Forum Moderators: coopster
<form action="address.php" method="post">
<table width="75%" border="0" cellpadding="0">
<tr align="center">
<th valign="middle">NAME;</th>
<td><span id="spryselect1">
<label for="title2"></label>
<select name="title" id="title2">
<option selected="selected">TITLE</option>
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Mr.">Mr.</option>
</select><sup>*</sup>
<br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
<td><span id="sprytextfield1">
<label for="last"></label>
<input name="last" type="text" id="last" onkeydown="if(event.keyCode==13) event.keyCode=9" onkeyup="return autoTab(this, 15, event)" />
<sup>*</sup>
<br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
<td><span id="sprytextfield2">
<label for="first"></label>
<input name="first" type="text" id="first" onkeydown="if(event.keyCode==13) event.keyCode=9" onkeyup="return autoTab(this, 15, event)" /><sup>*</sup>
<br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
<td style='padding:.75pt .75pt .75pt .75pt'><span id="sprytextfield4">
<input name="innitial" type="text" id="innitial" onkeyup="return autoTab(this, 1, event)" size="2" maxlength="1" />
</span></td>
<td><label for="suffix"></label>
<input name="suffix" type="text" id="suffix" onchange="javascript:this.value=this.value.toUpperCase()" onkeydown="if(event.keyCode==13) event.keyCode=9" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" /></td>
</tr>
</table>
<br />
<table width="100%" border="0" cellpadding="5">
<tr>
<td width="50%"><table width="100%" border="0" cellpadding="5">
<tr>
<th width="60%" align="right" nowrap="nowrap"><div class="hide"><a href="javascript:explain('Social Security Number', 'opener.document.form.username.value', 'Please enter your Sosial Security Number. <B><U>DO NOT</b></u> type any slashes (/), dashes (-) or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;">Social Security Number;</a><sup>*</sup></div></th>
<td width="10%" align="center" nowrap="nowrap"><span id="sprytextfield3">
<input name="ssn1" type="text" id="ssn1" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
<td width="5%" align="center" nowrap="nowrap">-</td>
<td width="10%" align="center" nowrap="nowrap"><span id="sprytextfield5">
<input name="ssn2" type="text" id="ssn2" onkeyup="return autoTab(this, 2, event)" size="2" maxlength="2" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
<td width="5%" align="center" nowrap="nowrap">-</td>
<td width="10%" align="center" nowrap="nowrap"><span id="sprytextfield7">
<input name="ssn3" type="text" id="ssn3" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
</tr>
</table></td>
<td><table width="100%" border="0" cellpadding="5">
<tr>
<th height="34" align="right" nowrap="nowrap">DATE OF BIRTH<sup>*</sup></th>
<td align="center" nowrap="nowrap"><span id="spryselect2">
<label for="dobmo"></label>
<select name="dobmo" id="dobmo">
<option selected="selected">MONTH</option>
<option value="January">January</option>
<option value="February">February</option>
<option value="March">March</option>
<option value="April">April</option>
<option value="May">May</option>
<option value="June">June</option>
<option value="July">July</option>
<option value="August">August</option>
<option value="September">September</option>
<option value="October">October</option>
<option value="November">November</option>
<option value="December">December</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
<td align="center" nowrap="nowrap"><span id="spryselect3">
<label for="dobday"></label>
<select name="dobday" id="dobday">
<option selected="selected">DAY</option>
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
<td align="center" nowrap="nowrap"><span id="sprytextfield6">
<label for="dobyr"></label>
<input name="dobyr" type="text" id="dobyr" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
</tr>
</table></td>
</tr>
</table>
<br />
<table width="100%" border="0" cellpadding="5">
<tr>
<td width="38%">Are you 18 or older? <sup>*</sup></td>
<td width="10%" nowrap="nowrap"><span id="spryselect4">
<label for="age"></label>
<select name="age" id="age">
<option selected="selected">SELECT</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
<th width="6%"> </th>
<td width="38%">Are you a U.S. citizen? <sup>*</sup></td>
<td width="10%" nowrap="nowrap"><span id="spryselect6">
<label for="uscit"></label>
<select name="uscit" id="uscit">
<option selected="selected">SELECT</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
</tr>
<tr>
<td width="38%">Are you your own legal guardian? <sup>*</sup></td>
<td width="10%" nowrap="nowrap"><span id="spryselect5">
<label for="guardian"></label>
<select name="guardian" id="guardian">
<option selected="selected">SELECT</option>
<option value="Yes">Yes</option>
<option value="nO">No</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
<th width="6%"> </th>
<td width="38%">Are you authorized to
work in New Hampshire? <sup>*</sup></td>
<td width="10%" nowrap="nowrap"><span id="spryselect7">
<label for="nh"></label>
<select name="nh" id="nh">
<option selected="selected">SELECT</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br />
<span class="selectRequiredMsg">Please select an item.</span></span></td>
</tr>
</table>
<br /> <div align="right">
<input type="submit" value="Next" />
