require_once 'config.php';
require_once 'HTML/QuickForm.php';
$form = new HTML_QuickForm('register');
$form->addElement('header', null, '2014 Membership Application');
//$form->addElement('static', 'pinfo', 'Address Information', '');
$form->addElement('text', 'name', 'Name');
$form->addRule('name', "Please enter your name.", 'required');
$form->addElement('text', 'address', 'Address');
$form->addRule('address', "Please enter your address.", 'required');
$form->addElement('text', 'city', 'City');
$form->addRule('city', "Please enter the city you live in.", 'required');
$form->addElement('text', 'state', 'State');
$form->addRule('state', "Please enter the state you live in.", 'required');
$form->addElement('text', 'zip', 'Zip');
$form->addRule('zip', "Please enter your zip code.", 'required');
$form->addElement('text', 'home_phone', 'Home Phone');
$form->addRule('home_phone', "Please enter your home phone number.", 'required');
$form->addElement('text', 'work_phone', 'Work Phone');
$form->addElement('text', 'email', 'Email Address');
$form->addRule('email', "The email you entered isn't valid.", 'email');
$form->addRule('email', "Please enter an email address.", 'required');
$form->addElement('textarea', 'other_clubs', 'What other clubs are you affiliated with?', '
');
$first_time = array();
$first_time[] =&
HTML_QuickForm::createElement('radio',null,null,'Yes','yes');
$first_time[] =&
HTML_QuickForm::createElement('radio',null,null,'No','no');
$form->addGroup($first_time, 'first_time', 'Are you a first time MAC member?', '
');
$form->addRule('first_time', 'Please choose Yes or No.', 'required', null);
$form->addElement('submit', 'btnSubmit', 'Register');
if( $form->validate()) {
$form->removeElement('btnSubmit');
$invoice_num = date("Ymd-GHs") . "-" . rand(1000, 9999);
$form->freeze();
require_once('Mail.php');
require_once('Mail/mime.php');
$headers = array('From' => MAIL_FROM,
'Bcc' => MAIL_TO,
'Subject' => MAIL_SUBJECT);
ob_start();
include('email_tmpl.php');
$htmlMessage = ob_get_contents();
ob_end_clean();
$data = $form->getSubmitValues();
$newPersonEmail = $data['email'];
$mime = new Mail_Mime();
$mime->setTxtBody($textMessage);
$mime->setHtmlBody($htmlMessage);
$mime->addAttachment($attachment);
$body = $mime->get();
$hdrs = $mime->headers($headers);
$mail = &Mail::factory('mail');
if( !$mail->send($newPersonEmail, $hdrs, $body) ){
die("Your registration could not be processed.");
}
}
?>
Your application has been submitted, pending payment.
Your invoice number is: An email was sent to you at with the information you provided. |
|
Pay via check:
Dave Kral 5828 W. Meadow Lake Rd. New Hope, MN 55428 Return to MAC Home Page |
Pay via PayPal:
|