<?
//the JLN event registration was redone:  nstampler Feb 06
//new JLN event registration log in page = index.php 
header("location:index.php?oid=$oid&pid=$pid");
exit();

// author:  SBHarbater
// date:  May 2001

require "../ssi/db.php3";
require "ssi/cookie.php";
require "ssi/showpage.php";

if ($oid)
{
$getorgname=mysql_query("select email from registration where id=$oid");
$orgemail=mysql_result($getorgname, 0, 0);
}
if ($pid)
{
$geteventinfo=mysql_query("select * from eventprofiles where id=$pid");
$eventinfo=mysql_fetch_array($geteventinfo);
}
if ($login)
	{

	$chkLogin = mysql_query("select * from registrants where email = '$email' and password = '$password' and orgid=$oid order by ID desc");
	if ($reg = mysql_fetch_array($chkLogin))
		{
		$loggedin = true;

		if ($cookie=="yes")
			{
			setcookie("ask", "no", time()+31536000, "/");
			setcookie("cemail", $email, time()+31536000, "/");
			setcookie("cpass", $password, time()+31536000, "/");
			}
		elseif ($cookie=="pw")
			{
			setcookie("ask", "yes", time()+31536000, "/");
			setcookie("cemail", $email, time()+31536000, "/");
			}

		if (!showpage($reg[ID], "page1db"))
		("Location: page2db.php3?ID=$reg[ID]&oid=$oid&pid=$pid&url=$url");

		$oldpassword = $password;
		$oldemail = $reg[email];
		$regID = $reg[ID];
		$firstname = $reg[fname];
		$lastname = $reg[lname];
		$dear=$reg[dear];
		$email = $reg[email];
		$address1 = $reg[address1];
		$address2 = $reg[address2];
		$city = $reg[city];
		$state = $reg[state];
		$zip = $reg[zip];
		$country = $reg[country];
		$homephone = $reg[homephone];
		$busphone = $reg[busphone];
		$fax = $reg[fax];
		$cell = $reg[cellphone];
		$oldpassword = $reg[password];
		$password = $reg[password];
		$cpassword = $reg[password];
		$getdemo=mysql_query("SELECT MONTH(dob) AS month, DAYOFMONTH(dob) AS day, YEAR(dob) as year, occupation, marital, gender FROM demographics WHERE regID=$regID") or die(mysql_error());
		if (mysql_num_rows($getdemo) > 0)
			{
			$demorecord=true;
			$demo=mysql_fetch_array($getdemo);
			$occupation=$demo[occupation];
			$marital=$demo[marital];
			$gender=$demo[gender];
			$month=$demo[month];
			$day=$demo[day];
			$year=$demo[year];
			}
		}
	else
		{
		$badLogin = true;
		}
	}

if ($submit == "yes")
	{

	require ("errorchk.php3");
	$emailErr1 = errorEmail($email);
	$fnameErr = requiredField($firstname);
	$emailErr = requiredField($email);
	$lnameErr = requiredField($lastname);
	$passErr1 = requiredField($password);
 	if ($password != $cpassword) $passErr = true;
	else $passErr = false;
	if ($pass1Err == false && $emailErr1 == false && $fnameErr == false && $emailErr == false && $lnameErr == false && $passErr == false && ! $exists)
		{
		if ($loggedin)
			{
			// check if password and regid still match (security)
			$checkpass=mysql_query("SELECT password FROM registrants WHERE ID=$regID") or die(mysql_error());
			if (mysql_result($checkpass, 0, 0)==$oldpassword)
				{
				// update registrants and demographics tables
				$sql="UPDATE registrants SET fname='$firstname', lname='$lastname', dear='$dear', email='$email', address1='$address1', address2='$address2', city='$city', state='$state', zip='$zip', country='$country', homephone='$homephone', busphone='$busphone', password='$password', fax='$fax', cellphone='$cellphone' WHERE ID=$regID";
				mysql_query($sql);
				if ($demorecord) $sql="UPDATE demographics SET gender='$gender', marital='$marital', dob='$year-$month-$day', occupation='$occupation' where regID=$regID";
				else $sql = "INSERT INTO demographics (gender, marital, dob, regID, occupation) values ('$gender', '$marital', '$year-$month-$day', $regID, '$occupation')";
				mysql_query($sql);
				}
			else echo "error:  pass and regid do not match";
			}
		else
			{
			$checkemail=mysql_query("select email from registrants where email='$email' and orgid=$oid");
			if (mysql_num_rows($checkemail)>0)
				{

