Location: PHPKode > projects > Gsys > admin/pledge_add.php
<?PHP
//Filename :  pledge_add.php
//Description : Form to gather the information about the new pledge to inset into database
//Author :  darc
//Last modified :  2006.12.20
    include '../includes/auth_pledge_ed.php'; //authenticate
?>

<html>
<head><title>Add Pledge to Database</title></head>
<body>
<br /><br />
<p><a href="pledge_man.php">Return Pledge Administration</a></p>
<br /><br />
<strong>Add Pledge to Database:</strong><br /><br />
<em>Follow input formattings provided</em><br />
<em>* indicates a required field</em><br /><br />

<!-- start form -->
<form method="post" action="pledge_functions.php?cat=add">
*First Name: <INPUT TYPE="text" NAME="f_name" SIZE="30"><br />
Middle Name: <INPUT TYPE="text" NAME="m_name" SIZE="30"><br />
*Last Name: <INPUT TYPE="text" NAME="l_name" SIZE="30"><br />
*Desired Username:  <INPUT TYPE="text" NAME="username" SIZE="30"><br />
*Password:  <INPUT TYPE="text" NAME="password" SIZE="30"><br />
*E-mail:  <INPUT TYPE="text" NAME="email" SIZE="30"><br />
Nickname: <INPUT TYPE="text" NAME="nickname" SIZE="30"><br />
*Phone Number: <INPUT TYPE="text" NAME="phone" SIZE="30" value="XXX-XXX-XXXX"><br />
Address: <INPUT TYPE="text" NAME="address" SIZE="30" value="123 Monkey Street"><br />
Town:  <INPUT TYPE="text" NAME="town" SIZE="30" value="Russellville"><br />
State:  <INPUT TYPE="text" NAME="state" SIZE="4" value="AR"><br />
Zip Code:  <INPUT TYPE="text" NAME="zip" SIZE="10"><br />
*Social Security Number:  <INPUT TYPE="text" NAME="ssn" SIZE="11" value="XXX-XX-XXXX"><br />
*STU#:  <INPUT TYPE="text" NAME="stu_num" SIZE="8" value="stuXXXXX"><br />
Date of Birth:  <INPUT TYPE="text" NAME="dob" SIZE="11" value="YYYY-MM-DD"><br />
On or Off Campus Residency: 
<input type="radio" name="on_off_campus" value="on" checked>On Campus 
<input type="radio" name="on_off_campus" value="off"> Off Campus 
<br /><br />
<INPUT TYPE="SUBMIT" NAME="submit" VALUE="Add Pledge">
</form>


<p><a href="pledge_man.php">Return Pledge Administration</a></p>
</body>
</html>
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