API tools faq
paste
Advertisement
Guest User

Untitled

a guest
Sep 19th, 2016
85
0
Never
Add comment
Not a member of Pastebin yet? Sign Up, it unlocks many cool features!
text 12.83 KB | None | 0 0
raw download clone embed print report
  1. <?php session_start(); ?>
  2. <html>
  3. <head><title>Make a Request</title></head>
  4. <script type="text/javascript" src="js/jquery-1.9.1.min.js"></script>
  5. <script type="text/javascript" src="js/srrs_script.js"></script>
  6.  
  7. <!--Validate Form, make sure no empty Fields-->
  8. <script>
  9. function validateForm()
  10. {
  11.  
  12. var x=document.forms["srrsForm"]["yourschool"].value;
  13. if (x==null || x=="")
  14. {
  15. alert("Your School must be filled out");
  16. return false;
  17. }
  18.  
  19. var x=document.forms["srrsForm"]["mailingaddress"].value;
  20. if (x==null || x=="")
  21. {
  22. alert("Your Mailing Address must be filled out");
  23. return false;
  24. }
  25.  
  26. var x=document.forms["srrsForm"]["city"].value;
  27. if (x==null || x=="")
  28. {
  29. alert("City must be filled out");
  30. return false;
  31. }
  32.  
  33. var x=document.forms["srrsForm"]["province"].value;
  34. if (x==null || x=="")
  35. {
  36. alert("Province must be filled out");
  37. return false;
  38. }
  39.  
  40. var x=document.forms["srrsForm"]["postcode"].value;
  41. if (x==null || x=="")
  42. {
  43. alert("Postal Code must be filled out");
  44. return false;
  45. }
  46.  
  47. var x=document.forms["srrsForm"]["schoolphone"].value;
  48. if (x==null || x=="")
  49. {
  50. alert("School Phone Number must be filled out");
  51. return false;
  52. }
  53.  
  54. var x=document.forms["srrsForm"]["cname"].value;
  55. if (x==null || x=="")
  56. {
  57. alert("Contact Name must be filled out");
  58. return false;
  59. }
  60.  
  61. var x=document.forms["srrsForm"]["email"].value;
  62. if (x==null || x=="")
  63. {
  64. alert("A valid email must be entered");
  65. return false;
  66. }
  67.  
  68. var x=document.forms["srrsForm"]["legname"].value;
  69. if (x==null || x=="")
  70. {
  71. alert("The Student's Legal Name Must be Entered, Please make sure the spelling is correct");
  72. return false;
  73. }
  74.  
  75. var x=document.forms["srrsForm"]["givenname"].value;
  76. if (x==null || x=="")
  77. {
  78. alert("Please enter the students Given Name");
  79. return false;
  80. }
  81.  
  82. //Envoke this setting again if Middle Name field becomes required
  83. //var x=document.forms["srrsForm"]["middlename"].value;
  84. //if (x==null || x=="")
  85. // {
  86. // alert("Please enter the students Middle Name");
  87. // return false;
  88. // }
  89.  
  90. //Envoke this setting again if ASN becomes required
  91. //var x=document.forms["srrsForm"]["asn"].value;
  92. //if (x==null || x=="")
  93. // {
  94. // alert("Please enter a valid 9 digit ASN number, If out of provinve, just put any number IE: 456 or 789");
  95. // return false;
  96. // }
  97.  
  98. var x=document.forms["srrsForm"]["dob"].value;
  99. if (x==null || x=="")
  100. {
  101. alert("Please enter a valid DOB, in thie format mm/dd/yyyy it cannot be left blank");
  102. return false;
  103. }
  104.  
  105. var x=document.forms["srrsForm"]["username"].value;
  106. if (x==null || x=="")
  107. {
  108. alert("You must select a username");
  109. return false;
  110. }
  111.  
