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1 |
[% USE KohaDates %] |
| 2 |
[% SET userupdateview = 1 %] |
| 3 |
|
| 4 |
[% INCLUDE 'doc-head-open.inc' %] |
| 5 |
[% IF ( LibraryNameTitle ) %][% LibraryNameTitle %][% ELSE %]Koha online[% END %] catalog › Your fines and charges |
| 6 |
[% INCLUDE 'doc-head-close.inc' %] |
| 7 |
|
| 8 |
<script type="text/javascript"> |
| 9 |
$(document).ready(function() { |
| 10 |
$( "#borrower_dateofbirth" ).datepicker(); |
| 11 |
}); |
| 12 |
</script> |
| 13 |
</head> |
| 14 |
|
| 15 |
<body id="opac-account"> |
| 16 |
<div id="doc3" class="yui-t1"> |
| 17 |
<div id="bd"> |
| 18 |
[% INCLUDE 'masthead.inc' %] |
| 19 |
|
| 20 |
<div id="yui-main"> |
| 21 |
<div class="yui-b"> |
| 22 |
<div class="yui-g"> |
| 23 |
<div id="useraccount" class="container"> |
| 24 |
|
| 25 |
[% IF empty_mandatory_fields %] |
| 26 |
<div class="dialog alert">You have not filled out all required fields. Please fill in all missing fields and resubmit.</div> |
| 27 |
[% END %] |
| 28 |
|
| 29 |
[% IF failed_captcha %] |
| 30 |
<div class="dialog alert">You typed in the wrong characters in the box before submitting. Please try again.</div> |
| 31 |
[% END %] |
| 32 |
|
| 33 |
<form method="post"> |
| 34 |
|
| 35 |
[% UNLESS |
| 36 |
hidden.defined('branchcode') |
| 37 |
%] |
| 38 |
|
| 39 |
<fieldset class="rows" id="memberentry_library"> |
| 40 |
|
| 41 |
<legend id="library_legend">Library</legend> |
| 42 |
<ol> |
| 43 |
[% UNLESS hidden.defined('branchcode') %] |
| 44 |
<li> |
| 45 |
[% IF mandatory.defined('branchcode') %] |
| 46 |
<label for="borrower_branchcode" class="required"> |
| 47 |
[% ELSE %] |
| 48 |
<label for="borrower_branchcode"> |
| 49 |
[% END %] |
| 50 |
Home Library:</label> |
| 51 |
|
| 52 |
<select id="borrower_branchcode" name="borrower_branchcode"> |
| 53 |
[% FOREACH b IN branches %] |
| 54 |
[% IF b.value == borrower.branchcode %] |
| 55 |
<option value="[% b.value %]" selected="selected">[% b.branchname %]</option> |
| 56 |
[% ELSE %] |
| 57 |
<option value="[% b.value %]">[% b.branchname %]</option> |
| 58 |
[% END %] |
| 59 |
[% END %] |
| 60 |
</select> |
| 61 |
</li> |
| 62 |
[% END %] |
| 63 |
</ol> |
| 64 |
</fieldset> |
| 65 |
[% END %] |
| 66 |
|
| 67 |
[% UNLESS |
| 68 |
hidden.defined('title') && hidden.defined('surname') && hidden.defined('firstname') && |
| 69 |
hidden.defined('dateofbirth') && hidden.defined('initials') && hidden.defined('othernames') && |
| 70 |
hidden.defined('sex') |
| 71 |
%] |
| 72 |
<fieldset class="rows" id="memberentry_identity"> |
| 73 |
<legend id="identity_legend">Identity</legend> |
| 74 |
|
| 75 |
<ol> |
| 76 |
[% UNLESS hidden.defined('title') %] |
| 77 |
<li> |
| 78 |
[% IF mandatory.defined('title') %] |
| 79 |
<label for="borrower_title" class="required"> |
| 80 |
[% ELSE %] |
| 81 |
<label for="borrower_title"> |
| 82 |
[% END %] |
| 83 |
Salutation:</label> |
| 84 |
|
| 85 |
<select id="borrower_title" name="borrower_title"> |
| 86 |
<option value=""> </option> |
| 87 |
[% FOREACH mt IN member_titles %] |
| 88 |
[% IF mt == borrower.title %] |
| 89 |
<option value="[% mt %]" selected="selected">[% mt %]</option> |
| 90 |
[% ELSE %] |
| 91 |
<option value="[% mt %]">[% mt %]</option> |
| 92 |
[% END %] |
| 93 |
[% END %] |
| 94 |
</select> |
| 95 |
</li> |
| 96 |
[% END %] |
| 97 |
|
| 98 |
[% UNLESS hidden.defined('surname') %] |
| 99 |
<li> |
| 100 |
[% IF mandatory.defined('surname') %] |
| 101 |
<label for="borrower_surname" class="required"> |
| 102 |
[% ELSE %] |