</div>
<table width="50%" border="1" cellpadding="0">
<tr align="center"> </tr>
</table>
</form>
<?php
session_start();
session_register('title');
session_register('last');
session_register('first');
session_register('innitial');
session_register('suffix');
session_register('ssn');
session_register('dobmo');
session_register('dobday');
session_register('dobyr');
session_register('age');
session_register('uscit');
session_register('guardian');
session_register('nh');
$_SESSION['title'] = $_POST['title'];
$_SESSION['last'] = $_POST['last'];
$_SESSION['first'] = $_POST['first'];
$_SESSION['innitial'] = $_POST['innitial'];
$_SESSION['Suffix'] = $_POST['suffix'];
$_SESSION['ssn'] = $_POST['ssn'];
$_SESSION['dobmo'] = $_POST['dobmo'];
$_SESSION['dobday'] = $_POST['dobday'];
$_SESSION['dobyr'] = $_POST['dobyr'];
$_SESSION['age'] = $_POST['age'];
$_SESSION['uscit'] = $_POST['uscit'];
$_SESSION['guardian'] = $_POST['guardian'];
$_SESSION['nh'] = $_POST['nh'];
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
<link href="../../css/onscreecn.css" rel="stylesheet" type="text/css" />
<script src="../../javascript/highlight-active-input.js.js" type="text/javascript"></script>
<script src="../../javascript/autoTab.js" type="text/javascript"></script>
<script src="../../javascript/SpryValidationSelect.js" type="text/javascript"></script>
<script src="../../javascript/dFilter.js" type="text/javascript"></script>
<script src="../../javascript/SpryValidationTextField.js" type="text/javascript"></script>
<link href="../../css/SpryValidationTextField.css" rel="stylesheet" type="text/css" />
<link href="../../css/SpryValidationSelect.css" rel="stylesheet" type="text/css" />
</head>
<body>
<form method="post" action="position.php">
<h2>section i: personal information</h2>
<h4>Contact Information:</h4>
<table width="100%" border="1" cellpadding="5">
<tr>
<td width="50%"><h4>Home/Physical Address:</h4>
<table width="100%">
<tr>
<td width="45%"><div align="left"><span id="sprytextfield1">
<input name="ship1" id="ship1" type="text" onchange="copyValue(this)" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 15, event)" size="25" /><sup>*</sup><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></div></td>
<td width="10%"> </td>
<td width="45%"><div align="left"><span id="sprytextfield2">
<input name="ship2" id="ship2" type="text" onchange="copyValue(this)" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 15, event)" size="25" maxlength="25" />
</span></div></td>
</tr>
</table> <table width="100%" border="0" cellpadding="0" class="MsoNormalTable">
<tr>
<td height="26"><div><span id="sprytextfield3">
<input name="shipcity" type="text" id="shipcity" onchange="copyValue(this)" onkeyup="return autoTab(this, 15, event)"/><sup>*</sup><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></div></td>
<td width="5%"> </td>
<td><span id="sprytextfield22">
<input name="shipstate" type="text" id="shipstate" onkeyup="return autoTab(this, 2, event)" size="2" maxlength="2" /><sup>*</sup><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
<td width="5%"></td>
<td width="1%" nowrap="nowrap"><div align="center"><span id="sprytextfield5">
<input name="shipzip" id="shipzip" type="text" onchange="copyValue(this)" onkeydown="if(event.keyCode==13) event.keyCode=9" onkeyup="return autoTab(this, 5, event)" size="5" maxlength="5" /><sup>*</sup><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></div></td>
</tr>
</table></td>
<td width="50%"><h4>Mailing Address: </h4>
<table width="100%">
<tr>
<td width="45%"><span id="sprytextfield13">
<input name="bill1" type="text" id="bill1" onchange="copyValue(this)" onclick="select()" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 15, event)" size="25" maxlength="25" />
</span></td>
<td width="10%"> </td>
<td width="45%"><span id="sprytextfield8">
<input name="bill2" id="bill2" type="text" onchange="copyValue(this)" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 15, event)" size="25" maxlength="25" />
</span></td>
</tr>
</table>
<table width="100%" border="0" cellpadding="0" class="MsoNormalTable">
<tr></tr>
<tr>
<td height="24"><div align="left"><span id="sprytextfield14">
<input name="billcity" type="text" id="billcity" onchange="copyValue(this)" onclick="select()" onkeyup="return autoTab(this, 15, event)" />
</span></div></td>
<td width="5%"> </td>
<td><span id="sprytextfield23">
<input name="billstate" type="text" id="billstate" onkeyup="return autoTab(this, 2, event)" size="2" maxlength="2" />
</span></td>
<td width="5%"></td>
<td width="10%" nowrap="nowrap"><span id="sprytextfield15">
<input name="billzip" type="text" id="billzip" onchange="copyValue(this)" onkeyup="return autoTab(this, 5, event)" size="5" maxlength="5" />
</span></td>
</tr>
</table></td>
</tr>
</table>
<br />
<table width="100%" border="0" cellpadding="5">
<tr>
<th width="23%" nowrap="nowrap" scope="row"> <div align="right"><a href="javascript:explain('Day Phone', 'opener.document.form.username.value', 'Please enter your daytime telephone number with area code. <B><U>DO NOT</b></u> type any slashes (/), dashes (-), parentheses or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;"> Daytime Phone</a></div></th>
<td width="6%" nowrap="nowrap">( <span id="sprytextfield16">
