File: /home/nyiet8349bzl/Backup/sbc_back/homedir/public_html/library-conference-registration.php
<?php include 'inc/header.php';?>
<?php include 'inc/slider.php';?>
<script type="text/javascript" src="http://code.jquery.com/jquery-2.1.4.min.js"></script>
<script src="//cdn.jsdelivr.net/webshim/1.14.5/polyfiller.js"></script>
<script>
webshims.setOptions('forms-ext', {types: 'date'});
webshims.polyfill('forms forms-ext');
$.webshims.formcfg = {
en: {
dFormat: '-',
dateSigns: '-',
patterns: {
d: "dd-mm-yy"
}
}
};
</script>
<div class="container">
<div class="row " >
<div class="col-lg-12 ">
<div class="sub_heading"> Library Conference on Building Digital India: Enhancing Capacities through Libraries and Information <a class="btn btn-danger pull-right"href="pdf/REGISTRATION-FORM.pdf" target="_blank">Online Registration Form </a> </div>
<br>
<form name="contactform" method="post" action="library-conference-registration.php">
<table width="600px">
<tr>
<td valign="top">
<label for="name">Name </label>
</td>
<td valign="top">
<input type="text" name="name" maxlength="50" size="30" required>
</td>
</tr>
<tr>
<td valign="top">
<label for="Organization">Organization</label>
</td>
<td valign="top">
<input type="text" name="Organization" maxlength="30" size="30" required>
</td>
</tr>
<tr>
<td valign="top">
<label for="Designation">Designation </label>
</td>
<td valign="top">
<input type="text" name="Designation" maxlength="30" size="30" required>
</td>
</tr>
<tr>
<td valign="top"">
<label for="Address">Address</label>
</td>
<td valign="top">
<textarea type="text" name="Address" maxlength="50" size="30" required>
</textarea>
</td>
</tr>
<tr>
<td valign="top"">
<label for="City">City</label>
</td>
<td valign="top">
<input type="text" name="City" maxlength="50" size="30" required />
</td>
</tr>
<tr>
<td valign="top"">
<label for="Country" >Country</label>
</td>
<td valign="top">
<input type="text" name="Country" maxlength="50" size="30" required/>
</td>
</tr>
<td valign="top"">
<label for="Postal">Postal</label>
</td>
<td valign="top">
<input type="text" name="Postal" maxlength="6" size="30" required />
</td>
</tr>
<tr>
<td valign="top">
<label for="telephone">Telephone</label>
</td>
<td valign="top">
<input type="text" name="telephone" maxlength="10" size="30" />
</td>
</tr>
<tr>
<td valign="top">
<label for="Mobile">Mobile</label>
</td>
<td valign="top">
<input type="text" name="Mobile" maxlength="10" size="30" required>
</td>
</tr>
<tr>
<tr>
<td valign="top">
<label for="Email">Email </label>
</td>
<td valign="top">
<input type="text" name="Email" maxlength="80" size="30" required>
</td>
</tr>
<tr>
<td>
<strong>Registration Fees </strong>
<td> <select name="Regtype">
<option value="Rs.2000/-">Rs.2000/- </option>
<option value="Rs.2250/-">Rs.2250/- </option>
<option value="Rs.2500/-">Rs.2500/- </option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<label for="Bank">Bank Name </label>
</td>
<td valign="top">
<input type="text" name="Bank" maxlength="80" size="30" required>
</td>
</tr>
</tr>
<tr>
<td valign="top">
<label for="Branch">Branch Name </label>
</td>
<td valign="top">
<input type="text" name="Branch" maxlength="80" size="30" required>
</td>
</tr>
<tr>
<td valign="top">
<label for="Cheque">Cheque/DD Number </label>
</td>
<td valign="top">
<input type="text" name="Cheque" maxlength="80" size="30" required>
</td>
</tr>
<tr>
<td valign="top">
<label for="Date">Date</label>
</td>
<td valign="top">
<input min="2016-01-01" max="2016-12-31" type="date" name = "Date" />
</td>
</tr>
<!--
<tr><td>Presenting Paper</td>
<td><input type="radio" name="paper" value="Yes">Yes</input>
<input type="radio" name="paper" value="No">No</input></td>
</tr>
</tr>
-->
<tr>
<td colspan="2" style="text-align:center">
<input type="submit" value="Submit" name="cc">
</td>
</tr>
</table>
</form>
<?php
if(isset($_POST['Email']))
{
// EDIT THE 2 LINES BELOW AS REQUIRED
$email_to = "makingcitiesresilient@gmail.com";
$email_subject = "Library Conference Registration";
function died($error) {
// your error code can go here
echo "We are very sorry, but there were error(s) found with the form you submitted. ";
//echo "These errors appear below.<br /><br />";
echo $error."<br /><br />";
//echo "Please go backth and fix these errors.<br /><br />";
die();
}
// validation expected data exists
if(!isset($_POST['name']) ||
