apply_online.php
[F] apply_online_doc.php
[F] apply_online_education.php
[F] apply_online_employment.php
[F] apply_online_training.php
[F] archive.php
[F] banner.fla
[F] banner.html
[F] banner.swf
[F] banner1.fla
[F] banner1.html
[F] captcha.php
[F] class.phpmailer.php
[F] class.smtp.php
[F] code.php
[F] common_msg.inc
[F] company_profile.php
[F] config.php
[F] config.php.bak
[F] contact_us.php
[F] create_image.php
[F] curl_file.php
[F] default.css
[F] diskspace.php
[F] diskspaceblock.php
[F] diskspacecrm.php
[F] diskspacewritecrm.php
[F] diskspacewriteiris.php
[F] diskspacewriter.php
[F] employers.php
[F] forgotpassword.php
[F] func-proc.php
[F] func_ajax.js
[F] func_all.php
[F] func_data.php
[F] func_data_validation.php
[F] func_data_validation_.php
[F] func_proc.php
[F] func_proc2.php
[F] func_select.php
[F] func_select_codes.php
[F] index.php
[F] index2.php
[F] job_info.php
[F] job_seekers.php
[F] jobs.php
[F] login.php
[F] mission.php
[F] neo.php
[F] page_job.php
[F] page_job1.php
[F] program_services.php
[F] quantumx.html
[F] recaptchalib.php
[F] request_form.php
[F] request_formx.php
[F] robots.txt
[F] send.php
[F] send_application.php
[F] sendcontactform.php
[F] sendemployerform.php
[F] sendmanpowerform.php
[F] sendregistrationform.php
[F] services.php
[F] SMTP.class
[F] submit.php
[F] support_staff&facilities.php
[F] thankyou_apply.php
[F] view_announcement.php
[F] view_announcements.php
[F] view_job.php
[F] view_jobs.php
[F] vision.php