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  1. class qfpregister extends WP_Widget
  2. {
  3. static private $login_registration_status;
  4. static function registration_form()
  5. {
  6. $username = esc_attr($_POST['username']);
  7. $password = esc_attr($_POST['password']);
  8. $firstname = esc_attr($_POST['firstname']);
  9. $middlename = esc_attr($_POST['middlename']);
  10. $lastname = esc_attr($_POST['lastname']);
  11. $companyname = esc_attr($_POST['companyname']);
  12. $dateofbirth = esc_attr($_POST['dateofbirth']);
  13. $ssn = esc_attr($_POST['ssn']);
  14. $workaddress1 = esc_attr($_POST['workaddress1']);
  15. $workaddress2 = esc_attr($_POST['workaddress2']);
  16. $workcity = esc_attr($_POST['workcity']);
  17. $workstate = esc_attr($_POST['workstate']);
  18. $workzipcode = esc_attr($_POST['workzipcode']);
  19. $homeaddress1 = esc_attr($_POST['homeaddress1']);
  20. $homeaddress2 = esc_attr($_POST['homeaddress2']);
  21. $homecity = esc_attr($_POST['homecity']);
  22. $homestate = esc_attr($_POST['homestate']);
  23. $homezipcode = esc_attr($_POST['homezipcode']);
  24. $phone = esc_attr($_POST['phone']);
  25. $fax = esc_attr($_POST['fax']);
  26. $email = esc_attr($_POST['email']);
  27. $website = esc_attr($_POST['website']);
  28. $biography = esc_attr($_POST['biography']);
  29. $photofilename = esc_attr($_POST['photofilename']);
  30. $billingsameashome = esc_attr($_POST['billingsameashome']);
  31. $billingsameaswork = esc_attr($_POST['billingsameaswork']);
  32. $chfcearneddate = esc_attr($_POST['chfcearneddate']);
  33. $chfccert = esc_attr($_POST['chfccert']);
  34. $pfsearneddate = esc_attr($_POST['pfsearneddate']);
  35. $pfscert = esc_attr($_POST['pfscert']);
  36. $msfsearneddate = esc_attr($_POST['msfsearneddate']);
  37. $msfscert = esc_attr($_POST['msfscert']);
  38. $msearneddate = esc_attr($_POST['msearneddate']);
  39. $mscert = esc_attr($_POST['mscert']);
  40. $qfpearneddate = esc_attr($_POST['qfpearneddate']);
  41. $qfpcert = esc_attr($_POST['qfpcert']);
  42. $othercreds = esc_attr($_POST['othercreds']);
  43. $regtype = esc_attr($_POST['regtype']);
  44. $ccnumber = esc_attr($_POST['ccnumber']);
  45. $ccexpmonth = esc_attr($_POST['ccexpmonth']);
  46. $ccexpyear = esc_attr($_POST['ccexpyear']);
  47. $cvvnumber = esc_attr($_POST['cvvnumber']);
  48. $html =
  49. '<div>';
  50. $html .= '<!-- Nav Tabs -->';
  51. $html .= '<ul class="nav nav-tabs" role="tablist">';
  52. $html .= '<li role="presentation" class="active"><a href="#contactinfo" aria-controls="contactinfo" role="tab"
  53. data-toggle="tab">Contact Info</a></li>';
  54. $html .= '<li role="presentation"><a href="#designations" aria-controls="designations" role="tab"
  55. data-toggle="tab">Underlying Qualifying Designations</a></li>';
  56. $html .= '<li role="presentation"><a href="#attestation" aria-controls="attestation" role="tab"
  57. data-toggle="tab">Attestation</a></li>';
  58. $html .= '</ul>';
  59. $html .= '</div>';
  60. $html .= '<div class="tab-content">';
  61. $html .= '<div role="tabpanel" class="tab-pane active container-fluid" id="contactinfo">';
  62. $html .= '<form action = "' . $_SERVER['REQUEST_URI'] . '" method = "post" enctype="multipart/form-data">';
  63. $html .= '<div class = "row">';
  64. $html .= '<div class="col-md-3">';
  65. $html .= '<label for = "username">Username <strong>*</strong></label>';
  66. $html .= '<input type = "text" name = "username" placeholder = "username">';