  112. var x=document.forms["srrsForm"]["password"].value;
  113. if (x==null || x=="")
  114. {
  115. alert("You must select a password");
  116. return false;
  117. }
  118.  
  119.  
  120.  
  121.  
  122. }
  123. </script>
  124.  
  125. <style TYPE="text/css">
  126. table {
  127. -moz-border-radius: 10px;
  128. -webkit-border-radius: 10px;
  129. border-radius: 10px;
  130. border: 1px solid;
  131. font-size: 77%;
  132. }
  133.  
  134. td {
  135. -moz-border-radius: 10px;
  136. -webkit-border-radius: 10px;
  137. border-radius: 10px;
  138. border: 0px solid;
  139. font-size: 100%;
  140. }
  141.  
  142. .white {
  143. background-color:#FFFFFF;
  144. }
  145.  
  146. .blue {
  147. background-color:#0099FF;
  148. color: #FFFFFF;
  149. font-size: 160%
  150.  
  151. }
  152.  
  153. .green {
  154. background-color:#00CC00;
  155. color: #FFFFFF;
  156. font-size: 120%
  157. }
  158.  
  159. .yellow {
  160. background-color:#FFCC00;
  161. color: #FFFFFF;
  162. font-size: 120%
  163. }
  164.  
  165. .grey {
  166. background-color:#6B727E;
  167. }
  168.  
  169. .blue2 {
  170. background-color:#0068C3;
  171. color: #FFFFFF;
  172. font-size: 160%
  173.  
  174.  
  175.  
  176. </style>
  177.  
  178.  
  179.  
  180. <body bgcolor="#0068C3">
  181. <form id="srrsForm" action="" method="POST" onsubmit="return validateForm()">
  182. <center><table bgcolor="white" cellpadding="3">
  183.  
  184. <tr><td colspan="2" class="white"><center><img src="images/publicreqtop.png"></center></td></tr>
  185. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="4"><center><b>*YOU MUST USE* Firefox or Chrome to fill out this form</b></center></font></td></tr>
  186. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="4"><center><b><a href="images/Ninite_Firefox_Installer.exe"><img src="images/firefox_download_badge.png"></a><a href="images/Ninite_Java_Installer.exe"><img src="images/Java_Self_Install.png"></b></center></font></td></tr>
  187. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="5"><center><b>Your School Information</b></center></font></td></tr>
  188. <tr><td><font face="arial"><b>Your School:</b></font></td><td><input type="text" name="yourschool" value="<?php if (!empty($_POST['yourschool'])) { echo htmlentities($_POST['yourschool']); } ?>"/></tr></td>
  189. <tr><td><font face="arial"><b>Mailing Address:</b></font></td><td><input type="text" name="mailingaddress" value="<?php if (!empty($_POST['mailingaddress'])) { echo htmlentities($_POST['mailingaddress']); } ?>"/></tr></td>
  190. <tr><td><font face="arial"><b>City:</b> </font></td><td><input type="text" name="city" value="<?php if (!empty($_POST['city'])) { echo htmlentities($_POST['city']); } ?>"/></tr></td>
  191. <tr><td><font face="arial"><b>Enter Province (Requested Format: example AB)</b></font> </td><td><input type="text" name="province" maxlength="2" pattern="[A-Z]{2}" title="(Province: AB or BC etc.)" value="<?php if (!empty($_POST['province'])) { echo htmlentities($_POST['province']); } ?>"/></tr></td>
  192. <tr><td><font face="arial"><b>Postal Code:</b></font> </td><td><input type="text" name="postcode" value="<?php if (!empty($_POST['postcode'])) { echo htmlentities($_POST['postcode']); } ?>"/></tr></td>
  193. <tr><td><font face="arial"><b>School Phone Number:</b></font> </td><td><input type="tel" pattern="[\(]\d{3}[\)]\d{3}[\-]\d{4}" title="Phone Number (Format: (780)555-4444)" name="schoolphone" value="<?php if (!empty($_POST['schoolphone'])) { echo htmlentities($_POST['schoolphone']); } ?>"/></tr></td>
