251 lines
5.1 KiB
Cheetah
251 lines
5.1 KiB
Cheetah
<TMPL_INCLUDE Name="members-top.inc">
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<H1> Confirm Record </H1>
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<TMPL_IF Name="OK">
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<table border=0 cellspacing=0 cellpadding=5>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B> NEW MEMBER </B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Name</B>
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</td>
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<td>
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<TMPL_VAR Name="name">
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B> MEMBERSHIP DETAILS </B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Membership Number</B>
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</td>
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<td>
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<TMPL_VAR Name="bornum">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Card Number</B>
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</td>
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<td>
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<TMPL_VAR Name="cardnum">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Membership Category</B>
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</td>
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<td>
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<TMPL_VAR Name="membercat">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Area </B>
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</td>
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<td>
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<TMPL_VAR Name="area">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Fee</B>
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</td>
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<td>
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<TMPL_VAR Name="fee">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Joining Date</B>
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</td>
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<td>
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<TMPL_VAR Name="joindate">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Expiry Date</B>
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</td>
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<td>
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<TMPL_VAR Name="expdate">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Joining Branch</B>
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</td>
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<td>
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<TMPL_VAR Name="branchcode">
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B>PERSONAL DETAILS</B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Ethnicity</B>
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</td>
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<td>
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<TMPL_VAR Name="ethnic">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Date Of Birth</B>
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</td>
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<td>
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<TMPL_VAR Name="dob">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Sex</B>
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</td>
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<td>
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<TMPL_VAR Name="sex">
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B>MEMBER ADDRESS</B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Postal Address</B>
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</td>
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<td>
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<TMPL_VAR Name="postal">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Home Address</B>
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</td>
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<td>
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<TMPL_VAR Name="home">
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B>MEMBER CONTACT DETAIL</B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Phone (Home)</B>
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</td>
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<td>
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<TMPL_VAR Name="phone">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Phone (Daytime)</B>
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</td>
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<td>
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<TMPL_VAR Name="phoneday">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Fax</B>
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</td>
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<td>
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<TMPL_VAR Name="faxnumber">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>E-mail</B>
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</td>
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<td>
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<TMPL_VAR Name="emailaddress">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Text messaging</B>
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</td>
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<td>
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<TMPL_VAR NAME=textmessaging>
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B>ALTERNATIVE CONTACT DETAIL</B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Name</B>
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</td>
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<td>
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<TMPL_VAR Name="contactname">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Phone</B>
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</td>
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<td>
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<TMPL_VAR Name="altphone">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Relationship</B>
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</td>
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<td>
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<TMPL_VAR Name="altrelationship">
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>Notes</B>
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</td>
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<td>
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<TMPL_VAR Name="altnotes">
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</td>
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</tr>
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<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
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<td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
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<B>NOTES</B>
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</td>
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</tr>
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<tr valign=top bgcolor="white" >
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<td>
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<B>General Notes</B>
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</td>
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<td>
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<TMPL_VAR Name="bornotes">
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</td>
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</tr>
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</TABLE><p>
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<form action="/cgi-bin/koha/insertdata.pl" method=post>
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<TMPL_LOOP NAME=inputsloop>
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<input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
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</TMPL_LOOP>
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<input type=submit name=submit value=Submit>
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</form>
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<form action="/cgi-bin/koha/memberentry.pl" method=post>
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<TMPL_LOOP NAME=inputsloop>
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<input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
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</TMPL_LOOP>
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<input type=submit name=return value="Go Back">
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</form>
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<TMPL_ELSE>
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<TMPL_VAR Name="string">
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</TMPL_IF>
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<TMPL_INCLUDE Name="members-bottom.inc">
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