  67. $html .= '</div>';
  68. $html .= '<div class="col-md-3">';
  69. $html .= '<label for = "firstname">First Name <strong>*</strong></label>';
  70. $html .= '<input type = "text" name = "firstname" placeholder = "firstname">';
  71. $html .= '</div>';
  72. $html .= '<div class="col-md-3">';
  73. $html .= '<label for = "middlename">Middle Name </label>';
  74. $html .= '<input type = "text" name = "middlename" placeholder = "middlename">';
  75. $html .= '</div>';
  76. $html .= '<div class="col-md-3">';
  77. $html .= '<label for = "lastname">Last Name <strong>*</strong></label>';
  78. $html .= '<input type="text" name="lastname" placeholder= "lastname">';
  79. $html .= '</div>';
  80. $html .= '</div>';
  81. $html .= '<div class="row">';
  82. $html = '<div class="col-md-3">';
  83. $html .= '<label for = "passowrd">Password <strong>*</strong></label>';
  84. $html .= '<input type = "password" name = "password" placeholder = "password">';
  85. $html .= '</div>';
  86. $html .= '<div class="col-md-3">';
  87. $html .= '<label for = "companyname">Company Name</label>';
  88. $html .= '<input type="text" name="companyname" placeholder = "companyname">';
  89. $html .= '</div>';
  90. $html .= '<div class="col-md-3">';
  91. $html .= '<label for="dateofbirth">Date of Birth <strong>*</strong></label>';
  92. $html .= '<input type="date" name="dateofbirth" placeholder = "dateofbirth">';
  93. $html .= '</div>';
  94. $html .= '<div class="col-md-3">';
  95. $html .= '<label for="ssn">Social Security Number <strong>*</strong></label>';
  96. $html .= '<input pattern="{d3}-{d2}-{d4}" name="ssn" placeholder = "ssn">';
  97. $html .= '</div>';
  98. $html .= '</div>';
  99. $html .= '<div class="row">';
  100. $html .= '<div class="col-md-3">';
  101. $html .= '<label for = "phone">Phone Number <strong>*</strong></label>';
  102. $html .= '<input type="text" name="phone" placeholder = "phone">';
  103. $html .= '</div>';
  104. $html .= '<div class="col-md-3">';
  105. $html .= '<label for = "fax">Fax</label>';
  106. $html .= '<input type="text" name = "fax" placeholder = "fax">';
  107. $html .= '</div>';
  108. $html .= '<div class="col-md-3">';
  109. $html .= '<label for="email">Email <strong>*</strong></label>';
  110. $html .= '<input type="text" name = "email" placeholder = "email">';
  111. $html .= '</div>';
  112. $html .= '<div class="col-md-3">';
  113. $html .= '<label for="website">Website</label>';
  114. $html .= '<input type="text" name="website" placeholder ="website">';
  115. $html .= '</div>';
  116. $html .= '</div>';
  117. $html .= '<div class="row">';
  118. $html .= '<div class="col-md-3">';
  119. $html .= '<label><strong>Business Address</strong></label>';
  120. $html .= '</div>';
  121. $html .= '<div class="col-md-3">';
  122. $html .= '<label><strong>Home Address</strong></label>';
  123. $html .= '</div>';
  124. $html .= '</div>';
  125. $html .= '<div class="row">';
  126. $html .= '<div class="col-md-3">';
  127. $html .= '<label for="workaddress1">Business Address 1</label>';
  128. $html .= '<input type="text" name="workaddress1" placeholder ="workaddress1">';
  129. $html .= '</div>';
  130. $html .= '<div class="col-md-3">';
  131. $html .= '<label for="homeaddress1">Home Address 1</label>';
  132. $html .= '<input type="text" name="homeaddress1" placeholder ="homeaddress1">';
  133. $html .= '</div>';
  134. $html .= '<div class="col-md-3">';
