1 <TMPL_INCLUDE Name="members-top.inc">
3 <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="membercat">
48 <tr valign=top bgcolor="white" >
53 <TMPL_VAR Name="area">
56 <tr valign=top bgcolor="white" >
64 <tr valign=top bgcolor="white" >
69 <TMPL_VAR Name="joindate">
72 <tr valign=top bgcolor="white" >
77 <TMPL_VAR Name="expdate">
80 <tr valign=top bgcolor="white" >
85 <TMPL_VAR Name="branchcode">
88 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
89 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
90 <B>PERSONAL DETAILS</B>
93 <tr valign=top bgcolor="white" >
98 <TMPL_VAR Name="ethnic">
101 <tr valign=top bgcolor="white" >
106 <TMPL_VAR Name="dob">
109 <tr valign=top bgcolor="white" >
114 <TMPL_VAR Name="sex">
117 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
118 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
119 <B>MEMBER ADDRESS</B>
122 <tr valign=top bgcolor="white" >
124 <B>Postal Address</B>
127 <TMPL_VAR Name="postal">
130 <tr valign=top bgcolor="white" >
135 <TMPL_VAR Name="home">
138 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
139 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
140 <B>MEMBER CONTACT DETAIL</B>
143 <tr valign=top bgcolor="white" >
148 <TMPL_VAR Name="phone">
151 <tr valign=top bgcolor="white" >
153 <B>Phone (Daytime)</B>
156 <TMPL_VAR Name="phoneday">
159 <tr valign=top bgcolor="white" >
164 <TMPL_VAR Name="faxnumber">
167 <tr valign=top bgcolor="white" >
172 <TMPL_VAR Name="emailaddress">
175 <tr valign=top bgcolor="white" >
177 <B>Text messaging</B>
180 <TMPL_VAR NAME=textmessaging>
183 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
184 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
185 <B>ALTERNATIVE CONTACT DETAIL</B>
188 <tr valign=top bgcolor="white" >
193 <TMPL_VAR Name="contactname">
196 <tr valign=top bgcolor="white" >
201 <TMPL_VAR Name="altphone">
204 <tr valign=top bgcolor="white" >
209 <TMPL_VAR Name="altrelationship">
212 <tr valign=top bgcolor="white" >
217 <TMPL_VAR Name="altnotes">
220 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
221 <td colspan=2 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
225 <tr valign=top bgcolor="white" >
230 <TMPL_VAR Name="bornotes">
234 <form action="/cgi-bin/koha/insertdata.pl" method=post>
235 <TMPL_LOOP NAME=inputsloop>
236 <input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
238 <input type=submit name=submit value=Submit>
240 <form action="/cgi-bin/koha/memberentry.pl" method=post>
241 <TMPL_LOOP NAME=inputsloop>
242 <input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
244 <input type=submit name=return value="Go Back">
247 <TMPL_VAR Name="string">
251 <TMPL_INCLUDE Name="members-bottom.inc">