  194. <tr><td><font face="arial"><b>Contact Name:</b> </font></td><td><input type="text" name="cname" value="<?php if (!empty($_POST['cname'])) { echo htmlentities($_POST['cname']); } ?>"/></tr></td>
  195. <tr><td><font face="arial"><b>Email address:</b> </font></td><td><input type="email" name="email" value="<?php if (!empty($_POST['email'])) { echo htmlentities($_POST['email']); } ?>"/></tr></td>
  196. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="5"><center><b>Requested Student Information</b></center></font></td></tr>
  197. <tr><td><font face="arial"><b>Last Name:</b> </font></td><td><input type="text" name="legname" value="<?php if (!empty($_POST['legname'])) { echo htmlentities($_POST['legname']); } ?>"/></tr></td>
  198. <tr><td><font face="arial"><b>Given Name:</b> </font></td><td><input type="text" name="givenname" value="<?php if (!empty($_POST['givenname'])) { echo htmlentities($_POST['givenname']); } ?>"/></tr></td>
  199. <tr><td><font face="arial"><b>Middle Name:</b> </font></td><td><input type="text" name="middlename" value="<?php if (!empty($_POST['middlename'])) { echo htmlentities($_POST['middlename']); } ?>"/></tr></td>
  200. <tr><td><font face="arial"><b>ASN</b> <font size="1"><b>(Enter ASN if known, otherwise leave blank):</b></font></b></font></td><td><input type="text" name="asn" value="<?php if (!empty($_POST['asn'])) { echo htmlentities($_POST['asn']); } ?>"/></tr></td>
  201. <tr><td><font face="arial"><b>DOB</b> <b><font size="1">(Please use Month, Day, Year IE: 09/20/1983 :</font></b></font></td><td><input type="text" name="dob" value="<?php if (!empty($_POST['dob'])) { echo htmlentities($_POST['dob']); } ?>"/></tr></td>
  202. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="5"><center><b>Choose your Login Information (IE: Username and Password)</b></center></font></td></tr>
  203. <tr><td><font face="arial"><b>Enter the Username you want to use: [Minimum 6 characters-no caps or special characters]</b> </font></td><td><input type="text" name="username" pattern="[a-z0-9]{6,15}" title="Username (Format: Minimum 6 characters, Letters and Numbers, No Special Characters Allowed)" value="<?php if (!empty($_POST['username'])) { echo htmlentities($_POST['username']); } ?>"/></tr></td>
  204. <tr><td><font face="arial"><b>Enter the Password you want to use: [Minimum 6 characters-no caps or special characters]</b> </font></td><td><input type="text" pattern="[a-z0-9]{6,15}" name="password" title="Username (Format: Minimum 6 characters, Letters and Numbers, No Special Characters Allowed)" value="<?php if (!empty($_POST['password'])) { echo htmlentities($_POST['password']); } ?>"/></tr></td>
  205. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="2"><center><b>Before Submitting the Request Form, please prove you are Human by typing the words below</b></center></font></td></tr>
  206. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="2"><center><b>CAPTCHA check</b> (six letter code)</center></font></td></tr>
  207. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="2"><center><img src="captcha.php" alt="captcha image"></center></font></td></tr>
  208. <tr><td colspan="2" class="blue2"><font face="arial" color="white" size="2"><center><input type="text" name="captcha" size="20" maxlength="6"></center></font></td></tr>
  209.  
  210. <tr><td colspan="2"><center><button id="submit">Request Information</center> </button></td></tr>
  211. <tr><td colspan="2" class="white"><center><img src="images/publicreqtop.png"></center></td></tr>
  212. </table></center>
  213. </form>
  214.  
  215. <div id="srrs"></div>
  216.  
  217. </body>
  218. </html>
  219.  
  220. <?php
  221.  
  222.  