  135. $html .= '<label for="bio">Biography / Areas of Specialty</label>';
  136. $html .= '<input type="text" name="bio" placeholder = "bio">';
  137. $html .= '</div>';
  138. $html .= '</div>';
  139. $html .= '<div class="row">';
  140. $html .= '<div class="col-md-3">';
  141. $html .= '<label for="workaddress2">Business Address 2</label>';
  142. $html .= '<input type="text" name="workaddress2" placeholder ="workaddress2">';
  143. $html .= '</div>';
  144. $html .= '<div class="col-md-3">';
  145. $html .= '<label for="homeaddress2">Home Address 2</label>';
  146. $html .= '<input type="text" name="homeaddress2" placeholder ="homeaddress2">';
  147. $html .= '</div>';
  148. $html .= '</div>';
  149. $html .= '<div class="row">';
  150. $html .= '<div class="col-md-3">';
  151. $html .= '<label for="workcity">City</label>';
  152. $html .= '<input type="text" name="workcity" placeholder ="workcity">';
  153. $html .= '</div>';
  154. $html .= '<div class="col-md-3">';
  155. $html .= '<label for="homecity">City</label>';
  156. $html .= '<input type="text" name="homecity" placeholder ="homecity">';
  157. $html .= '</div>';
  158. $html .= '</div>';
  159. $html .= '<div class="row">';
  160. $html .= '<div class="col-md-3">';
  161. $html .= '<label for="workstate">State</label>';
  162. $html .= '<select name="workstate" type="text">';
  163. $html .= '<option value="">Select...</option>';
  164. $html .= '<option value="AL">Alabama</option>';
  165. $html .= '<option value="AK">Alaska</option>';
  166. $html .= '<option value="AZ">Arizona</option>';
  167. $html .= '<option value="AR">Arkansas</option>';
  168. $html .= '<option value="CA">California</option>';
  169. $html .= '<option value="CO">Colorado</option>';
  170. $html .= '<option value="CT">Connecticut</option>';
  171. $html .= '<option value="DC">District of Columbia</option>';
  172. $html .= '<option value="DE">Delaware</option>';
  173. $html .= '<option value="FL">Florida</option>';
  174. $html .= '<option value="GA">Georgia</option>';
  175. $html .= '<option value="HI">Hawaii</option>';
  176. $html .= '<option value="ID">Idaho</option>';
  177. $html .= '<option value="IL">Illinois</option>';
  178. $html .= '<option value="IN">Indiana</option>';
  179. $html .= '<option value="IA">Iowa</option>';
  180. $html .= '<option value="KS">Kansas</option>';
  181. $html .= '<option value="KY">Kentucky</option>';
  182. $html .= '<option value="LA">Louisiana</option>';
  183. $html .= '<option value="ME">Maine</option>';
  184. $html .= '<option value="MD">Maryland</option>';
  185. $html .= '<option value="MA">Massachusetts</option>';
  186. $html .= '<option value="MI">Michigan</option>';
  187. $html .= '<option value="MN">Minnesota</option>';
  188. $html .= '<option value="MS">Mississippi</option>';
  189. $html .= '<option value="MO">Missouri</option>';
  190. $html .= '<option value="MT">Montana</option>';
  191. $html .= '<option value="NE">Nebraska</option>';
  192. $html .= '<option value="NV">Nevada</option>';
  193. $html .= '<option value="NH">New Hampshire</option>';
  194. $html .= '<option value="NJ">New Jersey</option>';
  195. $html .= '<option value="NM">New Mexico</option>';
  196. $html .= '<option value="NY">New York</option>';
  197. $html .= '<option value="NC">North Carolina</option>';
  198. $html .= '<option value="ND">North Dakota</option>';
  199. $html .= '<option value="OH">Ohio</option>';
  200. $html .= '<option value="OK">Oklahoma</option>';