				Header("Location: page1db.php3?exists=yes&ID=$regID&oid=$oid&pid=$pid&url=$url");
				exit;
				}
			else
				{
				$today = date( "Ymd", time() );
				$sql = "INSERT INTO registrants (fname, lname, dear, email, address1, address2, city, state, zip, country, homephone, busphone,  password, fax, cellphone, datejoined, orgid) VALUES ('$firstname', '$lastname', '$title', '$email', '$address1', '$address2', '$city', '$state', '$zip', '$country', '$homephone', '$busphone', '$password', '$fax', '$cell', '$today', $oid)";
				$result = mysql_query ($sql) or die(mysql_error());
				$regID = mysql_insert_id();
				$sql = "INSERT INTO demographics (gender, marital, dob, regID, occupation) values ('$gender', '$marital', '$year-$month-$day', $regID, '$occupation')";
				$result = mysql_query ($sql) or die(mysql_error());
				mysql_query("INSERT INTO updates (regID) VALUES ($regID)");
				//mailthe org that they have a new registrant
				$to=$orgemail;
				$from="website@jewishlearning.net";
				$subject="New Registrant";
				$body="You have a new registrant!\n";
				$body.="Name: $title $firstname $lastname\n";
				$body.="Email: $email\n";
				$body.="Address: $address1 $address2 \n $city $state $zip $country\n";
				$body.="Phone: $homephone\n";
				$body.="Gender: $gender\n";
				$body.="DOB: $month-$day-$year\n";
				mail($to, $subject,  $body, "From:  $from");
				}
			}

		// insert record into regorg if oid is set
		if ($pid!="")
			{
			//SEE IF THEY ALREADY REGISTERD FOR THIS EVENT
			$chkexist=mysql_query("select * from eventreg where regID=$regID and  eventID=$pid");

			if (mysql_num_rows($chkexist)==0)
				{
				//see where this person is coming from
				if(strstr($h_referer,'search'))
					$referer= "search";
				if(strstr($h_referer,'events'))
					$referer= "calendar";

				mysql_query("INSERT INTO eventreg (regID, eventID, orgid, referer) VALUES ($regID, $pid, $oid, '$referer')");

				//enter in roievents if theres a refering org
				if ($referorg)
					{
					$ip = getenv ("REMOTE_ADDR");
					mysql_query("insert into roievents (ip, orgid, profileid, regid) values ('$ip', $referorg, $pid, $regID)");
					}

				//email the person to tell him that he's registered
				//echo "you've, $reginfo[fname] $reginfo[lname] $reginfo[email] registered for  $eventinfo[longname]";
				$body= "$firstname $lastname,";
				$body .="\nYou've been pre-registered for $eventinfo[longname].  ";
				$body.="\nTo see our calendar please click the link below";
				$body .="\nwww.jewishlearning.net/events/calendar.php3?oid=$oid";
				$mailorgprereg='yes';
				mail($email, "Event Registration",  $body, "From:  $orgemail");


				$to2=$orgemail;
				$from2="website@jewishlearning.net";
				$subject2="Registrant Pre-Registered";
				$body2.="$title $firstname $lastname,";
				$body2.=" $email";
				$body2.=" registered for $eventinfo[longname]";
				mail($to2, $subject2,  $body2, "From:  $from2");
				}
			}
		// update updates table
		mysql_query("UPDATE updates SET page1db=NOW() WHERE regID=$regID");

		Header("Location: page2db.php3?ID=$regID&oid=$oid&pid=$pid&url=$url");
		}
	else $errors=true;
	}

require ('headers/header.php3');
?>

<P>

<?

