koha-dev.rot13.org Git - koha_gimpoz/blob - koha-tmpl/intranet-tmpl/default/en/members/jmemberentry.tmpl

   1 <TMPL_INCLUDE NAME="members-top.inc">
   2
   3 <h1>Add New Junior Member </h1><br>
   4 <form action=/cgi-bin/koha/newjmember.pl method=post>
   5         <!--<input type=hidden name=joining value="">
   6         <input type=hidden name=expiry value="">
   7         <input type=hidden name=type value="borrowers">-->
   8         <input type=hidden name=borrowernumber value="<TMPL_VAR NAME=member>">
   9         <input type=hidden name=updtype value=I>
  10         <input type=hidden name=area value="<TMPL_VAR NAME=area>">
  11         <input type=hidden name=city value="<TMPL_VAR NAME=city>">
  12         <input type=hidden name=street value="<TMPL_VAR NAME=address>">
  13         <input type=hidden name=streetaddress value="<TMPL_VAR NAME=streetaddress>">
  14         <input type=hidden name=streetcity value="<TMPL_VAR NAME=streetcity>">
  15         <input type=hidden name=phone value="<TMPL_VAR NAME=phone>">
  16         <input type=hidden name=phoneday value="<TMPL_VAR NAME=phoneday>">
  17         <input type=hidden name=faxnumber value="<TMPL_VAR NAME=faxnumber>">
  18         <input type=hidden name=emailaddress value="<TMPL_VAR NAME=emailaddress>">
  19         <input type=hidden name=contactname value="<TMPL_VAR NAME=contactname>">
  20         <input type=hidden name=altphone value"<TMPL_VAR NAME=altphone>">
  21
  22         <table border=0 cellspacing=0 cellpadding=5 >
  23         <tr valign=top bgcolor="99cc33" >
  24                 <td  COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
  25                         <B>PARENT OR GUARDIAN </b>
  26                 </td>
  27         </tr>
  28         <tr valign=top bgcolor=white>
  29                 <td>
  30                 <SELECT NAME="title" SIZE="1">
  31                         <OPTION value=" ">No Title
  32                         <TMPL_LOOP NAME=titleloop>
  33                         <OPTION value="<TMPL_VAR NAME=title>"<TMPL_VAR NAME=selected>><TMPL_VAR NAME=title>
  34                         </TMPL_LOOP>
  35                 </SELECT>
  36                 </td>
  37                 <td><input type=text name=firstname_guardian size=20 value="<TMPL_VAR NAME=firstname>"></td>
  38                 <td colspan=2><input type=text name=surname_guardian size=20 value="<TMPL_VAR NAME=surname>"></td>
  39                 <td><input type=text name=guardian_number size=20 value="<TMPL_VAR NAME=cardnumber>"></td>
  40         </tr>
  41         <tr valign=top bgcolor=white>
  42                 <td><FONT SIZE=2>Title</FONT></td>
  43                 <td><FONT SIZE=2>Given Names*</FONT></td>
  44                 <td colspan=2><FONT SIZE=2>Surname*</FONT></td>
  45                 <td><FONT SIZE=2>Membership No.</FONT></td>
  46         </tr>
  47         <TMPL_LOOP NAME=cmemloop>
  48         <tr valign=top bgcolor="99cc33">
  49                 <td COLSPAN=5 background="<TMPL_VAR name="themelang">/images/background-mem.gif">
  50                         <B>CHILD <TMPL_VAR NAME=count></b>
  51                 </td>
  52         </TR>
  53         <TR>
  54                 <td  COLSPAN=4   ALIGN=RIGHT ><font size=3 face='arial,helvetica'>
  55                         <STRONG>Member# <TMPL_VAR NAME=cmember></STRONG>, <b>Card Number*</b></STRONG>
  56                 </TD>
  57                 <TD>
  58                         <input type=text name=cardnumber_child_<TMPL_VAR NAME=i> size=20 value=""><br>
  59                         <input type=hidden name=bornumber_child_<TMPL_VAR NAME=i> value="<TMPL_VAR NAME=cmember>">
  60                 </td>
  61         </TR>
  62         <tr bgcolor=white>
  63                 <td><input type=text name=firstname_child_<TMPL_VAR NAME=i> size=20 value=""></td>
  64                 <td><input type=text name=surname_child_<TMPL_VAR NAME=i> size=20 value=""></td>
  65                 <td><input type=text name=dateofbirth_child_<TMPL_VAR NAME=i> size=10 value=""></TD>
  66                 <TD>
  67                         <input type="radio" name="sex_child_<TMPL_VAR NAME=i>" value="F"><b>F</b>
  68                         <input type="radio" name="sex_child_<TMPL_VAR NAME=i>" value="M"><b>M*</b>
  69                 </td>
  70                 <TD align=right><input type=text name=school_child_<TMPL_VAR NAME=i> size=20 value=""></TD>
  71         </tr>
  72         <tr valign=top bgcolor=white>
  73                 <td><FONT SIZE=2><b>Given Name*</b></FONT></td>
  74                 <td><FONT SIZE=2><b>Surname*</b></FONT></td>
  75                 <td><FONT SIZE=2><b>Date of Birth<BR>(<TMPL_VAR NAME=dateformat>)*</b></FONT></td>
  76                 <td><FONT SIZE=2>&nbsp;</FONT></td>
  77                 <td><FONT SIZE=2>School</FONT></td>
  78         </tr>
  79         <tr valign=top bgcolor=white>
  80                 <td  COLSPAN=5><textarea name=altnotes_child_<TMPL_VAR NAME=i> wrap=physical cols=70 rows=3></textarea></td>
  81         </tr>
  82         <tr valign=top bgcolor=white>
  83                 <td><FONT SIZE=2>Notes</font></td>
  84         </tr>
  85         </TMPL_LOOP>
  86         <tr valign=top bgcolor=white>
  87                 <td colspan=2 align="center"><input type=reset value="Clear all Fields"></td>
  88                 <td  COLSPAN=3 align="center">
  89                         <input type=image src="<TMPL_VAR name="interface">/<TMPL_VAR name="theme">/images/2rightarrow.png" ALT="Add New Member" border=0>
  90                 </td>
  91         </tr>
  92
  93         </TABLE>
  94 </form>
  95
  96
  97 <TMPL_INCLUDE NAME="members-bottom.inc">