115 lines
3.6 KiB
Cheetah
115 lines
3.6 KiB
Cheetah
<!-- TMPL_INCLUDE NAME="members-top.inc" -->
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<div id="mainbloc">
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<!-- TMPL_IF NAME="surname" -->
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<h1>Edit Institution</h1>
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<!-- TMPL_ELSE -->
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<h1>Add new Institution</h1>
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<!-- /TMPL_IF -->
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<form action="/cgi-bin/koha/members/newimember.pl" method="post">
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<input type="hidden" name="joining" value="">
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<input type="hidden" name="expiry" value="">
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<input type="hidden" name="type" value="borrowers">
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<input type="hidden" name="borrowernumber" value="<!-- TMPL_VAR NAME="member" -->">
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<input type="hidden" name="updtype" value="I">
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<table border="0" cellspacing="0" cellpadding="5">
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<tr valign="top">
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<td colspan="3"><input type="reset" value="Clear all Fields"></td>
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</tr>
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<tr align="right">
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<td colspan="2" align="right">
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<strong>Member# <!-- TMPL_VAR NAME="member" -->, Card number*</strong>
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</td>
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<td align="right"><input type="text" name="cardnumber_institution" size="20" value="<!-- TMPL_VAR NAME="cardnumber_institution" -->"></td>
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</tr>
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<tr valign="top" bgcolor="#99cc33">
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<td background="<!-- TMPL_VAR NAME="themelang" -->/images/background-mem.gif">
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<b>INSTITUTION DETAILS</b>
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</td>
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<td colspan="2" align="right" background="<!-- TMPL_VAR NAME="themelang" -->/images/background-mem.gif"> </td>
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</tr>
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<tr>
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<td colspan="3">Institution Name</td>
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</tr>
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<tr>
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<td colspan="3"><input type="text" name="institution_name" size="50" value="<!-- TMPL_VAR NAME="surname" -->"></td>
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</tr>
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<tr valign="top" bgcolor="#99cc33" >
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<td colspan="3" background="<!-- TMPL_VAR NAME="themelang" -->/images/background-mem.gif">
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<b>INSTITUTION ADDRESS</b>
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</td>
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</tr>
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<tr>
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<td >Postal Address*</td>
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<td>Zipcode / Town*</td>
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<td>Area</td>
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</tr>
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<tr>
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<td><input type="text" name="address" size="40" value="<!-- TMPL_VAR NAME="streetaddress" -->"></td>
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<td><input type="text" name="zipcode" size="20" value="<!-- TMPL_VAR NAME="zipcode" -->"> <br> <input type="text" name="city" size="20" value="<!-- TMPL_VAR NAME="city" -->"></td>
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<td>
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<!-- TMPL_VAR NAME="CGIbranch" -->
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</td>
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</tr>
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<tr valign="top" bgcolor="#99cc33">
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<td colspan="3" background="<!-- TMPL_VAR NAME="themelang" -->/images/background-mem.gif">
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<b>CONTACT DETAILS</b>
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</td>
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</tr>
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<tr>
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<td colspan="3">Contact Name*</td>
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</tr>
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<tr>
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<td colspan="3"><input type="text" name="contactname" size="40" value="<!-- TMPL_VAR NAME="contactname" -->"></td>
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</tr>
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<tr>
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<td>Phone (day)</td>
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<td>Fax</td>
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<td>Email</td>
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</tr>
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<tr>
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<td ><input type="text" name="phoneday" size="20" value="<!-- TMPL_VAR NAME="phoneday" -->"></td>
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<td><input type="text" name="faxnumber" size="20" value="<!-- TMPL_VAR NAME="faxnumber" -->"></td>
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<td ><input type="text" name="emailaddress" size="20" value="<!-- TMPL_VAR NAME="emailaddress" -->"></td>
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</tr>
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<tr>
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<td>Notes</td>
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</tr>
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<tr>
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<td colspan="3"><textarea name="altnotes" cols="70" rows="3"><!-- TMPL_VAR NAME="altnotes" --></textarea></td>
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</tr>
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<tr valign="top" bgcolor="#99cc33" >
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<td colspan="3" background="<!-- TMPL_VAR NAME="themelang" -->/images/background-mem.gif"><b>LIBRARY USE</b></td>
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</tr>
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<tr>
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<td colspan="3">Notes</td>
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</tr>
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<tr valign="top" >
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<td colspan="3"><textarea name="borrowernotes" cols="70" rows="3"><!-- TMPL_VAR NAME="borrowernotes" --></textarea></td>
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</tr>
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<tr>
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<td colspan="3" align="right" >
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<input type="submit" class="button" value="Save Changes">
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</td>
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</tr>
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</table>
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</form>
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</div>
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<!-- TMPL_VAR NAME="endmenumember" -->
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</body>
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</html>
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