if ($errors)
	{


	echo "<font face='Verdana, Arial' color='red'>";
	if ($emailErr == true) requiredFieldHandler('Email');
	if ($fnameErr == true) requiredFieldHandler('FirstName');
	if ($lnameErr == true) requiredFieldHandler('LastName');
	if ($passErr) echo "<br>Your password and confirmation do not match. Please re-enter.";
	if ($emailErr1 == true && $emailErr == false) errorEmailHandler();
	echo "</font><p>";
	}

if ($exists=='yes')
		echo "<center><font style='font-family:verdana,arial;font-size:9pt;'>Your email address already exists in our system.  <br>To retrieve your password, please click the forgot password link below<p>";

if (!$loggedin && $submit != 'yes')
	{
?>
<table align=center width=350 bgcolor=#c0c0c0 cellspacing=1 cellpadding=1 border=0 style="font-family:verdana,arial;font-size:9pt;">
<tr>
	<td colspan=3><b><center>Previous Registrants</center></b></td>
</tr>
<? if ($badLogin) { ?>
<tr>
	<td colspan=3><font color=red><center><b>Invalid password.</b></td>
</tr>
<? } ?>

<tr valign=bottom>
	<td><form method=post action="<? echo $PHP_SELF; ?>">&nbsp;&nbsp;Email</font><br>&nbsp;&nbsp;<input type=text name=email size=22 value="<? echo $email; ?>"></td>
	<td>Password</font><br><input type=password name=password size=8 value="<? echo $password; ?>"></td>
	<td><input type=submit value="Login"></td>
</tr>
<tr><td colspan=3><input type=radio name=cookie value=yes>Remember me on this computer</td></tr>
<tr><td colspan=3><input type=radio name=cookie value=pw>Remember me, but request my password</td></tr>
<tr><td colspan=3><input type=radio name=cookie value=no checked>Do not remember me on this computer</td></tr>
<tr><td colspan=3><center><a href="forgot.php3?oid=<? echo $oid ?>&pid=<? echo $pid ?>">Forgot your password?</a></td></tr>
<input type="hidden" name="login" value="true">
<input type="Hidden" name="url" value="<? echo $HTTP_REFERER ?>">
<input type="Hidden" name="oid" value="<? echo $oid ?>">
<input type="Hidden" name="pid" value="<? echo $pid ?>">

<?
if (! isset($h_referer))
{
$h_referer=getenv("HTTP_REFERER") ;
}
?>
<input type="Hidden" name="h_referer" value="<? echo $h_referer ?>">
<input type="Hidden" name="mo" value="<? echo $mo ?>">
<input type="Hidden" name="yr" value="<? echo $yr ?>">
<input type="Hidden" name="dy" value="<? echo $dy ?>">
<input type="Hidden" name="referorg" value="<? echo $referorg ?>">

</form>
</table>
<? } ?>


<p>
<form action="<? echo $PHP_SELF ?>" method=post>
<TABLE BORDER="0" valign="top" align=center style="font-family:verdana,arial;font-size:9pt;">
<?
if (!$loggedin && $submit != 'yes')
	{

?>
<tr><td colspan=2 align=center><b>New Registrants</b></td></tr>
<tr><td colspan=2 align=center>&nbsp;</td></tr>
<? }


?>
<TR>
  <TD>
	First Name:
  </td>
  <td align=left>
	<inPUT name="firstname" value="<? echo $firstname ?>" SIZE=20>
  </TD>
 </tr>
<tr>
  <TD>
	Last Name:
  </td>
  <td align=left>
	<inPUT name="lastname" value="<? echo $lastname ?>" SIZE=20>
  </TD>
</TR>

<tr><td>Title:</td><td align=left>
<select NAME="dear" WIDTH=13>
<option value=""></option>
<option value="Mr" <? if ($dear=="Mr") { ?> selected <? } ?>>Mr.
<option value="Mrs" <? if ($dear=="Mrs") { ?> selected <? } ?>>Mrs.
<option value="Ms" <? if ($dear=="Ms") { ?> selectd <? } ?>>Ms.
<option value="Dr" <? if ($dear=="Dr") { ?> selected <? } ?>>Dr.
<option value="Rabbi" <? if ($dear=="Rabbi") { ?> selected <? } ?>>Rabbi
</select></td></tr>