  201. $html .= '<option value="OR">Oregon</option>';
  202. $html .= '<option value="PA">Pennsylvania</option>';
  203. $html .= '<option value="RI">Rhode Island</option>';
  204. $html .= '<option value="SC">South Carolina</option>';
  205. $html .= '<option value="SD">South Dakota</option>';
  206. $html .= '<option value="TN">Tennessee</option>';
  207. $html .= '<option value="TX">Texas</option>';
  208. $html .= '<option value="UT">Utah</option>';
  209. $html .= '<option value="VA">Virginia</option>';
  210. $html .= '<option value="VT">Vermont</option>';
  211. $html .= '<option value="WA">Washington</option>';
  212. $html .= '<option value="WV">West Virginia</option>';
  213. $html .= '<option value="WI">Wisconsin</option>';
  214. $html .= '<option value="WY">Wyoming</option>';
  215. $html .= '</select>';
  216. $html .= '</div>';
  217. $html .= '<div class="col-md-3">';
  218. $html .= '<label for="homestate">State</label>';
  219. $html .= '<select name="homestate" type="text">';
  220. $html .= '<option value="">Select...</option>';
  221. $html .= '<option value="AL">Alabama</option>';
  222. $html .= '<option value="AK">Alaska</option>';
  223. $html .= '<option value="AZ">Arizona</option>';
  224. $html .= '<option value="AR">Arkansas</option>';
  225. $html .= '<option value="CA">California</option>';
  226. $html .= '<option value="CO">Colorado</option>';
  227. $html .= '<option value="CT">Connecticut</option>';
  228. $html .= '<option value="DC">District of Columbia</option>';
  229. $html .= '<option value="DE">Delaware</option>';
  230. $html .= '<option value="FL">Florida</option>';
  231. $html .= '<option value="GA">Georgia</option>';
  232. $html .= '<option value="HI">Hawaii</option>';
  233. $html .= '<option value="ID">Idaho</option>';
  234. $html .= '<option value="IL">Illinois</option>';
  235. $html .= '<option value="IN">Indiana</option>';
  236. $html .= '<option value="IA">Iowa</option>';
  237. $html .= '<option value="KS">Kansas</option>';
  238. $html .= '<option value="KY">Kentucky</option>';
  239. $html .= '<option value="LA">Louisiana</option>';
  240. $html .= '<option value="ME">Maine</option>';
  241. $html .= '<option value="MD">Maryland</option>';
  242. $html .= '<option value="MA">Massachusetts</option>';
  243. $html .= '<option value="MI">Michigan</option>';
  244. $html .= '<option value="MN">Minnesota</option>';
  245. $html .= '<option value="MS">Mississippi</option>';
  246. $html .= '<option value="MO">Missouri</option>';
  247. $html .= '<option value="MT">Montana</option>';
  248. $html .= '<option value="NE">Nebraska</option>';
  249. $html .= '<option value="NV">Nevada</option>';
  250. $html .= '<option value="NH">New Hampshire</option>';
  251. $html .= '<option value="NJ">New Jersey</option>';
  252. $html .= '<option value="NM">New Mexico</option>';
  253. $html .= '<option value="NY">New York</option>';
  254. $html .= '<option value="NC">North Carolina</option>';
  255. $html .= '<option value="ND">North Dakota</option>';
  256. $html .= '<option value="OH">Ohio</option>';
  257. $html .= '<option value="OK">Oklahoma</option>';
  258. $html .= '<option value="OR">Oregon</option>';
  259. $html .= '<option value="PA">Pennsylvania</option>';
  260. $html .= '<option value="RI">Rhode Island</option>';
  261. $html .= '<option value="SC">South Carolina</option>';
  262. $html .= '<option value="SD">South Dakota</option>';
  263. $html .= '<option value="TN">Tennessee</option>';