| 103 |
<label for="borrower_surname"> |
| 104 |
[% END %] |
| 105 |
Surname:</label> |
| 106 |
|
| 107 |
<input type="text" id="borrower_surname" name="borrower_surname" value="[% borrower.surname %]" /> |
| 108 |
[% IF mandatory.defined('surname') %]<span class="required">Required</span>[% END %] |
| 109 |
</li> |
| 110 |
[% END %] |
| 111 |
|
| 112 |
[% UNLESS hidden.defined('firstname') %] |
| 113 |
<li> |
| 114 |
[% IF mandatory.defined('firstname') %] |
| 115 |
<label for="borrower_firstname" class="required"> |
| 116 |
[% ELSE %] |
| 117 |
<label for="borrower_firstname"> |
| 118 |
[% END %] |
| 119 |
First name:</label> |
| 120 |
|
| 121 |
<input type="text" id="borrower_firstname" name="borrower_firstname" value="[% borrower.firstname %]" /> |
| 122 |
[% IF mandatory.defined('firstname') %]<span class="required">Required</span>[% END %] |
| 123 |
</li> |
| 124 |
[% END %] |
| 125 |
|
| 126 |
[% UNLESS hidden.defined('dateofbirth') %] |
| 127 |
<li> |
| 128 |
[% IF mandatory.defined('dateofbirth') %] |
| 129 |
<label for="borrower_dateofbirth" class="required"> |
| 130 |
[% ELSE %] |
| 131 |
<label for="borrower_dateofbirth"> |
| 132 |
[% END %] |
| 133 |
Date of birth:</label> |
| 134 |
|
| 135 |
<input type="text" id="borrower_dateofbirth" name="borrower_dateofbirth" value="[% borrower.dateofbirth | $KohaDates %]" readonly="readonly" size="10" /> |
| 136 |
|
| 137 |
<a href="#" style="font-size:85%;text-decoration:none;" onclick="document.getElementById('borrower_dateofbirth').value='';return false;">Clear date</a><p></p> |
| 138 |
|
| 139 |
[% IF mandatory.defined('dateofbirth') %]<span class="required">Required</span>[% END %] |
| 140 |
</li> |
| 141 |
[% END %] |
| 142 |
|
| 143 |
[% UNLESS hidden.defined('initials') %] |
| 144 |
<li> |
| 145 |
[% IF mandatory.defined('initials') %] |
| 146 |
<label for="borrower_initials" class="required"> |
| 147 |
[% ELSE %] |
| 148 |
<label for="borrower_initials"> |
| 149 |
[% END %] |
| 150 |
Initials:</label> |
| 151 |
|
| 152 |
<input type="text" id="borrower_initials" name="borrower_initials" value="[% borrower.initials %]" /> |
| 153 |
[% IF mandatory.defined('initials') %]<span class="required">Required</span>[% END %] |
| 154 |
</li> |
| 155 |
[% END %] |
| 156 |
|
| 157 |
[% UNLESS hidden.defined('othernames') %] |
| 158 |
<li> |
| 159 |
[% IF mandatory.defined('othernames') %] |
| 160 |
<label for="borrower_othernames" class="required"> |
| 161 |
[% ELSE %] |
| 162 |
<label for="borrower_othernames"> |
| 163 |
[% END %] |
| 164 |
Other names:</label> |
| 165 |
|
| 166 |
<input type="text" id="borrower_othernames" name="borrower_othernames" value="[% borrower.othernames %]" /> |
| 167 |
[% IF mandatory.defined('othernames') %]<span class="required">Required</span>[% END %] |
| 168 |
</li> |
| 169 |
[% END %] |
| 170 |
|
| 171 |
[% UNLESS hidden.defined('sex') %] |
| 172 |
<li class="radio"> |
| 173 |
<label for="sex-female">Female:</label> |
| 174 |
[% IF borrower.sex == 'F' %] |
| 175 |
<input type="radio" name="borrower_sex" id="sex-female" value="F" checked="checked" /> |
| 176 |
[% ELSE %] |
| 177 |
<input type="radio" name="borrower_sex" id="sex-female" value="F" /> |
| 178 |
[% END %] |
| 179 |
|
| 180 |
<label for="sex-male">Male:</label> |
| 181 |
[% IF borrower.sex == 'M' %] |
| 182 |
<input type="radio" name="borrower_sex" id="sex-male" value="M" checked="checked" /> |
| 183 |
[% ELSE %] |
| 184 |
<input type="radio" name="borrower_sex" id="sex-male" value="M" /> |
| 185 |
[% END %] |
| 186 |
|
| 187 |