<TR>
 <TD>
	E-mail Address:
  </td>
  <td align=left>
	<inPUT name="email" value= "<? echo $email ?>" SIZE=20>
  </TD>
</TR>
<TR>
  <TD>
	Postal Address: <i>(optional)</i>
  </td>
  <td align=left>
	<inPUT name="address1" value="<? echo $address1 ?>" SIZE=20 MAXSIZE=100>
  </td>
</TR>
<TR>
  <TD>
  </td>
  <td align=left>
	<inPUT name="address2" value="<? echo $address2 ?>" SIZE=20 MAXSIZE=100>
  </TD>
</TR>
<TR>
  <TD>
	City: </td>
  <td align=left><inPUT name="city" value="<? echo $city ?>" SIZE=20 MAXSIZE=35>
  </td>
</tr>
<tr>
  <TD>
	State or Province:
  </td>

<td><SELECT NAME="state" size="1" tabindex=5>
              <option value="">Select State</option>
              <OPTION value="AK" <? if ($state=='AK') echo " selected"; ?>>AK</OPTION>
              <OPTION value="AL" <? if ($state=='AL') echo " selected"; ?>>AL</OPTION>
              <OPTION value="AR" <? if ($state=='AR') echo " selected"; ?>>AR</OPTION>
              <OPTION value="AS" <? if ($state=='AS') echo " selected"; ?>>AS</OPTION>
              <OPTION value="AZ" <? if ($state=='AZ') echo " selected"; ?>>AZ</OPTION>
              <OPTION value="CA" <? if ($state=='CA') echo " selected"; ?>>CA</OPTION>
              <OPTION value="CO" <? if ($state=='CO') echo " selected"; ?>>CO</OPTION>
              <OPTION value="CT" <? if ($state=='CT') echo " selected"; ?>>CT</OPTION>
              <OPTION value="DC" <? if ($state=='DC') echo " selected"; ?>>DC</OPTION>
              <OPTION value="DE" <? if ($state=='DE') echo " selected"; ?>>DE</OPTION>
              <OPTION value="FL" <? if ($state=='FL') echo " selected"; ?>>FL</OPTION>
              <OPTION value="FM" <? if ($state=='FM') echo " selected"; ?>>FM</OPTION>
              <OPTION value="GA" <? if ($state=='GA') echo " selected"; ?>>GA</OPTION>
              <OPTION value="GU" <? if ($state=='GU') echo " selected"; ?>>GU</OPTION>
              <OPTION value="HI" <? if ($state=='HI') echo " selected"; ?>>HI</OPTION>
              <OPTION value="IA" <? if ($state=='IA') echo " selected"; ?>>IA</OPTION>
              <OPTION value="ID" <? if ($state=='ID') echo " selected"; ?>>ID</OPTION>
              <OPTION value="IL" <? if ($state=='IL') echo " selected"; ?>>IL</OPTION>
              <OPTION value="IN" <? if ($state=='IN') echo " selected"; ?>>IN</OPTION>
              <OPTION value="KS" <? if ($state=='KS') echo " selected"; ?>>KS</OPTION>
              <OPTION value="KY" <? if ($state=='KY') echo " selected"; ?>>KY</OPTION>
              <OPTION value="LA" <? if ($state=='LA') echo " selected"; ?>>LA</OPTION>
              <OPTION value="MA" <? if ($state=='MA') echo " selected"; ?>>MA</OPTION>
              <OPTION value="MD" <? if ($state=='MD') echo " selected"; ?>>MD</OPTION>
              <OPTION value="ME" <? if ($state=='ME') echo " selected"; ?>>ME</OPTION>
              <OPTION value="MH" <? if ($state=='MH') echo " selected"; ?>>MH</OPTION>
              <OPTION value="MI" <? if ($state=='MI') echo " selected"; ?>>MI</OPTION>
              <OPTION value="MN" <? if ($state=='MN') echo " selected"; ?>>MN</OPTION>
              <OPTION value="MO" <? if ($state=='MO') echo " selected"; ?>>MO</OPTION>
              <OPTION value="MS" <? if ($state=='MS') echo " selected"; ?>>MS</OPTION>
              <OPTION value="MT" <? if ($state=='MT') echo " selected"; ?>MT</OPTION>
