128 lines
3.6 KiB
Cheetah
128 lines
3.6 KiB
Cheetah
<TMPL_INCLUDE name="members-top.inc">
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<BLOCKQUOTE>
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<FONT SIZE=6><em>Add New Institution</em></FONT><br>
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<form action=/cgi-bin/koha/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 ><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><font size=3 face='arial,helvetica'>
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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=" "><br></td>
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</TR>
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<tr><td> </TD></TR>
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<tr valign=top bgcolor="99cc33" >
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<td COLSPAN=5 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">
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</td>
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</tr>
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<tr valign=top bgcolor=white>
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<td><FONT SIZE=2>Institution Name</FONT></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td colspan=3><input type=text name=institution_name size=50 value=""></td>
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</tr>
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<tr><td> </TD></TR>
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<tr valign=top bgcolor="99cc33" >
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<td COLSPAN=5 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 valign=top bgcolor=white>
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<td ><FONT SIZE=2>Postal Address*</FONT></td>
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<td><FONT SIZE=2>Town*</FONT></td>
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<td><FONT SIZE=2>Area</FONT></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td><input type=text name=address size=40 value=""></td>
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<td><input type=text name=city size=20 value=""></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><td> </TD></TR>
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<tr valign=top bgcolor="99cc33">
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<td COLSPAN=5 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 valign=top bgcolor=white>
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<td COLSPAN=3><FONT SIZE=2>Contact Name*</td>
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</tr>
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<tr valign=top bgcolor=white>
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<td COLSPAN=3><input type=text name=contactname size=40 value=""></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td><FONT SIZE=2>Phone (day)</td>
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<td><FONT SIZE=2>Fax</td>
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<td><FONT SIZE=2>Email</td>
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</tr>
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<tr valign=top bgcolor=white>
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<td ><input type=text name=phoneday size=20 value=""></td>
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<td><input type=text name=faxnumber size=20 value=""></td>
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<td ><input type=text name=emailaddress size=20 value=""></td>
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</tr>
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<tr><td> </TD></TR>
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<tr valign=top bgcolor=white>
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<td><FONT SIZE=2>Notes</font></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td COLSPAN=4><textarea name=altnotes wrap=physical cols=70 rows=3></textarea></td>
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</tr>
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<tr><td> </TD></TR>
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<tr valign=top bgcolor="99cc33" >
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<td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif"><B>LIBRARY USE</B></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td ><FONT SIZE=2>Notes</font></td>
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</tr>
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<tr valign=top >
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<td COLSPAN=5><textarea name=borrowernotes wrap=physical cols=70 rows=3></textarea></td>
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</tr>
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<tr><td> </TD></TR>
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<tr valign=top bgcolor=white>
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<td COLSPAN=5 align=right >
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<input type=image src="<TMPL_VAR name="themelang">/images/save-changes.gif" WIDTH=188 HEIGHT=44 ALT="Add New Member" border=0 >
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</td>
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</tr>
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</TABLE>
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</form>
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</BLOCKQUOTE>
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<br clear=all>
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<p> </p>
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<TMPL_VAR NAME=endmenumember>
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</body>
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</HTML>
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