1 <!-- TMPL_INCLUDE name="members-top.inc" -->
4 <!-- TMPL_IF name="surname" -->
5 <h1>Edit Institution</h1><br>
7 <h1>Add new Institution</h1><br>
9 <form action=/cgi-bin/koha/newimember.pl method=post>
10 <input type=hidden name=joining value="">
11 <input type=hidden name=expiry value="">
12 <input type=hidden name=type value="borrowers">
13 <input type=hidden name=borrowernumber value="<!-- TMPL_VAR NAME=member -->">
14 <input type=hidden name=updtype value=I>
16 <table border=0 cellspacing=0 cellpadding=5>
19 <td ><input type=reset value="Clear all Fields"></td>
23 <td COLSPAN=2 ALIGN=RIGHT><font size=3 face='arial,helvetica'>
24 <STRONG>Member# <!-- TMPL_VAR NAME="member" -->, Card Number*</STRONG>
26 <TD align=right><input type=text name=cardnumber_institution size=20 value=<!-- TMPL_VAR NAME=cardnumber_institution -->><br></td>
29 <tr><td> </TD></TR>
31 <tr valign=top bgcolor="99cc33" >
32 <td COLSPAN=5 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
33 <B>INSTITUTION DETAILS</b>
35 <td COLSPAN=2 ALIGN=RIGHT background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
39 <tr valign=top bgcolor=white>
40 <td><FONT SIZE=2>Institution Name</FONT></td>
42 <tr valign=top bgcolor=white>
43 <td colspan=3><input type=text name=institution_name size=50 value="<!-- TMPL_VAR name="surname" -->"></td>
45 <tr><td> </TD></TR>
47 <tr valign=top bgcolor="99cc33" >
48 <td COLSPAN=5 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
49 <B>INSTITUTION ADDRESS</b>
53 <tr valign=top bgcolor=white>
54 <td ><FONT SIZE=2>Postal Address*</FONT></td>
55 <td><FONT SIZE=2>Zipcode / Town*</FONT></td>
56 <td><FONT SIZE=2>Area</FONT></td>
58 <tr valign=top bgcolor=white>
59 <td><input type=text name=address size=40 value="<!-- TMPL_VAR name="streetaddress" -->"></td>
60 <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>
62 <!-- TMPL_VAR name="CGIbranch" -->
65 <tr><td> </TD></TR>
67 <tr valign=top bgcolor="99cc33">
68 <td COLSPAN=5 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
69 <B>CONTACT DETAILS</b>
73 <tr valign=top bgcolor=white>
74 <td COLSPAN=3><FONT SIZE=2>Contact Name*</td>
76 <tr valign=top bgcolor=white>
77 <td COLSPAN=3><input type=text name=contactname size=40 value="<!-- TMPL_VAR name="contactname" -->"></td>
81 <tr valign=top bgcolor=white>
82 <td><FONT SIZE=2>Phone (day)</td>
83 <td><FONT SIZE=2>Fax</td>
84 <td><FONT SIZE=2>Email</td>
86 <tr valign=top bgcolor=white>
87 <td ><input type=text name=phoneday size=20 value="<!-- TMPL_VAR name="phoneday" -->"></td>
88 <td><input type=text name=faxnumber size=20 value="<!-- TMPL_VAR name="faxnumber" -->"></td>
89 <td ><input type=text name=emailaddress size=20 value="<!-- TMPL_VAR name="emailaddress" -->"></td>
92 <tr><td> </TD></TR>
94 <tr valign=top bgcolor=white>
95 <td><FONT SIZE=2>Notes</font></td>
97 <tr valign=top bgcolor=white>
98 <td COLSPAN=4><textarea name=altnotes wrap=physical cols=70 rows=3><!-- TMPL_VAR name="altnotes" --></textarea></td>
101 <tr><td> </TD></TR>
103 <tr valign=top bgcolor="99cc33" >
104 <td COLSPAN=5 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif"><B>LIBRARY USE</B></td>
107 <tr valign=top bgcolor=white>
108 <td ><FONT SIZE=2>Notes</font></td>
111 <td COLSPAN=5><textarea name=borrowernotes wrap=physical cols=70 rows=3><!-- TMPL_VAR name="borrowernotes" --></textarea></td>
114 <tr><td> </TD></TR>
116 <tr valign=top bgcolor=white>
117 <td COLSPAN=5 align=right >
118 <input type=submit class="button" value="Save Changes" ALT="Add New Member" border=0 >
129 <!-- TMPL_VAR NAME=endmenumember -->