1 <TMPL_INCLUDE name="members-top.inc">
4 <FONT SIZE=6><em>Add New Institution</em></FONT><br>
5 <form action=/cgi-bin/koha/newimember.pl method=post>
6 <input type=hidden name=joining value="">
7 <input type=hidden name=expiry value="">
8 <input type=hidden name=type value="borrowers">
9 <input type=hidden name=borrowernumber value="<TMPL_VAR NAME=member>">
10 <input type=hidden name=updtype value=I>
12 <table border=0 cellspacing=0 cellpadding=5>
15 <td ><input type=reset value="Clear all Fields"></td>
19 <td COLSPAN=2 ALIGN=RIGHT><font size=3 face='arial,helvetica'>
20 <STRONG>Member# <TMPL_VAR NAME="member">, Card Number*</STRONG>
22 <TD align=right><input type=text name=cardnumber_institution size=20 value=" "><br></td>
25 <tr><td> </TD></TR>
27 <tr valign=top bgcolor="99cc33" >
28 <td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
29 <B>INSTITUTION DETAILS</b>
31 <td COLSPAN=2 ALIGN=RIGHT background="<TMPL_VAR name="themelang">/images/background-mem.gif">
35 <tr valign=top bgcolor=white>
36 <td><FONT SIZE=2>Institution Name</FONT></td>
38 <tr valign=top bgcolor=white>
39 <td colspan=3><input type=text name=institution_name size=50 value=""></td>
41 <tr><td> </TD></TR>
43 <tr valign=top bgcolor="99cc33" >
44 <td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
45 <B>INSTITUTION ADDRESS</b>
49 <tr valign=top bgcolor=white>
50 <td ><FONT SIZE=2>Postal Address*</FONT></td>
51 <td><FONT SIZE=2>Town*</FONT></td>
52 <td><FONT SIZE=2>Area</FONT></td>
54 <tr valign=top bgcolor=white>
55 <td><input type=text name=address size=40 value=""></td>
56 <td><input type=text name=city size=20 value=""></td>
58 <TMPL_VAR name="CGIbranch">
61 <tr><td> </TD></TR>
63 <tr valign=top bgcolor="99cc33">
64 <td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
65 <B>CONTACT DETAILS</b>
69 <tr valign=top bgcolor=white>
70 <td COLSPAN=3><FONT SIZE=2>Contact Name*</td>
72 <tr valign=top bgcolor=white>
73 <td COLSPAN=3><input type=text name=contactname size=40 value=""></td>
77 <tr valign=top bgcolor=white>
78 <td><FONT SIZE=2>Phone (day)</td>
79 <td><FONT SIZE=2>Fax</td>
80 <td><FONT SIZE=2>Email</td>
82 <tr valign=top bgcolor=white>
83 <td ><input type=text name=phoneday size=20 value=""></td>
84 <td><input type=text name=faxnumber size=20 value=""></td>
85 <td ><input type=text name=emailaddress size=20 value=""></td>
88 <tr><td> </TD></TR>
90 <tr valign=top bgcolor=white>
91 <td><FONT SIZE=2>Notes</font></td>
93 <tr valign=top bgcolor=white>
94 <td COLSPAN=4><textarea name=altnotes wrap=physical cols=70 rows=3></textarea></td>
97 <tr><td> </TD></TR>
99 <tr valign=top bgcolor="99cc33" >
100 <td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif"><B>LIBRARY USE</B></td>
103 <tr valign=top bgcolor=white>
104 <td ><FONT SIZE=2>Notes</font></td>
107 <td COLSPAN=5><textarea name=borrowernotes wrap=physical cols=70 rows=3></textarea></td>
110 <tr><td> </TD></TR>
112 <tr valign=top bgcolor=white>
113 <td COLSPAN=5 align=right >
114 <input type=image src="<TMPL_VAR name="themelang">/images/save-changes.gif" WIDTH=188 HEIGHT=44 ALT="Add New Member" border=0 >
125 <TMPL_VAR NAME=endmenumember>