Koha/koha-tmpl/intranet-tmpl/default/en/newmember.tmpl

<TMPL_INCLUDE Name="members-top.inc">

<H1> Confirm Record </H1>
<TMPL_IF Name="OK">
	<table border=0 cellspacing=0 cellpadding=5>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B> NEW MEMBER </B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Name</B>
			</td>
			<td>
				<TMPL_VAR Name="name">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B> MEMBERSHIP DETAILS </B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Membership Number</B>
			</td>
			<td>
				<TMPL_VAR Name="bornum">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Card Number</B>
			</td>
			<td>
				<TMPL_VAR Name="cardnum">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Membership Category</B>
			</td>
			<td>
				<TMPL_VAR Name="membercat">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Area </B>
			</td>
			<td>
				<TMPL_VAR Name="area">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Fee</B>
			</td>
			<td>
				<TMPL_VAR Name="fee">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Joining Date</B>
			</td>
			<td>
				<TMPL_VAR Name="joindate">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Expiry Date</B>
			</td>
			<td>
				<TMPL_VAR Name="expdate">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Joining Branch</B>
			</td>
			<td>
				<TMPL_VAR Name="joinbranch">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B>PERSONAL DETAILS</B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Ethnicity</B>
			</td>
			<td>
				<TMPL_VAR Name="ethnic">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Date Of Birth</B>
			</td>
			<td>
				<TMPL_VAR Name="dob">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Sex</B>
			</td>
			<td>
				<TMPL_VAR Name="sex">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B>MEMBER ADRESS</B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Postal Adress</B>
			</td>
			<td>
				<TMPL_VAR Name="postal">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Home Adress</B>
			</td>
			<td>
				<TMPL_VAR Name="home">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B>MEMBER CONTACT DETAIL</B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Phone (Home)</B>
			</td>
			<td>
				<TMPL_VAR Name="phone">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Phone (Daytime)</B>
			</td>
			<td>
				<TMPL_VAR Name="phoneday">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Fax</B>
			</td>
			<td>
				<TMPL_VAR Name="faxnumber">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>E-mail</B>
			</td>
			<td>
				<TMPL_VAR Name="emailaddress">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B>ALTERNATIVE CONTACT DETAIL</B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Name</B>
			</td>
			<td>
				<TMPL_VAR Name="contactname">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Phone</B>
			</td>
			<td>
				<TMPL_VAR Name="altphone">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Relationship</B>
			</td>
			<td>
				<TMPL_VAR Name="altrelationship">
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>Notes</B>
			</td>
			<td>
				<TMPL_VAR Name="altnotes">
			</td>
		</tr>
		<tr valign=top bgcolor="<TMPL_VAR Name="main">" >
			<td background="<TMPL_VAR Name="image">">
				<B>NOTES</B>
			</td>
			<td>
				&nbsp;
			</td>
		</tr>
		<tr valign=top bgcolor="white" >
			<td>
				<B>General Notes</B>
			</td>
			<td>
				<TMPL_VAR Name="bornotes">
			</td>
		</tr>
		</TABLE><p>
		<form action="/cgi-bin/koha/insertdata.pl" method=post>
			<TMPL_LOOP NAME=inputsloop>
				<input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
			</TMPL_LOOP>
			<input type=submit name=submit value=submit>
		</form>
<TMPL_ELSE>
	<TMPL_VAR Name="string">
</TMPL_IF>


<TMPL_INCLUDE Name="members-bottom.inc">