<label for="sex-none">N/A:</label> |
| 188 |
[% IF borrower.sex == '' %] |
| 189 |
<input type="radio" name="borrower_sex" id="sex-none" value="" checked="checked" /> |
| 190 |
[% ELSE %] |
| 191 |
<input type="radio" name="borrower_sex" id="sex-none" value="" /> |
| 192 |
[% END %] |
| 193 |
|
| 194 |
[% IF mandatory.defined('sex') %]<span class="required">Required</span>[% END %] |
| 195 |
</li> |
| 196 |
[% END %] |
| 197 |
</ol> |
| 198 |
</fieldset> |
| 199 |
[% END %] |
| 200 |
|
| 201 |
[% UNLESS |
| 202 |
hidden.defined('streetnumber') && hidden.defined('address') && hidden.defined('address2') && |
| 203 |
hidden.defined('city') && hidden.defined('state') && hidden.defined('zipcode') && |
| 204 |
hidden.defined('country') |
| 205 |
%] |
| 206 |
<fieldset class="rows" id="memberentry_mainaddress"> |
| 207 |
<legend id="mainaddress_legend">Main address</legend> |
| 208 |
|
| 209 |
<ol> |
| 210 |
[% UNLESS hidden.defined('streetnumber') %] |
| 211 |
<li> |
| 212 |
[% IF mandatory.defined('streetnumber') %] |
| 213 |
<label for="borrower_streetnumber" class="required"> |
| 214 |
[% ELSE %] |
| 215 |
<label for="borrower_streetnumber"> |
| 216 |
[% END %] |
| 217 |
Street number:</label> |
| 218 |
|
| 219 |
<input type="text" id="borrower_streetnumber" name="borrower_streetnumber" value="[% borrower.streetnumber %]" /> |
| 220 |
[% IF mandatory.defined('streetnumber') %]<span class="required">Required</span>[% END %] |
| 221 |
</li> |
| 222 |
[% END %] |
| 223 |
|
| 224 |
[% UNLESS hidden.defined('address') %] |
| 225 |
<li> |
| 226 |
[% IF mandatory.defined('address') %] |
| 227 |
<label for="borrower_address" class="required"> |
| 228 |
[% ELSE %] |
| 229 |
<label for="borrower_address"> |
| 230 |
[% END %] |
| 231 |
Address:</label> |
| 232 |
|
| 233 |
<input type="text" id="borrower_address" name="borrower_address" value="[% borrower.address %]" /> |
| 234 |
[% IF mandatory.defined('address') %]<span class="required">Required</span>[% END %] |
| 235 |
</li> |
| 236 |
[% END %] |
| 237 |
|
| 238 |
[% UNLESS hidden.defined('address2') %] |
| 239 |
<li> |
| 240 |
[% IF mandatory.defined('address2') %] |
| 241 |
<label for="borrower_address2" class="required"> |
| 242 |
[% ELSE %] |
| 243 |
<label for="borrower_address2"> |
| 244 |
[% END %] |
| 245 |
Address 2:</label> |
| 246 |
|
| 247 |
<input type="text" id="borrower_address2" name="borrower_address2" value="[% borrower.address2 %]" /> |
| 248 |
[% IF mandatory.defined('address2') %]<span class="required">Required</span>[% END %] |
| 249 |
</li> |
| 250 |
[% END %] |
| 251 |
|
| 252 |
[% UNLESS hidden.defined('city') %] |
| 253 |
<li> |
| 254 |
[% IF mandatory.defined('city') %] |
| 255 |
<label for="borrower_city" class="required"> |
| 256 |
[% ELSE %] |
| 257 |
<label for="borrower_city"> |
| 258 |
[% END %] |
| 259 |
City:</label> |
| 260 |
|
| 261 |
<input type="text" id="borrower_city" name="borrower_city" value="[% borrower.city %]" /> |
| 262 |
[% IF mandatory.defined('city') %]<span class="required">Required</span>[% END %] |
| 263 |
</li> |
| 264 |
[% END %] |
| 265 |
|
| 266 |
[% UNLESS hidden.defined('state') %] |
| 267 |
<li> |
| 268 |
[% IF mandatory.defined('state') %] |
| 269 |
<label for="borrower_state" class="required"> |
| 270 |
[% ELSE %] |
| 271 |
<label for="borrower_state"> |
| 272 |
[% END %] |
| 273 |
State:</label> |
| 274 |
|
| 275 |
<input type="text" id="borrower_state" name="borrower_state" value="[% borrower.state %]" /> |
| 276 |
[% IF mandatory.defined('state') %]<span class="required">Required</span>[% END %] |