              <OPTION value="NC" <? if ($state=='NC') echo " selected"; ?>>NC</OPTION>
              <OPTION value="ND" <? if ($state=='ND') echo " selected"; ?>>ND</OPTION>
              <OPTION value="NE" <? if ($state=='NE') echo " selected"; ?>>NE</OPTION>
             <OPTION value="NH" <? if ($state=='NH') echo " selected"; ?>>NH</OPTION>
             <OPTION value="NJ"  <? if ($state=='NJ') echo " selected"; ?>>NJ</OPTION>
              <OPTION value="NM" <? if ($state=='NM') echo " selected"; ?>>NM</OPTION>
              <OPTION value="NV" <? if ($state=='NV') echo " selected"; ?>>NV</OPTION>
              <OPTION value="NY" <? if ($state=='NY') echo " selected"; ?>>NY</OPTION>
              <OPTION value="OH" <? if ($state=='OH') echo " selected"; ?>>OH</OPTION>
              <OPTION value="OK" <? if ($state=='OK') echo " selected"; ?>>OK</OPTION>
              <OPTION value="OR" <? if ($state=='OR') echo " selected"; ?>>OR</OPTION>
              <OPTION value="PA" <? if ($state=='PA') echo " selected"; ?>>PA</OPTION>
	      <OPTION value="PR" <? if ($state=='PR') echo " selected"; ?>>PR</OPTION>
            <OPTION value="PW" <? if ($state=='PW') echo " selected"; ?>>PW</OPTION>
           <OPTION value="RI" <? if ($state=='RI') echo " selected"; ?>>RI</OPTION>
            <OPTION value="SC" <? if ($state=='SC') echo " selected"; ?>>SC</OPTION>
           <OPTION value="SD" <? if ($state=='SD') echo " selected"; ?>>SD</OPTION>
           <OPTION value="TN" <? if ($state=='TN') echo " selected"; ?>>TN</OPTION>
            <OPTION value="TX" <? if ($state=='TX') echo " selected"; ?>>TX</OPTION>
            <OPTION value="UT" <? if ($state=='UT') echo " selected"; ?>>UT</OPTION>
            <OPTION value="VA" <? if ($state=='VA') echo " selected"; ?>>VA</OPTION>
            <OPTION value="VI" <? if ($state=='VI') echo " selected"; ?>>VI</OPTION>
            <OPTION value="VT" <? if ($state=='VT') echo " selected"; ?>>VT</OPTION>
            <OPTION value="WA" <? if ($state=='WA') echo " selected"; ?>>WA</OPTION>
             <OPTION value="WI" <? if ($state=='WI') echo " selected"; ?>>WI</OPTION>
             <OPTION value="WV" <? if ($state=='WV') echo " selected"; ?>>WV</OPTION>
             <OPTION value="WY" <? if ($state=='WY') echo " selected"; ?>>WY</OPTION>
            <OPTION value="AB" <? if ($state=='AB') echo " selected"; ?>>AB</OPTION>
           <OPTION value="BC" <? if ($state=='BC') echo " selected"; ?>>BC</OPTION>
             <OPTION value="MB" <? if ($state=='MB') echo " selected"; ?>>MB</OPTION>
            <OPTION value="NB" <? if ($state=='NB') echo " selected"; ?>>NB</OPTION>
             <OPTION value="NF" <? if ($state=='NF') echo " selected"; ?>>NF</OPTION>
             <OPTION value="NT"  <? if ($state=='NT') echo " selected"; ?>>NT</OPTION>
              <OPTION value="NS" <? if ($state=='NS') echo " selected"; ?>>NS</OPTION>
               <OPTION value="ON" <? if ($state=='ON') echo " selected"; ?>>ON</OPTION>
               <OPTION value="PE" <? if ($state=='PE') echo " selected"; ?>>PE</OPTION>
               <OPTION value="QC" <? if ($state=='QC') echo " selected"; ?>>QC</OPTION>
               <OPTION value="SK" <? if ($state=='SK') echo " selected"; ?>>SK</OPTION>
               <OPTION value="YT" <? if ($state=='YT') echo " selected"; ?>>YT</OPTION>
     </SELECT></font></td>





