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studentform.php
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183 lines (151 loc) · 8.64 KB
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<?php
session_start();
?>
<html lang="en-US"><head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Hospitality: Community Service – myLerner</title>
<style type="text/css"></style>
<link rel="dns-prefetch" href="//maxcdn.bootstrapcdn.com">
<link rel="dns-prefetch" href="//fonts.googleapis.com">
<link rel="dns-prefetch" href="//s.w.org">
<link rel="stylesheet" id="font-awesome-css" href="//maxcdn.bootstrapcdn.com/font-awesome/4.6.3/css/font-awesome.min.css?ver=4.6.3" type="text/css" media="all">
<link rel="stylesheet" id="colormag_google_fonts-css" href="//fonts.googleapis.com/css?family=Open+Sans%3A400%2C600&ver=4.7.3" type="text/css" media="all">
<link rel="stylesheet" id="colormag_style-css" href="themes/mylerner/style.css" type="text/css" media="all">
<link rel="stylesheet" id="colormag-fontawesome-css" href="themes/colormag/fontawesome/css/font-awesome.css" type="text/css" media="all">
<link rel="shortcut icon" href="themes/img/favicon.png" type="image/x-icon"><style id="fit-vids-style">.fluid-width-video-wrapper{width:100%;position:relative;padding:0;}.fluid-width-video-wrapper iframe,.fluid-width-video-wrapper object,.fluid-width-video-wrapper embed {position:absolute;top:0;left:0;width:100%;height:100%;}</style></head>
<body class="post-template-default single single-post postid-236 single-format-standard wide">
<div id="page" class="hfeed site">
<header id="masthead" class="site-header clearfix">
<div id="header-text-nav-container" class="clearfix">
<div class="news-bar">
<div class="inner-wrap clearfix">
<div class="date-in-header" id="header-date">Date Locaton</div>
<div class="social-links clearfix">
<ul>
<li><a href="https://www.facebook.com/UDLerner/" target="_blank"><i class="fa fa-facebook"></i></a></li><li><a href="https://twitter.com/UDLernerCollege" target="_blank"><i class="fa fa-twitter"></i></a></li>
</ul>
</div><!-- .social-links -->
</div>
</div>
<div class="inner-wrap">
<div id="header-text-nav-wrap" class="clearfix">
<div id="header-left-section">
<div id="header-logo-image">
<a href="http://my.lerner.udel.edu/" title="myLerner" rel="home"><img src="themes/img/myLerner-logo.png" alt="myLerner"></a>
</div><!-- #header-logo-image -->
<div id="header-text" class="screen-reader-text">
<h3 id="site-title">
<a href="http://my.lerner.udel.edu/" title="myLerner" rel="home">myLerner</a>
</h3>
<!-- #site-description -->
</div><!-- #header-text -->
</div><!-- #header-left-section -->
<div id="header-right-section"></div><!-- #header-right-section -->
</div><!-- #header-text-nav-wrap -->
</div><!-- .inner-wrap -->
<nav id="site-navigation" class="main-navigation clearfix" role="navigation">
<div class="inner-wrap clearfix">
<div class="home-icon">
<a href="http://my.lerner.udel.edu/" title="myLerner"><i class="fa fa-home"></i></a>
</div>
<div class="home-icon">
<a href="status.php" title="View your hours to date"><i class="fa fa-user" aria-hidden="true"></i></a>
</div>
</nav>
</div><!-- #header-text-nav-container -->
</header>
<div id="main" class="clearfix">
<div class="inner-wrap clearfix">
<div id="primary">
<div id="content" class="clearfix">
<article id="post-236" class="post-236 post type-post status-publish format-standard hentry category-undergraduate-students">
<div class="article-content clearfix">
<header class="entry-header">
<h1 class="entry-title">Community Service Form</h1>
</header>
<div class="entry-content clearfix">
<form action="/form_submission.php" method="post">
Today's date: <input type="text" name="todaydate" id="form-date" readonly><br>
First name: <input type="text" name="fname" value="<?php echo $_SESSION['cas_data']['FIRSTNAME']; ?>" readonly><br>