| 277 |
</li> |
| 278 |
[% END %] |
| 279 |
|
| 280 |
[% UNLESS hidden.defined('zipcode') %] |
| 281 |
<li> |
| 282 |
[% IF mandatory.defined('zipcode') %] |
| 283 |
<label for="borrower_zipcode" class="required"> |
| 284 |
[% ELSE %] |
| 285 |
<label for="borrower_zipcode"> |
| 286 |
[% END %] |
| 287 |
Zip/Postal code:</label> |
| 288 |
|
| 289 |
<input type="text" id="borrower_zipcode" name="borrower_zipcode" value="[% borrower.zipcode %]" /> |
| 290 |
[% IF mandatory.defined('zipcode') %]<span class="required">Required</span>[% END %] |
| 291 |
</li> |
| 292 |
[% END %] |
| 293 |
|
| 294 |
[% UNLESS hidden.defined('country') %] |
| 295 |
<li> |
| 296 |
[% IF mandatory.defined('country') %] |
| 297 |
<label for="borrower_country" class="required"> |
| 298 |
[% ELSE %] |
| 299 |
<label for="borrower_country"> |
| 300 |
[% END %] |
| 301 |
Country:</label> |
| 302 |
|
| 303 |
<input type="text" id="borrower_country" name="borrower_country" value="[% borrower.country %]" /> |
| 304 |
[% IF mandatory.defined('country') %]<span class="required">Required</span>[% END %] |
| 305 |
</li> |
| 306 |
[% END %] |
| 307 |
|
| 308 |
</ol> |
| 309 |
</fieldset> |
| 310 |
[% END %] |
| 311 |
|
| 312 |
[% UNLESS |
| 313 |
hidden.defined('phone') && hidden.defined('phonepro') && hidden.defined('mobile') && |
| 314 |
hidden.defined('email') && hidden.defined('emailpro') && hidden.defined('fax') |
| 315 |
%] |
| 316 |
<fieldset class="rows" id="memberentry_contact"> |
| 317 |
<legend id="contact_legend">Contact information</legend> |
| 318 |
|
| 319 |
<ol> |
| 320 |
[% UNLESS hidden.defined('phone') %] |
| 321 |
<li> |
| 322 |
[% IF mandatory.defined('phone') %] |
| 323 |
<label for="borrower_phone" class="required"> |
| 324 |
[% ELSE %] |
| 325 |
<label for="borrower_phone"> |
| 326 |
[% END %] |
| 327 |
Primary phone:</label> |
| 328 |
|
| 329 |
<input type="text" id="borrower_phone" name="borrower_phone" value="[% borrower.phone %]" /> |
| 330 |
[% IF mandatory.defined('phone') %]<span class="required">Required</span>[% END %] |
| 331 |
</li> |
| 332 |
[% END %] |
| 333 |
|
| 334 |
[% UNLESS hidden.defined('phonepro') %] |
| 335 |
<li> |
| 336 |
[% IF mandatory.defined('phonepro') %] |
| 337 |
<label for="borrower_phonepro" class="required"> |
| 338 |
[% ELSE %] |
| 339 |
<label for="borrower_phonepro"> |
| 340 |
[% END %] |
| 341 |
Secondary phone:</label> |
| 342 |
|
| 343 |
<input type="text" id="borrower_phonepro" name="borrower_phonepro" value="[% borrower.phonepro %]" /> |
| 344 |
[% IF mandatory.defined('phonepro') %]<span class="required">Required</span>[% END %] |
| 345 |
</li> |
| 346 |
[% END %] |
| 347 |
|
| 348 |
[% UNLESS hidden.defined('mobile') %] |
| 349 |
<li> |
| 350 |
[% IF mandatory.defined('mobile') %] |
| 351 |
<label for="borrower_mobile" class="required"> |
| 352 |
[% ELSE %] |
| 353 |
<label for="borrower_mobile"> |
| 354 |
[% END %] |
| 355 |
Mobile phone:</label> |
| 356 |
|
| 357 |
<input type="text" id="borrower_mobile" name="borrower_mobile" value="[% borrower.mobile %]" /> |
| 358 |
[% IF mandatory.defined('mobile') %]<span class="required">Required</span>[% END %] |
| 359 |
</li> |
| 360 |
[% END %] |
| 361 |
|
| 362 |
[% UNLESS hidden.defined('email') %] |
| 363 |
<li> |
| 364 |
[% IF mandatory.defined('email') %] |
| 365 |
<label for="borrower_email" class="required"> |
| 366 |
[% ELSE %] |
| 367 |
<label for="borrower_email"> |
| 368 |
[% END %] |
| 369 |
Primary email:</label> |
| 370 |
|
| 371 |