  264. $html .= '<option value="TX">Texas</option>';
  265. $html .= '<option value="UT">Utah</option>';
  266. $html .= '<option value="VA">Virginia</option>';
  267. $html .= '<option value="VT">Vermont</option>';
  268. $html .= '<option value="WA">Washington</option>';
  269. $html .= '<option value="WV">West Virginia</option>';
  270. $html .= '<option value="WI">Wisconsin</option>';
  271. $html .= '<option value="WY">Wyoming</option>';
  272. $html .= '</select>';
  273. $html .= '</div>';
  274. $html .= '</div>';
  275. $html .= '<div class="row">';
  276. $html .= '<div class="col-md-3">';
  277. $html .= '<label for "workzip">Work Zip Code</label>';
  278. $html .= '<input type="text" name="workzip" placeholder ="workzip"/>';
  279. $html .= '</div>';
  280. $html .= '<div class="col-md-3">';
  281. $html .= '<label for="homezip">Home Zip Code</label>';
  282. $html .= '<input type="text" name="homezip" placeholder ="homezip"/>';
  283. $html .= '</div>';
  284. $html .= '<div class="col-md-3">';
  285. $html .= '<label for="billingsameashome">Billing Address Same as Home Address?</label>';
  286. $html .= '<input type="checkbox" name="billingsameashome" placeholder ="billingsameashome"/><br/>';
  287. $html .= '<label for="billingsameaswork">Billing Address Same as Work Address?</label>';
  288. $html .= '<input type="checkbox" name="billingsameaswork" placeholder ="billingsameaswork"/><br/>';
  289. $html .= '</div';
  290. $html .= '<div class="col-md-3">';
  291. $html .= '<label for="photologfilename">Photo/Logo Filename</label>';
  292. $html .= '<input type="file" name="photologfilename" placeholder ="photologofilename"/>';
  293. $html .= '<input type="submit" name="contactnext"/>';
  294. $html .= '</div>';
  295. $html .= '</div>'; // close tabpane
  296. $html .= '<div role="tabpanel" class="tab-pane container-fluid id="designations>';
  297. $html .= '<div class="row">';
  298. $html .= '<div class="col-md-3">';
  299. $html .= '<input type="checkbox" name="chfcbox" placeholder ="chfcbox" />';
  300. $html .= '<label for="chfcbox">ChFC&copy; (The American College)</label>';
  301. $html .= '</div>';
  302. $html .= '<div class="col-md-3">';
  303. $html .= '<label for="chfcdate">Date Earned</label>';
  304. $html .= '<input type="date" name="chfcdate" placeholder ="chfcdate"/>';
  305. $html .= '</div>';
  306. $html .= '<div class="col-md-3">';
  307. $html .= '<label for="chfccert">Certificate#</label>';
  308. $html .= '<input type="text" name="chfccert" placeholder ="chfccert"/>';
  309. $html .= '</div>';
  310. $html .= '</div>';
  311. $html .= '<div class="row">';
  312. $html .= '<div class="col-md-3">';
  313. $html .= '<input type="checkbox" name="pfsbox" placeholder ="pfsbox" />';
  314. $html .= '<label for="pfsbox">PFS&trade; (AICPA - American Institute of CPAs)</label>';
  315. $html .= '</div>';
  316. $html .= '<div class="col-md-3">';
  317. $html .= '<label for="pfsdate">Date Earned</label>';
  318. $html .= '<input type="date" name="pfsdate" placeholder ="pfsdate"/>';
  319. $html .= '</div>';
  320. $html .= '<div class="col-md-3">';
  321. $html .= '<label for="pfscert">Certificate#</label>';
  322. $html .= '<input type="text" name="pfscert" placeholder ="pfscert"/>';
  323. $html .= '</div>';
  324. $html .= '</div>';
  325. $html .= '<div class="row">';
  326. $html .= '<div class="col-md-3">';
  327. $html .= '<input type="checkbox" name="pfsbox" placeholder ="pfsbox" />';
