1 <!-- TMPL_INCLUDE Name="members-top.inc" -->
3 <!-- TMPL_IF Name="OK" -->
4 <H1> Confirm Record </H1>
5 <table border=0 cellspacing=0 cellpadding=5>
6 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
7 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
11 <tr valign=top bgcolor="white" >
16 <!-- TMPL_VAR Name="name" -->
19 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
20 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
21 <B> MEMBERSHIP DETAILS </B>
24 <tr valign=top bgcolor="white" >
26 <B>Membership Number</B>
29 <!-- TMPL_VAR Name="bornum" -->
32 <tr valign=top bgcolor="white" >
37 <!-- TMPL_VAR Name="cardnum" -->
40 <tr valign=top bgcolor="white" >
42 <B>Membership Category</B>
45 <!-- TMPL_VAR Name="memcat" -->
48 <tr valign=top bgcolor="white" >
53 <!-- TMPL_VAR Name="fee" -->
56 <tr valign=top bgcolor="white" >
61 <!-- TMPL_VAR Name="joindate" -->
64 <tr valign=top bgcolor="white" >
69 <!-- TMPL_VAR Name="expdate" -->
72 <tr valign=top bgcolor="white" >
77 <!-- TMPL_VAR Name="branchcode" -->
80 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
81 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
82 <B>PERSONAL DETAILS</B>
85 <tr valign=top bgcolor="white" >
90 <!-- TMPL_VAR Name="dob" -->
93 <tr valign=top bgcolor="white" >
98 <!-- TMPL_IF Name="sex" -->
105 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
106 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
107 <B>MEMBER ADDRESS</B>
110 <tr valign=top bgcolor="white" >
112 <B>Postal Address</B>
115 <!-- TMPL_VAR Name="postal" -->
118 <tr valign=top bgcolor="white" >
123 <!-- TMPL_VAR Name="home" -->
126 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
127 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
128 <B>MEMBER CONTACT DETAIL</B>
131 <tr valign=top bgcolor="white" >
136 <!-- TMPL_VAR Name="phone" -->
139 <tr valign=top bgcolor="white" >
144 <!-- TMPL_VAR Name="phoneday" -->
147 <tr valign=top bgcolor="white" >
152 <!-- TMPL_VAR Name="faxnumber" -->
155 <tr valign=top bgcolor="white" >
160 <!-- TMPL_VAR Name="emailaddress" -->
163 <tr valign=top bgcolor="white" >
165 <B>Text messaging</B>
168 <!-- TMPL_VAR NAME=textmessaging -->
171 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
172 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
173 <B>ALTERNATIVE CONTACT DETAIL</B>
176 <tr valign=top bgcolor="white" >
181 <!-- TMPL_VAR Name="contactname" -->
184 <tr valign=top bgcolor="white" >
189 <!-- TMPL_VAR Name="altphone" -->
192 <tr valign=top bgcolor="white" >
197 <!-- TMPL_VAR Name="altrelationship" -->
200 <tr valign=top bgcolor="white" >
205 <!-- TMPL_VAR Name="altnotes" -->
208 <tr valign=top bgcolor="<!-- TMPL_VAR Name="main" -->" >
209 <td colspan=2 background="<!-- TMPL_VAR name="themelang" -->/images/background-mem.gif">
213 <tr valign=top bgcolor="white" >
218 <!-- TMPL_VAR Name="bornotes" -->
222 <form action="/cgi-bin/koha/insertdata.pl" method=post>
223 <!-- TMPL_LOOP NAME=inputsloop -->
224 <input type=hidden name="<!-- TMPL_VAR NAME="key" -->" value="<!-- TMPL_VAR NAME="value" -->">
226 <input type=submit name=submit value=Submit>
230 <p>The following fields have a forbidden value. Please push the back button and try again : </p>
231 <!-- TMPL_IF name="cardnumber" -->
234 <!-- TMPL_IF name="invalid_cardnumber" -->
235 Invalid cardnumber<br/>
237 <!-- TMPL_IF name="gender" -->
240 <!-- TMPL_IF name="firstname" -->
243 <!-- TMPL_IF name="surname" -->
246 <!-- TMPL_IF name="address" -->
247 Postal Street Address<br/>
249 <!-- TMPL_IF name="city" -->
255 <!-- TMPL_INCLUDE Name="members-bottom.inc" -->