1 <TMPL_INCLUDE Name="members-top.inc">
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" >
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" >
93 <tr valign=top bgcolor="white" >
101 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
102 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
103 <B>MEMBER ADDRESS</B>
106 <tr valign=top bgcolor="white" >
108 <B>Postal Address</B>
111 <TMPL_VAR Name="postal">
114 <tr valign=top bgcolor="white" >
119 <TMPL_VAR Name="home">
122 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
123 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
124 <B>MEMBER CONTACT DETAIL</B>
127 <tr valign=top bgcolor="white" >
132 <TMPL_VAR Name="phone">
135 <tr valign=top bgcolor="white" >
137 <B>Phone (Daytime)</B>
140 <TMPL_VAR Name="phoneday">
143 <tr valign=top bgcolor="white" >
148 <TMPL_VAR Name="faxnumber">
151 <tr valign=top bgcolor="white" >
156 <TMPL_VAR Name="emailaddress">
159 <tr valign=top bgcolor="white" >
161 <B>Text messaging</B>
164 <TMPL_VAR NAME=textmessaging>
167 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
168 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
169 <B>ALTERNATIVE CONTACT DETAIL</B>
172 <tr valign=top bgcolor="white" >
177 <TMPL_VAR Name="contactname">
180 <tr valign=top bgcolor="white" >
185 <TMPL_VAR Name="altphone">
188 <tr valign=top bgcolor="white" >
193 <TMPL_VAR Name="altrelationship">
196 <tr valign=top bgcolor="white" >
201 <TMPL_VAR Name="altnotes">
204 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
205 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
209 <tr valign=top bgcolor="white" >
214 <TMPL_VAR Name="bornotes">
218 <form action="/cgi-bin/koha/insertdata.pl" method=post>
219 <TMPL_LOOP NAME=inputsloop>
220 <input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
222 <input type=submit name=submit value=Submit>
226 <p>The following fields have a forbidden value. Please push the back button and try again : </p>
227 <TMPL_IF name="cardnumber">
230 <TMPL_IF name="invalid_cardnumber">
231 Invalid_cardnumber<br/>
233 <TMPL_IF name="gender">
236 <TMPL_IF name="firstname">
239 <TMPL_IF name="surname">
242 <TMPL_IF name="address">
243 Postal Street Address<br/>
245 <TMPL_IF name="city">
251 <TMPL_INCLUDE Name="members-bottom.inc">