<input type="text" id="borrower_email" name="borrower_email" value="[% borrower.email %]" /> |
| 372 |
[% IF mandatory.defined('email') %]<span class="required">Required</span>[% END %] |
| 373 |
</li> |
| 374 |
[% END %] |
| 375 |
|
| 376 |
[% UNLESS hidden.defined('emailpro') %] |
| 377 |
<li> |
| 378 |
[% IF mandatory.defined('emailpro') %] |
| 379 |
<label for="borrower_emailpro" class="required"> |
| 380 |
[% ELSE %] |
| 381 |
<label for="borrower_emailpro"> |
| 382 |
[% END %] |
| 383 |
Secondary email:</label> |
| 384 |
|
| 385 |
<input type="text" id="borrower_emailpro" name="borrower_emailpro" value="[% borrower.emailpro %]" /> |
| 386 |
[% IF mandatory.defined('emailpro') %]<span class="required">Required</span>[% END %] |
| 387 |
</li> |
| 388 |
[% END %] |
| 389 |
|
| 390 |
[% UNLESS hidden.defined('fax') %] |
| 391 |
<li> |
| 392 |
[% IF mandatory.defined('fax') %] |
| 393 |
<label for="borrower_fax" class="required"> |
| 394 |
[% ELSE %] |
| 395 |
<label for="borrower_fax"> |
| 396 |
[% END %] |
| 397 |
Fax:</label> |
| 398 |
|
| 399 |
<input type="text" id="borrower_fax" name="borrower_fax" value="[% borrower.fax %]" /> |
| 400 |
[% IF mandatory.defined('fax') %]<span class="required">Required</span>[% END %] |
| 401 |
</li> |
| 402 |
[% END %] |
| 403 |
</ol> |
| 404 |
</fieldset> |
| 405 |
[% END %] |
| 406 |
|
| 407 |
[% UNLESS |
| 408 |
hidden.defined('B_address') && hidden.defined('B_address2') && hidden.defined('B_city') && |
| 409 |
hidden.defined('B_state') && hidden.defined('B_zipcode') && hidden.defined('B_county') && |
| 410 |
hidden.defined('B_phone') && hidden.defined('B_email') && hidden.defined('contactnote') |
| 411 |
%] |
| 412 |
<fieldset class="rows" id="memberentry_alternateaddress"> |
| 413 |
<legend id="alternateaddress_legend">Alternate address</legend> |
| 414 |
|
| 415 |
<ol> |
| 416 |
[% UNLESS hidden.defined('B_address') %] |
| 417 |
<li> |
| 418 |
[% IF mandatory.defined('B_address') %] |
| 419 |
<label for="borrower_B_address" class="required"> |
| 420 |
[% ELSE %] |
| 421 |
<label for="borrower_B_address"> |
| 422 |
[% END %] |
| 423 |
Address:</label> |
| 424 |
|
| 425 |
<input type="text" id="borrower_B_address" name="borrower_B_address" value="[% borrower.B_address %]" /> |
| 426 |
[% IF mandatory.defined('B_address') %]<span class="required">Required</span>[% END %] |
| 427 |
</li> |
| 428 |
[% END %] |
| 429 |
|
| 430 |
[% UNLESS hidden.defined('B_address2') %] |
| 431 |
<li> |
| 432 |
[% IF mandatory.defined('B_address2') %] |
| 433 |
<label for="borrower_B_address2" class="required"> |
| 434 |
[% ELSE %] |
| 435 |
<label for="borrower_B_address2"> |
| 436 |
[% END %] |
| 437 |
Address 2:</label> |
| 438 |
|
| 439 |
<input type="text" id="borrower_B_address2" name="borrower_B_address2" value="[% borrower.B_address2 %]" /> |
| 440 |
[% IF mandatory.defined('B_address2') %]<span class="required">Required</span>[% END %] |
| 441 |
</li> |
| 442 |
[% END %] |
| 443 |
|
| 444 |
[% UNLESS hidden.defined('B_city') %] |
| 445 |
<li> |
| 446 |
[% IF mandatory.defined('B_city') %] |
| 447 |
<label for="borrower_B_city" class="required"> |
| 448 |
[% ELSE %] |
| 449 |
<label for="borrower_B_city"> |
| 450 |
[% END %] |
| 451 |
City:</label> |
| 452 |
|
| 453 |
<input type="text" id="borrower_B_city" name="borrower_B_city" value="[% borrower.B_city %]" /> |
| 454 |
[% IF mandatory.defined('B_city') %]<span class="required">Required</span>[% END %] |
| 455 |
</li> |
| 456 |
[% END %] |
| 457 |
|
| 458 |
[% UNLESS hidden.defined('B_state') %] |
