1 <TMPL_INCLUDE Name="members-top.inc">
3 <H1> Potwierd¼ Wpis </H1>
5 <table border=0 cellspacing=0 cellpadding=5>
6 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
7 <td background="<TMPL_VAR Name="image">">
8 <B> NOWY CZYTELNIK </B>
14 <tr valign=top bgcolor="white" >
19 <TMPL_VAR Name="name">
22 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
23 <td background="<TMPL_VAR Name="image">">
24 <B> SZCZEGÓ£Y CZ£ONKOWSKIE </B>
30 <tr valign=top bgcolor="white" >
32 <B>Numer czytelnika</B>
35 <TMPL_VAR Name="bornum">
38 <tr valign=top bgcolor="white" >
43 <TMPL_VAR Name="cardnum">
46 <tr valign=top bgcolor="white" >
48 <B>Kategoria cz³onkowstwa</B>
51 <TMPL_VAR Name="membercat">
54 <tr valign=top bgcolor="white" >
59 <TMPL_VAR Name="area">
62 <tr valign=top bgcolor="white" >
70 <tr valign=top bgcolor="white" >
75 <TMPL_VAR Name="joindate">
78 <tr valign=top bgcolor="white" >
80 <B>Termin wyga¶niêcia</B>
83 <TMPL_VAR Name="expdate">
86 <tr valign=top bgcolor="white" >
91 <TMPL_VAR Name="joinbranch">
94 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
95 <td background="<TMPL_VAR Name="image">">
96 <B>DANE PERSONALNE</B>
102 <tr valign=top bgcolor="white" >
107 <TMPL_VAR Name="ethnic">
110 <tr valign=top bgcolor="white" >
112 <B>Data urodzenia</B>
115 <TMPL_VAR Name="dob">
118 <tr valign=top bgcolor="white" >
123 <TMPL_VAR Name="sex">
126 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
127 <td background="<TMPL_VAR Name="image">">
128 <B>ADRES CZYTELNIKA</B>
134 <tr valign=top bgcolor="white" >
136 <B>Adres pocztowy</B>
139 <TMPL_VAR Name="postal">
142 <tr valign=top bgcolor="white" >
147 <TMPL_VAR Name="home">
150 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
151 <td background="<TMPL_VAR Name="image">">
152 <B>DANE OSOBY KONTAKTOWEJ</B>
158 <tr valign=top bgcolor="white" >
163 <TMPL_VAR Name="phone">
166 <tr valign=top bgcolor="white" >
168 <B>Tel. (W pracy)</B>
171 <TMPL_VAR Name="phoneday">
174 <tr valign=top bgcolor="white" >
179 <TMPL_VAR Name="faxnumber">
182 <tr valign=top bgcolor="white" >
187 <TMPL_VAR Name="emailaddress">
190 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
191 <td background="<TMPL_VAR Name="image">">
192 <B>ALTERNATYWNE DANE OSOBY KONTAKTOWEJ</B>
198 <tr valign=top bgcolor="white" >
203 <TMPL_VAR Name="contactname">
206 <tr valign=top bgcolor="white" >
211 <TMPL_VAR Name="altphone">
214 <tr valign=top bgcolor="white" >
219 <TMPL_VAR Name="altrelationship">
222 <tr valign=top bgcolor="white" >
227 <TMPL_VAR Name="altnotes">
230 <tr valign=top bgcolor="<TMPL_VAR Name="main">" >
231 <td background="<TMPL_VAR Name="image">">
238 <tr valign=top bgcolor="white" >
243 <TMPL_VAR Name="bornotes">
247 <form action="/cgi-bin/koha/insertdata.pl" method=post>
248 <TMPL_LOOP NAME=inputsloop>
249 <input type=hidden name="<TMPL_VAR NAME="key">" value="<TMPL_VAR NAME="value">">
251 <input type=submit name=submit value=Prze¶lij>
254 <TMPL_VAR Name="string">
258 <TMPL_INCLUDE Name="members-bottom.inc">