97 lines
4.3 KiB
Cheetah
97 lines
4.3 KiB
Cheetah
<!-- TMPL_INCLUDE NAME="members-top.inc" -->
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<h1>Add New Junior Member </h1><br>
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<form action=/cgi-bin/koha/newjmember.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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<input type=hidden name=area value="<!-- TMPL_VAR NAME=area -->">
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<input type=hidden name=city value="<!-- TMPL_VAR NAME=city -->">
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<input type=hidden name=physstreet value="<!-- TMPL_VAR NAME=physstreet -->">
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<input type=hidden name=streetaddress value="<!-- TMPL_VAR NAME=streetaddress -->">
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<input type=hidden name=streetcity value="<!-- TMPL_VAR NAME=streetcity -->">
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<input type=hidden name=phone value="<!-- TMPL_VAR NAME=phone -->">
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<input type=hidden name=phoneday value="<!-- TMPL_VAR NAME=phoneday -->">
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<input type=hidden name=faxnumber value="<!-- TMPL_VAR NAME=faxnumber -->">
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<input type=hidden name=emailaddress value="<!-- TMPL_VAR NAME=emailaddress -->">
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<input type=hidden name=contactname value="<!-- TMPL_VAR NAME=contactname -->">
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<input type=hidden name=altphone value"<!-- TMPL_VAR NAME=altphone -->">
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<table border=0 cellspacing=0 cellpadding=5 >
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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>PARENT OR GUARDIAN </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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<SELECT NAME="title" SIZE="1">
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<OPTION value=" ">No Title
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<!-- TMPL_LOOP NAME=titleloop -->
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<OPTION value="<!-- TMPL_VAR NAME=title -->" <!-- TMPL_VAR NAME=selected -->><!-- TMPL_VAR NAME=title -->
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<!-- /TMPL_LOOP -->
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</SELECT>
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</td>
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<td><input type=text name=firstname_guardian size=20 value="<!-- TMPL_VAR NAME=firstname -->"></td>
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<td colspan=2><input type=text name=surname_guardian size=20 value="<!-- TMPL_VAR NAME=surname -->"></td>
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<td><input type=text name=guardian_number size=20 value="<!-- TMPL_VAR NAME=cardnumber -->"></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td><FONT SIZE=2>Salutation</FONT></td>
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<td><FONT SIZE=2>Given Names*</FONT></td>
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<td colspan=2><FONT SIZE=2>Surname*</FONT></td>
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<td><FONT SIZE=2>Membership No.</FONT></td>
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</tr>
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<!-- TMPL_LOOP NAME=cmemloop -->
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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>CHILD <!-- TMPL_VAR NAME=count --></b>
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</td>
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</TR>
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<TR>
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<td COLSPAN=4 ALIGN=RIGHT ><font size=3 face='arial,helvetica'>
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<STRONG>Member# <!-- TMPL_VAR NAME=cmember --></STRONG>, <b>Card number*</b></STRONG>
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</TD>
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<TD>
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<input type=text name=cardnumber_child_<!-- TMPL_VAR NAME=i --> size=20 value="<!-- TMPL_VAR NAME=jcardnumber -->"><br>
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<input type=hidden name=bornumber_child_<!-- TMPL_VAR NAME=i --> value="<!-- TMPL_VAR NAME=cmember -->">
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</td>
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</TR>
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<tr bgcolor=white>
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<td><input type=text name=firstname_child_<!-- TMPL_VAR NAME=i --> size=20 value=""></td>
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<td><input type=text name=surname_child_<!-- TMPL_VAR NAME=i --> size=20 value=""></td>
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<td><input type=text name=dateofbirth_child_<!-- TMPL_VAR NAME=i --> size=10 value=""></TD>
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<TD>
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<input type="radio" name="sex_child_<!-- TMPL_VAR NAME=i -->" value="F"><b>F</b>
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<input type="radio" name="sex_child_<!-- TMPL_VAR NAME=i -->" value="M"><b>M*</b>
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</td>
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<TD align=right><input type=text name=school_child_<!-- TMPL_VAR NAME=i --> size=20 value=""></TD>
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</tr>
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<tr valign=top bgcolor=white>
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<td><FONT SIZE=2><b>Given Name*</b></FONT></td>
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<td><FONT SIZE=2><b>Surname*</b></FONT></td>
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<td><FONT SIZE=2><b>Date of Birth<BR>(<!-- TMPL_VAR NAME=dateformat -->)*</b></FONT></td>
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<td><FONT SIZE=2> </FONT></td>
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<td><FONT SIZE=2>School</FONT></td>
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</tr>
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<tr valign=top bgcolor=white>
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<td COLSPAN=5><textarea name=altnotes_child_<!-- TMPL_VAR NAME=i --> wrap=physical cols=70 rows=3></textarea></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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<!-- /TMPL_LOOP -->
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<tr valign=top bgcolor=white>
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<td colspan=2 align="center"><input type=reset value="Clear all Fields"></td>
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<td COLSPAN=3 align="center">
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<input type=image src="<!-- TMPL_VAR name="interface" -->/<!-- TMPL_VAR name="theme" -->/images/2rightarrow.png" 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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<!-- TMPL_INCLUDE NAME="members-bottom.inc" -->
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