| 459 |
<li> |
| 460 |
[% IF mandatory.defined('B_state') %] |
| 461 |
<label for="borrower_B_state" class="required"> |
| 462 |
[% ELSE %] |
| 463 |
<label for="borrower_B_state"> |
| 464 |
[% END %] |
| 465 |
State:</label> |
| 466 |
|
| 467 |
<input type="text" id="borrower_B_state" name="borrower_B_state" value="[% borrower.B_state %]" /> |
| 468 |
[% IF mandatory.defined('B_state') %]<span class="required">Required</span>[% END %] |
| 469 |
</li> |
| 470 |
[% END %] |
| 471 |
|
| 472 |
[% UNLESS hidden.defined('B_zipcode') %] |
| 473 |
<li> |
| 474 |
[% IF mandatory.defined('B_zipcode') %] |
| 475 |
<label for="borrower_B_zipcode" class="required"> |
| 476 |
[% ELSE %] |
| 477 |
<label for="borrower_B_zipcode"> |
| 478 |
[% END %] |
| 479 |
Zip/Postal code:</label> |
| 480 |
|
| 481 |
<input type="text" id="borrower_B_zipcode" name="borrower_B_zipcode" value="[% borrower.B_zipcode %]" /> |
| 482 |
[% IF mandatory.defined('B_zipcode') %]<span class="required">Required</span>[% END %] |
| 483 |
</li> |
| 484 |
[% END %] |
| 485 |
|
| 486 |
[% UNLESS hidden.defined('B_country') %] |
| 487 |
<li> |
| 488 |
[% IF mandatory.defined('B_country') %] |
| 489 |
<label for="borrower_B_country" class="required"> |
| 490 |
[% ELSE %] |
| 491 |
<label for="borrower_B_country"> |
| 492 |
[% END %] |
| 493 |
Country:</label> |
| 494 |
|
| 495 |
<input type="text" id="borrower_B_country" name="borrower_B_country" value="[% borrower.B_country %]" /> |
| 496 |
[% IF mandatory.defined('B_country') %]<span class="required">Required</span>[% END %] |
| 497 |
</li> |
| 498 |
[% END %] |
| 499 |
|
| 500 |
[% UNLESS hidden.defined('B_phone') %] |
| 501 |
<li> |
| 502 |
[% IF mandatory.defined('B_phone') %] |
| 503 |
<label for="borrower_B_phone" class="required"> |
| 504 |
[% ELSE %] |
| 505 |
<label for="borrower_B_phone"> |
| 506 |
[% END %] |
| 507 |
Phone:</label> |
| 508 |
|
| 509 |
<input type="text" id="borrower_B_phone" name="borrower_B_phone" value="[% borrower.B_phone %]" /> |
| 510 |
[% IF mandatory.defined('B_phone') %]<span class="required">Required</span>[% END %] |
| 511 |
</li> |
| 512 |
[% END %] |
| 513 |
|
| 514 |
[% UNLESS hidden.defined('B_email') %] |
| 515 |
<li> |
| 516 |
[% IF mandatory.defined('B_email') %] |
| 517 |
<label for="borrower_B_email" class="required"> |
| 518 |
[% ELSE %] |
| 519 |
<label for="borrower_B_email"> |
| 520 |
[% END %] |
| 521 |
Email:</label> |
| 522 |
|
| 523 |
<input type="text" id="borrower_B_email" name="borrower_B_email" value="[% borrower.B_email %]" /> |
| 524 |
[% IF mandatory.defined('B_email') %]<span class="required">Required</span>[% END %] |
| 525 |
</li> |
| 526 |
[% END %] |
| 527 |
|
| 528 |
[% UNLESS hidden.defined('contactnote') %] |
| 529 |
<li> |
| 530 |
[% IF mandatory.defined('contactnote') %] |
| 531 |
<label for="borrower_contactnote" class="required"> |
| 532 |
[% ELSE %] |
| 533 |
<label for="borrower_contactnote"> |
| 534 |
[% END %] |
| 535 |
Contact Note:</label> |
| 536 |
|
| 537 |
<textarea id="borrower_contactnote" name="borrower_contactnote" cols="40" rows="2">[% borrower.contactnote %]</textarea> |
| 538 |
[% IF mandatory.defined('contactnote') %]<span class="required">Required</span>[% END %] |
| 539 |
</li> |
| 540 |
[% END %] |
| 541 |
|
| 542 |
</ol> |
| 543 |
</fieldset> |
| 544 |
[% END %] |
| 545 |
|
| 546 |
[% UNLESS |
| 547 |
hidden.defined('altcontactsurname') && hidden.defined('altcontactfirstname') && hidden.defined('altcontactaddress1') && |
| 548 |