!isset($_POST['Organization']) ||
!isset($_POST['Designation']) ||
!isset($_POST['Address']) ||
!isset($_POST['City']) ||
!isset($_POST['Country']) ||
!isset($_POST['Postal']) ||
!isset($_POST['telephone'])||
!isset($_POST['Mobile']) ||
!isset($_POST['Email']) ||
!isset($_POST['Bank']) ||
!isset($_POST['Branch']) ||
!isset($_POST['Cheque']) ||
!isset($_POST['Date']) ||
!isset($_POST['Regtype']))
{
died('\nWe are sorry, but there appears to be a problem with the form you submitted.');
}
$first_name = isset($_POST['name']); // required
$Organization = isset($_POST['Organization']); // required
$Designation = isset($_POST['Designation']); // required
$address = isset($_POST['Address']); // required
$City = isset($_POST['City']); // required
$Country = isset($_POST['Country']); // required
$Postal = isset($_POST['Postal']); // required
$telephone = isset($_POST['telephone']); // not required
$Mobile = isset($_POST['Mobile']); // not required
$email_from = isset($_POST['Email']); // required
$Bank = isset($_POST['Bank']); // required
$Branch = isset($_POST['Branch']); // required
$Regtype = isset($_POST['Regtype']); // required
$Cheque = isset($_POST['Cheque']); // required
$date = isset($_POST['Date']); // required
/* $error_message = "";
$email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/';
if(!preg_match($email_exp,$email_from)) {
$error_message .= 'The Email Address you entered does not appear to be valid.<br />';
}
$string_exp = "/^[A-Za-z .'-]+$/";
if(!preg_match($string_exp,$first_name)) {
$error_message .= 'The Name you entered does not appear to be valid.<br />';
}
if(!preg_match($string_exp,$address)) {
$error_message .= 'The Address you entered does not appear to be valid.<br />';
}
if($Regtype == '') {
$error_message .= 'You did not Select Your Registration Type:.<br />';
}
if(strlen($error_message) > 0) {
died($error_message);
}*/
$email_message = "Form details below.\n\n";
function clean_string($string) {
$bad = array("content-type","bcc:","to:","cc:","href");
return str_replace($bad,"",$string);
}
$email_message .= "Name : ".clean_string($_POST['name'])."\n";
$email_message .= "Organization : ".clean_string($_POST['Organization'])."\n";
$email_message .= "Designation : ".clean_string($_POST['Designation'])."\n";
$email_message .= "Address : ".clean_string($_POST['Address'])."\n";
$email_message .= "City : ".clean_string($_POST['City'])."\n";
$email_message .= "Country : ".clean_string($_POST['Country'])."\n";
$email_message .= "Postal : ".clean_string($_POST['Postal'])."\n";
$email_message .= "Telephone : ".clean_string($_POST['telephone'])."\n";
$email_message .= "Mobile : ".clean_string($_POST['Mobile'])."\n";
$email_message .= "Email : ".clean_string($_POST['Email'])."\n";
$email_message .= "Registration Fee: ".clean_string($_POST['Regtype'])."\n";
$email_message .= "Bank Name: ".clean_string($_POST['Bank'])."\n";
$email_message .= "Branch Name: ".clean_string($_POST['Branch'])."\n";
$email_message .= "DD/Cheque Number: ".clean_string($_POST['Cheque'])."\n";
$email_message .= "Submitted Date: ".clean_string($_POST['Date'])."\n";
if($_SERVER['REQUEST_METHOD'] == 'POST'){
$con = mysql_connect("localhost","sbsc_register","sbsc@123");
if (!$con)
{
die('Could not connect: ' . mysql_error());
}
mysql_select_db("sbsc_register", $con);
$sql = "INSERT INTO `form2`(`Name`, `Organization`, `Designation`, `Address`, `City`, `Country`, `Postal`, `Telephone`, `Mobile`, `Email`, `RegistrationFee`, `Bank`, `Branch`, `Cheque`, `Date`) VALUES ('$_POST[name]','$_POST[Organization]','$_POST[Designation]','$_POST[Address]','$_POST[City]','$_POST[Country]','$_POST[Postal]','$_POST[telephone]','$_POST[Mobile]','$_POST[Email]','$_POST[Regtype]','$_POST[Bank]','$_POST[Branch]','$_POST[Cheque]','$_POST[Date]')";
if (!mysql_query($sql,$con))
{
die('Error: ' . mysql_error());
}
echo "Your Information Was Successfully Posted";
mysql_close($con);
}
// create email headers
$headers = 'From: '.$_POST['Email']."\r\n".
'Reply-To: '.$_POST['Email']."\r\n" .
'X-Mailer: PHP/' . phpversion();
@mail($email_to, $email_subject, $email_message, $headers);
?>
<!-- include your own success html here -->
Thank you for contacting us. We will be in touch with you very soon.
<?php
}
?>
</div>
<div class="clearfix"></div>
</div>
</div>
</div>
<div class="clr"></div>
<?php include 'inc/footer.php';?>