|
Server : Apache/2.4.62 System : FreeBSD fbsdweb2.web.rcn.net 14.1-RELEASE FreeBSD 14.1-RELEASE releng/14.1-n267679-10e31f0946d8 GENERIC amd64 User : www ( 80) PHP Version : 8.3.8 Disable Function : NONE Directory : /domains/highlandlabs/cqi-bin/ALFA_DATA/alfasymlink/root/domains/enrgy/jobs/JobForm7.11.17/ |
Upload File : |
<?php
// if the from is loaded from WordPress form loader plugin,
// the phpfmg_display_form() will be called by the loader
if( !defined('FormmailMakerFormLoader') ){
# This block must be placed at the very top of page.
# --------------------------------------------------
require_once( dirname(__FILE__).'/form.lib.php' );
phpfmg_display_form();
# --------------------------------------------------
};
function phpfmg_form( $sErr = false ){
$style=" class='form_text' ";
?>
<div id='frmFormMailContainer'>
<form name="frmFormMail" id="frmFormMail" target="submitToFrame" action='<?php echo PHPFMG_ADMIN_URL . '' ; ?>' method='post' enctype='multipart/form-data' onsubmit='return fmgHandler.onSubmit(this);'>
<input type='hidden' name='formmail_submit' value='Y'>
<input type='hidden' name='mod' value='ajax'>
<input type='hidden' name='func' value='submit'>
<ol class='phpfmg_form' >
<li class='field_block' id='field_0_div'><div class='col_label'>
<label class='form_field'>Name of Contact</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_0" id="field_0" value="<?php phpfmg_hsc("field_0", ""); ?>" class='text_box'>
<div id='field_0_tip' class='instruction'>Name of Contact</div>
</div>
</li>
<li class='field_block' id='field_1_div'><div class='col_label'>
<label class='form_field'>Agency</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_1" id="field_1" value="<?php phpfmg_hsc("field_1", ""); ?>" class='text_box'>
<div id='field_1_tip' class='instruction'>If applicable</div>
</div>
</li>
<li class='field_block' id='field_2_div'><div class='col_label'>
<label class='form_field'>Company</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_2" id="field_2" value="<?php phpfmg_hsc("field_2", ""); ?>" class='text_box'>
<div id='field_2_tip' class='instruction'>Company</div>
</div>
</li>
<li class='field_block' id='field_3_div'><div class='col_label'>
<label class='form_field'>Address 1</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_3" id="field_3" value="<?php phpfmg_hsc("field_3", ""); ?>" class='text_box'>
<div id='field_3_tip' class='instruction'>Address 1</div>
</div>
</li>
<li class='field_block' id='field_4_div'><div class='col_label'>
<label class='form_field'>Address 2</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_4" id="field_4" value="<?php phpfmg_hsc("field_4", ""); ?>" class='text_box'>
<div id='field_4_tip' class='instruction'>Address 2</div>
</div>
</li>
<li class='field_block' id='field_5_div'><div class='col_label'>
<label class='form_field'>City State Zip</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_5" id="field_5" value="<?php phpfmg_hsc("field_5", ""); ?>" class='text_box'>
<div id='field_5_tip' class='instruction'>City State Zip</div>
</div>
</li>
<li class='field_block' id='field_6_div'><div class='col_label'>
<label class='form_field'>Email Address</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_6" id="field_6" value="<?php phpfmg_hsc("field_6", ""); ?>" class='text_box'>
<div id='field_6_tip' class='instruction'>Email Address</div>
</div>
</li>
<li class='field_block' id='field_7_div'><div class='col_label'>
<label class='form_field'>Phone</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_7" id="field_7" value="<?php phpfmg_hsc("field_7", "Choice 1|Choice 2|Choice 3"); ?>" class='text_box'>
<div id='field_7_tip' class='instruction'>Phone</div>
</div>
</li>
<li class='field_block' id='field_8_div'><div class='col_label'>
<label class='form_field'>Ad Package</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<?php phpfmg_dropdown( 'field_8', "Budget|Basic|Contract A|Contract B|Contract C|Free Trial (new advertisers only)" );?>
<div id='field_8_tip' class='instruction'>Ad Package Select from pulldown</div>
</div>
</li>
<li class='field_block' id='field_9_div'><div class='col_label'>