hidden.defined('altcontactaddress2') && hidden.defined('altcontactaddress3') && hidden.defined('altcontactstate') && |
| 549 |
hidden.defined('altcontactzipcode') && hidden.defined('altcontactcountry') && hidden.defined('altcontactphone') |
| 550 |
%] |
| 551 |
<fieldset class="rows" id="memberentry_alternatecontact"> |
| 552 |
<legend id="alternatecontact_legend">Alternate contact</legend> |
| 553 |
|
| 554 |
<ol> |
| 555 |
[% UNLESS hidden.defined('altcontactsurname') %] |
| 556 |
<li> |
| 557 |
[% IF mandatory.defined('altcontactsurname') %] |
| 558 |
<label for="borrower_altcontactsurname" class="required"> |
| 559 |
[% ELSE %] |
| 560 |
<label for="borrower_altcontactsurname"> |
| 561 |
[% END %] |
| 562 |
Surname:</label> |
| 563 |
|
| 564 |
<input type="text" id="borrower_altcontactsurname" name="borrower_altcontactsurname" value="[% borrower.altcontactsurname %]" /> |
| 565 |
[% IF mandatory.defined('altcontactsurname') %]<span class="required">Required</span>[% END %] |
| 566 |
</li> |
| 567 |
[% END %] |
| 568 |
|
| 569 |
[% UNLESS hidden.defined('altcontactfirstname') %] |
| 570 |
<li> |
| 571 |
[% IF mandatory.defined('altcontactfirstname') %] |
| 572 |
<label for="borrower_altcontactfirstname" class="required"> |
| 573 |
[% ELSE %] |
| 574 |
<label for="borrower_altcontactfirstname"> |
| 575 |
[% END %] |
| 576 |
First name:</label> |
| 577 |
|
| 578 |
<input type="text" id="borrower_altcontactfirstname" name="borrower_altcontactfirstname" value="[% borrower.altcontactfirstname %]" /> |
| 579 |
[% IF mandatory.defined('altcontactfirstname') %]<span class="required">Required</span>[% END %] |
| 580 |
</li> |
| 581 |
[% END %] |
| 582 |
|
| 583 |
[% UNLESS hidden.defined('altcontactaddress1') %] |
| 584 |
<li> |
| 585 |
[% IF mandatory.defined('altcontactaddress1') %] |
| 586 |
<label for="borrower_altcontactaddress1" class="required"> |
| 587 |
[% ELSE %] |
| 588 |
<label for="borrower_altcontactaddress1"> |
| 589 |
[% END %] |
| 590 |
Address:</label> |
| 591 |
|
| 592 |
<input type="text" id="borrower_altcontactaddress1" name="borrower_altcontactaddress1" value="[% borrower.altcontactaddress1 %]" /> |
| 593 |
[% IF mandatory.defined('altcontactaddress1') %]<span class="required">Required</span>[% END %] |
| 594 |
</li> |
| 595 |
[% END %] |
| 596 |
|
| 597 |
[% UNLESS hidden.defined('altcontactaddress2') %] |
| 598 |
<li> |
| 599 |
[% IF mandatory.defined('altcontactaddress2') %] |
| 600 |
<label for="borrower_altcontactaddress2" class="required"> |
| 601 |
[% ELSE %] |
| 602 |
<label for="borrower_altcontactaddress2"> |
| 603 |
[% END %] |
| 604 |
Address 2:</label> |
| 605 |
|
| 606 |
<input type="text" id="borrower_altcontactaddress2" name="borrower_altcontactaddress2" value="[% borrower.altcontactaddress2 %]" /> |
| 607 |
[% IF mandatory.defined('altcontactaddress2') %]<span class="required">Required</span>[% END %] |
| 608 |
</li> |
| 609 |
[% END %] |
| 610 |
|
| 611 |
[% UNLESS hidden.defined('altcontactaddress3') %] |
| 612 |
<li> |
| 613 |
[% IF mandatory.defined('altcontactaddress3') %] |
| 614 |
<label for="borrower_altcontactaddress3" class="required"> |
| 615 |
[% ELSE %] |
| 616 |
<label for="borrower_altcontactaddress3"> |
| 617 |
[% END %] |
| 618 |
City:</label> |
| 619 |
|
| 620 |
<input type="text" id="borrower_altcontactaddress3" name="borrower_altcontactaddress3" value="[% borrower.altcontactaddress3 %]" /> |
| 621 |
[% IF mandatory.defined('altcontactaddress3') %]<span class="required">Required</span>[% END %] |
| 622 |
</li> |
| 623 |
[% END %] |
| 624 |