</TR>
<TR>
  <TD>
	Zip or Postal Code:</td>
   <td align=left><inPUT name="zip" value="<? echo $zip ?>" SIZE=20>
  </TD>
</tr>
<tr>
  <TD>
	Country:</td>
  <td align=left><font face=Arial,helvetica size=4><SELECT Size=1 NAME="country">
<option value="US" <? if ($country=="student") { ?> selected <? } ?>>Select country
<option>
<option value="US" <? if ($country=="US") { ?> selected <? } ?>>United States
<option value="IL" <? if ($country=="IL") { ?> selected <? } ?>>Israel
<option value="CA" <? if ($country=="CA") { ?> selected <? } ?>>Canada
<option value="GB" <? if ($country=="GB") { ?> selected <? } ?>>United Kingdom
<option>
<option value="AF">Afghanistan
<option value="AL">Albania
<option value="DZ">Algeria
<option value="AS">American Samoa
<option value="AD">Andorra
<option value="AO">Angola
<option value="AI">Anguilla
<option value="AQ">Antarctica
<option value="AG">Antigua and Barbuda&nbsp;&nbsp;
<option value="AR">Argentina
<option value="AM">Armenia
<option value="AW">Aruba
<option value="AU">Australia
<option value="AT">Austria
<option value="AZ">Azerbaijan
<option value="BS">Bahamas
<option value="BH">Bahrain
<option value="BD">Bangladesh
<option value="BB">Barbados
<option value="BY">Belarus
<option value="BE">Belgium
<option value="BZ">Belize
<option value="BJ">Benin
<option value="BM">Bermuda
<option value="BT">Bhutan
<option value="BO">Bolivia
<option value="BA">Bosnia Hercegovina
<option value="BW">Botswana
<option value="BV">Bouvet Island
<option value="BR">Brazil
<option value="BN">Brunei Darussalam
<option value="BG">Bulgaria
<option value="BF">Burkina Faso
<option value="BI">Burundi
<option value="KH">Cambodia
<option value="CM">Cameroon
<option value="CA">Canada
<option value="CV">Cape Verde
<option value="KY">Cayman Islands
<option value="CF">C. African Republic
<option value="TD">Chad
<option value="CL">Chile
<option value="CN">China
<option value="CX">Christmas Island
<option value="CC">Cocos Islands
<option value="CO">Colombia
<option value="KM">Comoros
<option value="CG">Congo
<option value="CK">Cook Islands
<option value="CR">Costa Rica
<option value="CI">Cote d'Ivoire
<option value="HR">Croatia
<option value="CU">Cuba
<option value="CY">Cyprus
<option value="CS">Czech Republic
<option value="DK">Denmark
<option value="DJ">Djibouti
<option value="DM">Dominica
<option value="DO">Dominican Republic
<option value="TP">East Timor
<option value="EC">Ecuador
<option value="EG">Egypt
<option value="SV">El Salvador
<option value="GQ">Equatorial Guinea
<option value="EE">Estonia
<option value="ET">Ethiopia
<option value="FK">Falkland Islands
<option value="FO">Faroe Islands
<option value="FJ">Fiji
<option value="FI">Finland
<option value="FR">France
<option value="GF">French Guiana
<option value="GA">Gabon
<option value="GM">Gambia
<option value="GE">Georgia
<option value="DE">Germany
<option value="GH">Ghana
<option value="GI">Gibraltar
<option value="GR">Greece
<option value="GL">Greenland
<option value="GD">Grenada
<option value="GP">Guadeloupe
<option value="GU">Guam
<option value="GT">Guatemala
<option value="GS">Guernsey
<option value="GN">Guinea
<option value="GW">Guinea Bissau
<option value="GY">Guyana
<option value="HT">Haiti
<option value="HN">Honduras
<option value="HK">Hong Kong
<option value="HU">Hungary
<option value="IS">Iceland
<option value="IN">India
<option value="ID">Indonesia
<option value="IR">Iran
<option value="IQ">Iraq
<option value="IE">Ireland
<option value="IM">Isle of Man
<option value="IL">Israel
<option value="IT">Italy
<option value="JM">Jamaica
<option value="JP">Japan
<option value="JE">Jersey
<option value="JO">Jordan
<option value="KZ">Kazakhstan
<option value="KE">Kenya
<option value="KI">Kiribati
<option value="KP">Korea North
<option value="KR">Korea South
<option value="KW">Kuwait