  328. $html .= '<label for="pfsbox">PFS&trade; (AICPA - American Institute of CPAs)</label>';
  329. $html .= '</div>';
  330. $html .= '<div class="col-md-3">';
  331. $html .= '<label for="pfsdate">Date Earned</label>';
  332. $html .= '<input type="date" name="pfsdate" placeholder ="pfsdate"/>';
  333. $html .= '</div>';
  334. $html .= '<div class="col-md-3">';
  335. $html .= '<label for="pfscert">Certificate#</label>';
  336. $html .= '<input type="text" name="pfscert" placeholder ="pfscert"/>';
  337. $html .= '</div>';
  338. $html .= '</div>';
  339. $html .= '<div class="row">';
  340. $html .= '<div class="col-md-3">';
  341. $html .= '<input type="checkbox" name="cfpbox" placeholder ="cfpbox" />';
  342. $html .= '<label for="pfsbox">CFP&copy; (CFP Board)</label>';
  343. $html .= '</div>';
  344. $html .= '<div class="col-md-3">';
  345. $html .= '<label for="cfpdate">Date Earned</label>';
  346. $html .= '<input type="date" name="cfpdate" placeholder ="cfpdate"/>';
  347. $html .= '</div>';
  348. $html .= '<div class="col-md-3">';
  349. $html .= '<label for="cfpcert">Certificate#</label>';
  350. $html .= '<input type="text" name="cfpcert" placeholder ="cfpcert"/>';
  351. $html .= '</div>';
  352. $html .= '</div>';
  353. $html .= '<div class="row">';
  354. $html .= '<div class="col-md-3">';
  355. $html .= '<input type="checkbox" name="msfsbox" placeholder ="msfsbox" />';
  356. $html .= '<label for="msfsbox">MSFS (The American College)</label>';
  357. $html .= '</div>';
  358. $html .= '<div class="col-md-3">';
  359. $html .= '<label for="msfsdate">Date Earned</label>';
  360. $html .= '<input type="date" name="msfsdate" placeholder ="msfsdate"/>';
  361. $html .= '</div>';
  362. $html .= '<div class="col-md-3">';
  363. $html .= '<label for="msfscert">Certificate#</label>';
  364. $html .= '<input type="text" name="msfscert" placeholder ="msfscert"/>';
  365. $html .= '</div>';
  366. $html .= '</div>';
  367. $html .= '<div class="row">';
  368. $html .= '<div class="col-md-3">';
  369. $html .= '<input type="checkbox" name="msbox" placeholder ="msbox" />';
  370. $html .= '<label for="msbox">MS (College for Financial Planning)</label>';
  371. $html .= '</div>';
  372. $html .= '<div class="col-md-3">';
  373. $html .= '<label for="msdate">Date Earned</label>';
  374. $html .= '<input type="date" name="msdate" placeholder ="msdate"/>';
  375. $html .= '</div>';
  376. $html .= '<div class="col-md-3">';
  377. $html .= '<label for="mscert">Certificate#</label>';
  378. $html .= '<input type="text" name="mscert" placeholder ="mscert"/>';
  379. $html .= '</div>';
  380. $html .= '</div>';
  381. $html .= '<div class="row">';
  382. $html .= '<div class="col-md-3">';
  383. $html .= '<input type="checkbox" name="pfsbox" placeholder ="pfsbox" />';
  384. $html .= '<label for="pfsbox">PFS&trade; (AICPA - American Institute of CPAs)</label>';
  385. $html .= '</div>';
  386. $html .= '<div class="col-md-3">';
  387. $html .= '<label for="pfsdate">Date Earned</label>';
  388. $html .= '<input type="date" name="pfsdate" placeholder ="pfsdate"/>';
  389. $html .= '</div>';
  390. $html .= '<div class="col-md-3">';
  391. $html .= '<label for="pfscert">Certificate#</label>';
  392. $html .= '<input type="text" name="pfscert" placeholder ="pfscert"/>';
  393. $html .= '</div>';
  394. $html .= '<hr>';
  395. $html .= '</div>';
  396. $html .= '<div class="row">';
  397. $html .= '<div class="col-md-3">';