|
| 625 |
[% UNLESS hidden.defined('altcontactstate') %] |
| 626 |
<li> |
| 627 |
[% IF mandatory.defined('altcontactstate') %] |
| 628 |
<label for="borrower_altcontactstate" class="required"> |
| 629 |
[% ELSE %] |
| 630 |
<label for="borrower_altcontactstate"> |
| 631 |
[% END %] |
| 632 |
State:</label> |
| 633 |
|
| 634 |
<input type="text" id="borrower_altcontactstate" name="borrower_altcontactstate" value="[% borrower.altcontactstate %]" /> |
| 635 |
[% IF mandatory.defined('altcontactstate') %]<span class="required">Required</span>[% END %] |
| 636 |
</li> |
| 637 |
[% END %] |
| 638 |
|
| 639 |
[% UNLESS hidden.defined('altcontactzipcode') %] |
| 640 |
<li> |
| 641 |
[% IF mandatory.defined('altcontactzipcode') %] |
| 642 |
<label for="borrower_altcontactzipcode" class="required"> |
| 643 |
[% ELSE %] |
| 644 |
<label for="borrower_altcontactzipcode"> |
| 645 |
[% END %] |
| 646 |
Zip/Postal code:</label> |
| 647 |
|
| 648 |
<input type="text" id="borrower_altcontactzipcode" name="borrower_altcontactzipcode" value="[% borrower.altcontactzipcode %]" /> |
| 649 |
[% IF mandatory.defined('altcontactzipcode') %]<span class="required">Required</span>[% END %] |
| 650 |
</li> |
| 651 |
[% END %] |
| 652 |
|
| 653 |
[% UNLESS hidden.defined('altcontactcountry') %] |
| 654 |
<li> |
| 655 |
[% IF mandatory.defined('altcontactcountry') %] |
| 656 |
<label for="borrower_altcontactcountry" class="required"> |
| 657 |
[% ELSE %] |
| 658 |
<label for="borrower_altcontactcountry"> |
| 659 |
[% END %] |
| 660 |
Country:</label> |
| 661 |
|
| 662 |
<input type="text" id="borrower_altcontactcountry" name="borrower_altcontactcountry" value="[% borrower.altcontactcountry %]" /> |
| 663 |
[% IF mandatory.defined('altcontactcountry') %]<span class="required">Required</span>[% END %] |
| 664 |
</li> |
| 665 |
[% END %] |
| 666 |
|
| 667 |
[% UNLESS hidden.defined('altcontactphone') %] |
| 668 |
<li> |
| 669 |
[% IF mandatory.defined('altcontactphone') %] |
| 670 |
<label for="borrower_altcontactphone" class="required"> |
| 671 |
[% ELSE %] |
| 672 |
<label for="borrower_altcontactphone"> |
| 673 |
[% END %] |
| 674 |
Phone:</label> |
| 675 |
|
| 676 |
<input type="text" id="borrower_altcontactphone" name="borrower_altcontactphone" value="[% borrower.altcontactphone %]" /> |
| 677 |
[% IF mandatory.defined('altcontactphone') %]<span class="required">Required</span>[% END %] |
| 678 |
</li> |
| 679 |
[% END %] |
| 680 |
</ol> |
| 681 |
</fieldset> |
| 682 |
[% END %] |
| 683 |
|
| 684 |
[% UNLESS action == 'edit' %] |
| 685 |
<p>Please type this following characters into the box below : [% captcha %]</p> |
| 686 |
<p> |
| 687 |
<input type="text" name="captcha" id="captcha" /> |
| 688 |
<input type="hidden" name="captcha_digest" value="[% captcha_digest %]" /> |
| 689 |
</p> |
| 690 |
[% END %] |
| 691 |
|
| 692 |
[% IF action == 'edit' %] |
| 693 |
<input type="hidden" name="action" value="update" /> |
| 694 |
<input type="submit" value="Submit Update Request" /> |
| 695 |
[% ELSE %] |
| 696 |
<input type="hidden" name="action" value="create" /> |
| 697 |
<input type="submit" value="Submit" /> |
| 698 |
[% END %] |
| 699 |
|
| 700 |
</form> |
| 701 |
|
| 702 |
</div><!--/div id="useraccount" --> |
| 703 |
</div> |
| 704 |
</div> |
| 705 |
</div> |
| 706 |
|
| 707 |
<div class="yui-b"> |
| 708 |
<div id="leftmenus" class="container"> |
| 709 |
[% INCLUDE 'navigation.inc' IsPatronPage=1 %] |
| 710 |
</div> |
| 711 |
</div> |
| 712 |
</div> |
| 713 |
[% INCLUDE 'opac-bottom.inc' %] |