<input name="dayarea" type="text" id="dayarea" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
</span> ) </td>
<td><span id="sprytextfield17">
<input name="dayno1" type="text" id="dayno1" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
</span></td>
<td>-</td>
<td><span id="sprytextfield18">
<input name="dayno2" type="text" id="dayno2" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" />
</span></td>
<th width="10%"> </th>
<th width="33%"><div align="right"><a href="javascript:explain('Evening Phone', 'opener.document.form.username.value', 'Please enter your evening telephone number with area code. <B><U>DO NOT</b></u> type any slashes (/), dashes (-), parentheses or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;">Evening Phone</a><sup>*</sup></div></th>
<td width="5%" nowrap="nowrap"> <label for="evephone"></label>
(<span id="sprytextfield4">
<input name="evearea" type="text" id="evearea" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
)<br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td><td width="3%" nowrap="nowrap"><span id="sprytextfield6">
<input name="eveno1" type="text" id="eveno1" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td><td width="2%">-</td><td width="9%" nowrap="nowrap"><span id="sprytextfield12">
<input name="eveno2" type="text" id="eveno2" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" /><br />
<span class="textfieldRequiredMsg">A value is required.</span></span></td>
</tr></table>
<br />
<table width="100%" border="0" cellpadding="5">
<tr>
<th width="23%" nowrap="nowrap" scope="row"><div align="right"><a href="javascript:explain('Fax Phonee', 'opener.document.form.username.value', 'Please enter your fax number with area code (if applicable). <B><U>DO NOT</b></u> type any slashes (/), dashes (-), parentheses or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;">Fax Phone</a></div></th>
<td width="6%" nowrap="nowrap"><span id="sprytextfield9">(
<input name="faxarea" type="text" id="faxarea" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
) </span></td>
<td width="4%"><span id="sprytextfield10">
<input name="faxno1" type="text" id="faxno1" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
</span></td>
<td width="2%">-</td>
<td width="3%"><span id="sprytextfield11">
<input name="faxno2" type="text" id="faxno2" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" />
</span></td>
<th width="10%"> </th>
<th width="33%"><div class="hide">
<div align="right"><a href="javascript:explain('Day Phonee', 'opener.document.form.username.value', 'Please enter your daytime telephone number with area code. <B><U>DO NOT</b></u> type any slashes (/), dashes (-), parentheses or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;">Cell/Other Phone</a></div>
</div></th>
<td width="5%" nowrap="nowrap"><label for="evephone2"></label>
(<span id="sprytextfield19">
<input name="otharea" type="text" id="otharea" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
)<br />
</span></td>
<td width="3%"><span id="sprytextfield20">
<input name="othno1" type="text" id="othno1" onkeyup="return autoTab(this, 3, event)" size="3" maxlength="3" />
</span></td>
<td width="2%">-</td>
<td width="9%"><span id="sprytextfield21">
<input name="othno2" type="text" id="othno2" onkeyup="return autoTab(this, 4, event)" size="4" maxlength="4" />
<br />
</span></td>
</tr>
</table>
<br />
<table width="100%" border="0" cellpadding="5">
<tr>
<th width="20%" nowrap="nowrap" scope="row"><div align="left" class="hide">
<div align="right">Primary E-mail<sup>*</sup></div>
</div></th>
<td width="25%"><span id="sprytextfield7"><a href="javascript:explain('Day Phone', 'opener.document.form.username.value', 'Please enter your daytime telephone number with area code. <B><U>DO NOT</b></u> type any slashes (/), dashes (-), parentheses or spaces. The field has been automatically formatted and the cursor will go to the next field once the maximum limit has been reached');" onmouseover="window.status='Click for explanation...';return true;" onmouseout="window.status='';return true;">
<input name="primaryemail" type="text" id="primaryemail" style="text-transform:lowercase" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 30, event)" size="35" />
</a><br />
<span class="textfieldRequiredMsg">A value is required.</span><span class="textfieldInvalidFormatMsg">Invalid format.</span></span></td>
<th width="10%"> </th>
<th width="20%"><div align="right">Alternate E-mail</div></th>
<td><input name="alternateemail" type="text" id="alternateemail" style="text-transform:lowercase" onkeydown="if(event.keyCode==13) event.keyCode=9;" onkeyup="return autoTab(this, 30, event)" size="35" /></td>
</tr>
</table>
<br />
<div class="hide"></div>
<div class="hide">
<table width="50%">
<tr>
<td><div align="right">Perfered Contact Method:</div></td>
<td><p><span id="spryselect2">
<label for="contact"></label>
<select name="contact" id="contact">
<option selected="selected">SELECT</option>
<option value="E-mail">E-Mail</option>
<option value="Fax">Fax</option>
<option value="Mail">Mail</option>
<option value="Phone">Phone</option>
</select>
<span class="selectRequiredMsg">Please select an item.</span></span></p></td>
</tr>
</table>
<div align="right">
<input type="submit" value="Next">
</div>
</div>
</form>