VL-e registration form
Registration form for Course
. Information on the Course will be published on the\n". "web site at http://www.vl-e.nl/CreatingValue/\n\n"; $emailHeader = "I would like to attend the course on May 22, 23, 24 and July 5 at the World Trade Center in Amsterdam."; require("form.php"); if ($bPost) $bDone = true; $form = "
\n"; $form .= "

". $emailHeader ."

"; $form .= "\n"; $arr = Array("mr.", "ms."); $form .= dropCell("I am ", dropRadio("m/v", $arr, false,"",false)); $form .= dropCell1("Title", dropTextInput("titel", 30, false)); $form .= dropCell("Initials ", dropTextInput("initialen", 30, false)); $form .= dropCell1("First name *", dropTextInput("voornaam", 30, true)); $form .= dropCell("Prefix ", dropTextInput("tussenvoegsel", 30, false)); $form .= dropCell1("Last name *", dropTextInput("achternaam", 30, true)); $form .= dropCell("Organisation * ", dropTextInput("organisatie", 30, true)); $form .= dropCell1("Function", dropTextInput("functie", 30, false)); $form .= dropCell("Address *", dropTextInput("adres", 30, true)); $form .= dropCell1("Postal code *", dropTextInput("postcode", 30, true)); $form .= dropCell("City *", dropTextInput("plaats", 30, true)); $form .= dropCell("Country *", dropTextInput("land", 30, true)); $form .= dropCell1("Telephone", dropTextInput("telefoon", 30)); $form .= dropCell("Email *", dropTextInput("email", 30, true)); $arr2 = Array("Vegetarian", "Non-vegetarian"); $form .= dropCell("Food restrictions ", dropRadio("food", $arr2, false,"",false)); $form .= dropCell("Comments or questions", dropTextInput("comments", 50, false)); $form .= ""; $form .= "

* = required field

"; $form .= "
By completing this form I agree to pay EUR 3.500,00 (excl. VAT) and will receive the invoice on the mentioned address. I understood that payment is due before the first day of the course. This order can be cancelled by contacting Chantal Schoof (+31(0)10-4082032) on May 8 the latest.

"; $form .= "\n"; $form .= "\n"; $form .= "

"; if (!$bDone) { echo $form; } else { //echo "
$emailData
"; $bSuccess = appendCSV("CVreg.csv", ";"); if ($bSuccess) { global $csvArr; $emailData2=$emailData2.$emailData; $bSuccess = @mail(substr($csvArr[14],1,strlen($csvArr[14])-2), "Registration VL-E: Creating Value Course", $emailData2, "From: cschoof@rsm.nl"); $bSuccess = @mail("cschoof@rsm.nl", "Registration form Creating Value", $emailData, "From: cschoof@rsm.nl"); } if (!$bSuccess) { echo "

Fout: Kon e-mail niet versturen.

"; } else { ?>

Thank you very much for your registration.