  398. $html .= '<input type="checkbox" name="qfpbox" placeholder ="qfpbox" />';
  399. $html .= '<label for="qfpbox">QFP (Qualified Financial Planner)</label>';
  400. $html .= '</div>';
  401. $html .= '<div class="col-md-3">';
  402. $html .= '<label for="qfpdate">Date Earned</label>';
  403. $html .= '<input type="date" name="qfpdate" placeholder ="qfpdate"/>';
  404. $html .= '</div>';
  405. $html .= '<div class="col-md-3">';
  406. $html .= '<label for="qfpcert">Certificate#</label>';
  407. $html .= '<input type="text" name="qfpcert" placeholder ="qfpcert"/>';
  408. $html .= '</div>';
  409. $html .= '</div>';
  410. $html .= '<div class="row">';
  411. $html .= '<div class="col-md-3">';
  412. $html .= '<label for="othercreds">Other Credentials or Designations (e.g. CPA, CLU, Esq.)</label>';
  413. $html .= '<input type="text" name="othercreds" placeholder ="othercreds"/>';
  414. $html .= '</div>';
  415. $html .= '<div class="col-md-3">';
  416. $html .= '<input type="submit" name="designationnext" value="Next"/>';
  417. $html .= '</div>';
  418. $html .= '</div>';
  419. $html .= '</div>'; // close designations tab
  420. $html .= '<div role="tabpanel" class="tab-pane container-fluid" id="attestation">';
  421. $html .= '<div class="row">';
  422. $html .= '<div class="col-md-3">';
  423. $html .= '<div class="btn-group" data-toggle="buttons">';
  424. $html .= '<label class="btn btn-primary">';
  425. $html .= '<input type="radio" name="options" id="membership">Membership (Includes Full Listing in QFP Registry):';
  426. $html .= '</label>';
  427. $html .= '<label class="btn btn-primary">';
  428. $html .= '<input type="radio" name="options" id="nonmember">Non-Membership / QFP Registrant Only:>';
  429. $html .= '</label>';
  430. $html .= '<label class="btn btn-primary">';
  431. $html .= '<input type="radio" name="options" id="nocharge">N/C for First Year QFP Registry Registrants (Includes Name & QFP Only - Must select Membership Above for Full Registry Lising):>';
  432. $html .= '</label>';
  433. $html .= '</div>';
  434. $html .= '</div>';
  435. $html .= '<div class="col-md-3">';
  436. $html .= '<label for="ccnumber">Credit Card Number</label>';
  437. $html .= '<input type="text" name="ccnumber" placeholder ="ccnumber"/>';
  438. $html .= '</div>';
  439. $html .= '<div class="col-md-3">';
  440. $html .= '<label for="expmonth">Expiration Month</label>';
  441. $html .= '<select name="expmonth" type="text">';
  442. $html .= '<option value="">Select...</option>';
  443. $html .= '<option value="1">January</option>';
  444. $html .= '<option value="2">February</option>';
  445. $html .= '<option value="3">March</option>';
  446. $html .= '<option value="4">April</option>';
  447. $html .= '<option value="5">May</option>';
  448. $html .= '<option value="6">June</option>';
  449. $html .= '<option value="7">July</option>';
  450. $html .= '<option value="8">August</option>';
  451. $html .= '<option value="9">September</option>';
  452. $html .= '<option value="10">October</option>';
  453. $html .= '<option value="11">November</option>';
  454. $html .= '<option value="12">December</option>';
  455. $html .= '</select>';
  456. $html .= '</div>';
  457. $html .= '<div class="col-md-3">';
  458. $html .= '<label for="expyear">Expiration Year</label>';
  459. $html .= '<select name="expyear" type="text">';
  460. $html .= '<option value="2016">2016</option>';
  461. $html .= '<option value="2017">2017</option>';