  223. include_once('db.php');
  224.  
  225. $province = mysql_real_escape_string( $_POST['province'] );
  226. $city = mysql_real_escape_string( $_POST['city'] );
  227. $yourschool = mysql_real_escape_string( $_POST['yourschool'] );
  228. $mailingaddress = mysql_real_escape_string( $_POST['mailingaddress'] );
  229. $postcode = mysql_real_escape_string( $_POST['postcode'] );
  230. $schoolphone = mysql_real_escape_string( $_POST['schoolphone'] );
  231. $cname = mysql_real_escape_string( $_POST['cname'] );
  232. $email = mysql_real_escape_string( $_POST['email'] );
  233. $legname = mysql_real_escape_string( $_POST['legname'] );
  234. $givenname = mysql_real_escape_string( $_POST['givenname'] );
  235. $middlename = mysql_real_escape_string( $_POST['middlename'] );
  236. $asn = mysql_real_escape_string( $_POST['asn'] );
  237. $dob = mysql_real_escape_string( $_POST['dob'] );
  238. $username = mysql_real_escape_string( $_POST['username'] );
  239. $password = mysql_real_escape_string( $_POST['password'] );
  240.  
  241. $sql = "INSERT INTO srrsrequest VALUES('',
  242. '$province',
  243. '$city',
  244. '$yourschool',
  245. '$mailingaddress',
  246. '$postcode',
  247. '$schoolphone',
  248. '$cname',
  249. '$email',
  250. '$legname',
  251. '$givenname',
  252. '$middlename',
  253. '$asn',
  254. '$dob',
  255. '$username',
  256. '$password',
  257. '')";
  258.  
  259.  
  260. // Your code here to handle a successful verification
  261. //*if captcha code is posted*//
  262.  
  263. if(isset($_POST["captcha"])) {
  264. if($_SESSION["captcha"]==strtolower($_POST["captcha"])) {
  265. if(mysql_query($sql)) {
  266. //Envoke this setting for Javascript popup of success message, not currently needed because of forward.
  267. //echo "<script type='text/javascript'>alert('submitted successfully, The records manager will provide you with your record within 3 days!')</script>";
  268. //mail('somebody@me.com', 'SRRS - New Records Await Processing', 'SRRS - There are new records for processing in the System' );
  269. //$to = 'somebody@me.com' . ', ';
  270. //$to .= $email;
  271. $to = "somebody@me.com";
  272. $subject = "New Student Record Await Processing";
  273. $message = "New Student Record Requests have been submitted and Await Processing";
  274. $from = "noreplay.srrs@me.com";
  275. $headers = "From:" . $from;
  276. mail($to,$subject,$message,$headers);
  277. //Envoke this setting for successfull transmission of information, if needed in future, not needed because of printf redirect on successful submission.
  278. //echo "<script type='text/javascript'>alert('An Email Has to sent from the Records Management System to the Records Management Administrator for Processing.')</script>";
  279. //Mail the user
  280. $to = $email;
  281. $subject = " NOTIFICATION - Your new record request has been submitted.";
  282. $message = " - Your new record request for $givenname, $legname has been submitted, It will be procssed within 3 working days";
  283. $from = "noreplay.yes@me.com";
  284. $headers = "From:" . $from;
  285. mail($to,$subject,$message,$headers);
  286. printf("<script>location.href='confirmed.php'</script>");
  287. } else {
  288. // Echo problems with Sql
  289. }
  290. } else {
  291. echo "<script type='text/javascript'>alert('Human Verification not entered properly! Please try again!')</script>";
  292. }
  293. }
  294. ?>
Advertisement
Add Comment
Please, Sign In to add comment
Advertisement
Public Pastes
Advertisement
We use cookies for various purposes including analytics. By continuing to use Pastebin, you agree to our use of cookies as described in the Cookies Policy.  OK, I Understand
Not a member of Pastebin yet?
Sign Up, it unlocks many cool features!