<label class='form_field'>Contract Term</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<?php phpfmg_dropdown( 'field_9', "One month|Three months|Six months|Other" );?>
<div id='field_9_tip' class='instruction'>Contract Term</div>
</div>
</li>
<li class='field_block' id='field_10_div'><div class='col_label'>
<label class='form_field'>Start Date</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="text" name="field_10" id="field_10" value="<?php phpfmg_hsc("field_10", ""); ?>" class='text_box'>
<div id='field_10_tip' class='instruction'>Start Date</div>
</div>
</li>
<li class='field_block' id='field_11_div'><div class='col_label'>
<label class='form_field'>Ad Copy</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<textarea name="field_11" id="field_11" rows=4 cols=25 class='text_area'><?php phpfmg_hsc("field_11"); ?></textarea>
<div id='field_11_tip' class='instruction'>Put Ad Copy Here</div>
</div>
</li>
<li class='field_block' id='field_12_div'><div class='col_label'>
<label class='form_field'>Ad Copy Upload</label> <label class='form_required' > </label> </div>
<div class='col_field'>
<input type="file" name="field_12" id="field_12" value="" class='text_box' onchange="fmgHandler.check_upload(this);">
<div id='field_12_tip' class='instruction'>Or upload your copy here</div>
</div>
</li>
<li class='field_block' id='phpfmg_captcha_div'>
<div class='col_label'></div><div class='col_field'>
<?php phpfmg_show_captcha(); ?>
</div>
</li>
<li>
<div class='col_label'> </div>
<div class='form_submit_block col_field'>
<input type='submit' value='Submit' class='form_button'>
<div id='err_required' class="form_error" style='display:none;'>
<label class='form_error_title'>Please check the required fields</label>
</div>
<span id='phpfmg_processing' style='display:none;'>
<img id='phpfmg_processing_gif' src='<?php echo PHPFMG_ADMIN_URL . '?mod=image&func=processing' ;?>' border=0 alt='Processing...'> <label id='phpfmg_processing_dots'></label>
</span>
</div>
</li>
</ol>
</form>
<iframe name="submitToFrame" id="submitToFrame" src="javascript:false" style="position:absolute;top:-10000px;left:-10000px;" /></iframe>
</div>
<!-- end of form container -->
<!-- [Your confirmation message goes here] -->
<div id='thank_you_msg' style='display:none;'>
Your form has been sent. Thank you!
</div>
<?php
phpfmg_javascript($sErr);
}
# end of form
function phpfmg_form_css(){
$formOnly = isset($GLOBALS['formOnly']) && true === $GLOBALS['formOnly'];
?>
<style type='text/css'>
<?php
if( !$formOnly ){
echo"
body{
margin-left: 18px;
margin-top: 18px;
}
body{
font-family : Verdana, Arial, Helvetica, sans-serif;
font-size : 13px;
color : #474747;
background-color: transparent;
}
select, option{
font-size:13px;
}
";
}; // if
?>
ol.phpfmg_form{
list-style-type:none;
padding:0px;
margin:0px;
}
ol.phpfmg_form input, ol.phpfmg_form textarea, ol.phpfmg_form select{
border: 1px solid #ccc;
-moz-border-radius: 3px;
-webkit-border-radius: 3px;
border-radius: 3px;
}
ol.phpfmg_form li{
margin-bottom:5px;
clear:both;
display:block;
overflow:hidden;
width: 100%
}
.form_field, .form_required{
font-weight : bold;
}
.form_required{
color:red;
margin-right:8px;
}
.field_block_over{
}
.form_submit_block{
padding-top: 3px;
}
.text_box,.text_select {
height: 32px;
}
.text_box, .text_area, .text_select {
min-width:160px;
max-width:300px;
width: 100%;
margin-bottom: 10px;
}
.text_area{
height:80px;
}
.form_error_title{
font-weight: bold;
color: red;
}
.form_error{
background-color: #F4F6E5;
border: 1px dashed #ff0000;
padding: 10px;
margin-bottom: 10px;
}
.form_error_highlight{
background-color: #F4F6E5;
border-bottom: 1px dashed #ff0000;
}
div.instruction_error{
color: red;
font-weight:bold;
}
hr.sectionbreak{
height:1px;
color: #ccc;
}
#one_entry_msg{
background-color: #F4F6E5;
border: 1px dashed #ff0000;
padding: 10px;
margin-bottom: 10px;
}
#frmFormMailContainer input[type="submit"]{
padding: 10px 25px;
font-weight: bold;
margin-bottom: 10px;
background-color: #FAFBFC;
}
#frmFormMailContainer input[type="submit"]:hover{
background-color: #E4F0F8;
}
<?php phpfmg_text_align();?>
</style>
<?php
}
# end of css
# By: formmail-maker.com
?>