  462. $html .= '<option value="2018">2018</option>';
  463. $html .= '<option value="2019">2019</option>';
  464. $html .= '<option value="2020">2020</option>';
  465. $html .= '<option value="2021">2021</option>';
  466. $html .= '<option value="2022">2022</option>';
  467. $html .= '<option value="2023">2023</option>';
  468. $html .= '<option value="2024">2024</option>';
  469. $html .= '<option value="2025">2025</option>';
  470. $html .= '<option value="2026">2026</option>';
  471. $html .= '</select>';
  472. $html .= '<label for="cvvcode">CVV Code</label>';
  473. $html .= '<input type="text" name="cvvcode" placeholder ="cvvcode">';
  474. $html .= '</div>';
  475. $html .= '</div>';
  476. $html .= '<div class="row">';
  477. $html .= '<div class = "col-md-6">';
  478. $html .= '<label border-width="1px">
  479. Next I, ';
  480. echo $firstname;
  481. ' ';
  482. echo $lastname;
  483. ' hereby attest, under penalty of perjury and subject to
  484. a monetary penalty of not less than $10,000, that I hae earned or been granted or one
  485. or more of the herein indicated underlying qualifying designations of
  486. Financial Planning, and that I have not here made any false or misleading
  487. representations.
  488. </label>';
  489. $html .= '</div>';
  490. $html .= '<div class="col-md-6">';
  491. $html .= '<a href="https://iaqfp.org/wp-content/uploads/2016/06/IAQFP-Code-of-Ethics-Professional-Conduct.pdf" target="_blank">IAQFP Code of Ethics and Professional Conduct</a>';
  492. $html .= '<a href="https://iaqfp.org/wp-content/uploads/2016/06/IAQFP-Disciplinary-Procedures-Complaint-Process.pdf" target="_blank">IAQFP Disciplinary Procedures and Complaint Process</a>';
  493. $html .= '<a href="https://iaqfp.org/wp-content/uploads/2016/06/IAQFP-Certified-Financial-Planners-QFP-Designation-Usage-Guidelines.pdf" target="_blank">IAQFP Certified Financial Planner Usage Guidelines</a>';
  494. $html .= '<a href="https://iaqfp.org/wp-content/uploads/2016/06/IAQFP-Continuing-Education-Requirements.pdf" target="_blank">IAQFP Continuing Education Requirements</a>';
  495. $html .= '<a href="https://iaqfp.org/wp-content/uploads/2016/06/IAQFP-Membership-Agreement.pdf" target="_self"> IAQFP Membership Agreement</a>';
  496. $html .= '<input type="submit" name="reg_submit" value="I Agree />';
  497. $html .= '</div>';
  498. $html .= '</div>';
  499. $html .= '</div>'; // close attestation tab
  500. $html .= '</form>';
  501. $html .= '</div>';
  502. $html .= '</div> ';
  503. return $html;
  504. $userdata = array(
  505. 'email'=>$email,
  506. 'username'=>$username,
  507. 'password'=>$password,
  508. );
  509. $userid = wp_insert_user($userdata);
  510. $data = array(
  511. 'firstname'=> $firstname,
  512. 'middlename'=> $middlename,
  513. 'lastname'=> $lastname,
  514. 'workaddress1' => $workaddress1,
  515. 'workaddress2' => $workaddress2,
  516. 'workcity' => $workcity,
  517.  
  518. );
  519. foreach($data as $k => $v){
  520. update_user_meta($userid, $k, v);
  521. }
  522. if(is_wp_error($userid)){
  523. echo 'User registration failed';
  524. }
  525. else{
  526. echo 'User registration succeeded. We will verify credentials and follow up via email.';
  527. }
  528. }
  529.  
  530.  
  531. }
  532.  
  533. function register_qfpform(){
  534. register_widget('registration_form');
  535. add_action('widgets_init', 'register_qfpform');
  536. }
  537.  
  538. }
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