Last name: <input type="text" name="lname" value="<?php echo $_SESSION['cas_data']['LASTNAME']; ?>" readonly><br>
UDNetID: <input title="UD Email Prefix" type ="text" name="id"value="<?php echo $_SESSION['cas_data']['UDELNETID']; ?>" readonly><br>
Student email: <input type="email" name="email"value="<?php echo strtolower($_SESSION['cas_data']['EMAIL']); ?>" readonly><br>
Major: <select name="major">
<option value="HRIM">HRIM</option>
<option value="HSIM">HSIM</option>
</select><br><br>
Organization: <input type="text" name="organization"><br>
Agency Website: <input type="text" name="website"><br>
Location/address of community site:
<input type="text" name="location"><br>
Non-profit agency that benefited from your service:
<input type="text" name="agency"><br>
Date(s) of Work: <br>
Started: <input type="date" name="workdates-start">
Ended: <input type="date" name="workdates-end"><br>
Number of Hours Worked: <input type="number" name="hoursworked" min="1" max="99999"><br>
Describe your specific activities: <input type="text" name="activities"><br>
Describe the value in what you did for the agency/site:
<input type="text" name="valuesite"><br>
Describe the value in what this experience did for YOU (your comments
about the experience): <input type="text" name="valueyou"><br>
<b>Contact information for supervisor at community site:</b><br><br><br>
Supervisor Name: <input type="text" name="supname"><br>
Supervisor Title: <input type="text" name="suptitle"><br>
Supervisor E-Mail: <input type="text" name="supemail"><br>
Supervisor Phone: <input type="text" name="supphone"><br>
<b>Is the Supervisor a student?<b>
<select>
<option value="yes">YES</option>
<option value="no">No</option>
</select><br><br>
<b>Is the Supervisor related to you?<b>
<select>
<option value="yes">YES</option>
<option value="no">NO</option>
</select><br><br>
<b>If yes to the above question(s), please resubmit form with a supervisor
who is not a student or relative.<b><br><br>
<!-- Signature of Student: <input type="text" name="supsig"><br> -->
<input type="submit" value="Submit">
</form>
</div>
</article>
</div><!-- #content -->
<ul class="default-wp-page clearfix">
<li class="previous"><a href="http://my.lerner.udel.edu/undergraduate-students/undergraduate-advising" rel="prev"><span class="meta-nav">←</span> Advising</a></li>
<li class="next"><a href="http://my.lerner.udel.edu/undergraduate-students/undergraduate-advising/senior-check-out" rel="next">Senior Check-out <span class="meta-nav">→</span></a></li>
</ul>
</div><!-- #primary -->
</div><!-- #main -->
<footer id="colophon" class="clearfix">
<div class="footer-socket-wrapper clearfix">
<div class="inner-wrap">
<div class="footer-socket-area">
<div class="footer-socket-right-section">
<div class="social-links clearfix">
<ul>
<li><a href="https://www.facebook.com/UDLerner/" target="_blank"><i class="fa fa-facebook"></i></a></li><li><a href="https://twitter.com/UDLernerCollege" target="_blank"><i class="fa fa-twitter"></i></a></li> </ul>
</div><!-- .social-links -->
</div>
</div>
</div>
</div>
</footer>
<script>
const days = ["Sunday", "Monday", "Tuesday" ,"Wednesday", "Thursday", "Friday", "Saturday"];
const monthNames = ["January", "February", "March", "April", "May", "June",
"July", "August", "September", "October", "November", "December"];
const n = new Date();
const y = n.getFullYear();
const m = n.getMonth() + 1;
const monthName = n.getMonth();
const d = n.getDate();
const day = n.getDay();
document.getElementById("form-date").value = m + "/" + d + "/" + y;
document.getElementById("header-date").innerHTML = days[day] + ", " + monthNames[monthName] + " " + d + ", " + y;
</script>
<a href="#masthead" id="scroll-up" style="display: none;"><i class="fa fa-chevron-up"></i></a>
</div><!-- #page -->
</body></html>