<option value="KG">Kyrgyzstan
<option value="LA">Laos
<option value="LV">Latvia
<option value="LB">Lebanon
<option value="LS">Lesotho
<option value="LR">Liberia
<option value="LI">Liechtenstein
<option value="LT">Lithuania
<option value="LU">Luxembourg
<option value="MO">Macau
<option value="MG">Madagascar
<option value="MW">Malawi
<option value="MY">Malaysia
<option value="MV">Maldives
<option value="ML">Mali
<option value="MT">Malta
<option value="MH">Marshall Islands
<option value="MQ">Martinique
<option value="MR">Mauritania
<option value="MU">Mauritius
<option value="MX">Mexico
<option value="FM">Micronesia
<option value="MD">Moldova
<option value="MC">Monaco
<option value="MN">Mongolia
<option value="MS">Montserrat
<option value="MA">Morocco
<option value="MZ">Mozambique
<option value="MM">Myanmar
<option value="NA">Namibia
<option value="NR">Nauru
<option value="NP">Nepal
<option value="NL">Netherlands
<option value="AN">Netherlands Antilles
<option value="NC">New Caledonia
<option value="NZ">New Zealand
<option value="NI">Nicaragua
<option value="NE">Niger
<option value="NG">Nigeria
<option value="NU">Niue
<option value="NF">Norfolk Island
<option value="NO">Norway
<option value="OM">Oman
<option value="PK">Pakistan
<option value="PW">Palau
<option value="PA">Panama
<option value="PG">Papua New Guinea
<option value="PY">Paraguay
<option value="PE">Peru
<option value="PH">Philippines
<option value="PN">Pitcairn
<option value="PL">Poland
<option value="PT">Portugal
<option value="PR">Puerto Rico
<option value="QA">Qatar
<option value="RO">Romania
<option value="RU">Russian Federation
<option value="RW">Rwanda
<option value="SH">Saint Helena
<option value="KN">Saint Kitts and Nevis
<option value="LC">Saint Lucia
<option value="WS">Samoa
<option value="SM">San Marino
<option value="ST">Sao Tome and Principe
<option value="SA">Saudi Arabia
<option value="SN">Senegal
<option value="SC">Seychelles
<option value="SL">Sierra Leone
<option value="SG">Singapore
<option value="SI">Slovenia
<option value="SK">Slowak Republic
<option value="SB">Solomon Islands
<option value="SO">Somalia
<option value="ZA">South Africa
<option value="SU">Soviet Union
<option value="ES">Spain
<option value="LK">Sri Lanka
<option value="SD">Sudan
<option value="SR">Suriname
<option value="SZ">Swaziland
<option value="SE">Sweden
<option value="CH">Switzerland
<option value="SY">Syria
<option value="TW">Taiwan
<option value="TJ">Tajikistan
<option value="TZ">Tanzania
<option value="TH">Thailand
<option value="TG">Togo
<option value="TK">Tokelau
<option value="TO">Tonga
<option value="TT">Trinidad and Tobago
<option value="TN">Tunisia
<option value="TR">Turkey
<option value="TM">Turkmenistan
<option value="TV">Tuvalu
<option value="UG">Uganda
<option value="UA">Ukraine
<option value="AE">United Arab Emirates
<option value="GB">United Kingdom
<option value="US">United States
<option value="UY">Uruguay
<option value="UZ">Uzbekistan
<option value="VU">Vanuatu
<option value="VA">Vatican City State
<option value="VE">Venezuela
<option value="VN">Vietnam
<option value="VG">Virgin Islands (UK)
<option value="VI">Virgin Islands (US)
<option value="EH">Western Sahara
<option value="YE">Yemen
<option value="YU">Yugoslavia
<option value="ZR">Zaire
<option value="ZM">Zambia
<option value="ZW">Zimbabwe
</SELECT></TD>
</TR>
<TR>
  <TD>Home Telephone:<i>(optional)</i></td>
<td align=left><INPUT name="homephone" value="<? echo $homephone ?>" SIZE=20></td></tr>
<tr><TD>Business Telephone:<i>(optional)</i></td>
<td align=left><INPUT name="busphone" value="<? echo $busphone ?>" SIZE= 20></TD></TR>
<tr><TD>Fax:<i>(optional)</i></td>
<td align=left><INPUT name="fax" value="<? echo $fax ?>" SIZE= 20></TD></TR>
<tr><TD>Cellphone:<i>(optional)</i></td>
<td align=left><INPUT name="cell" value="<? echo $cell ?>" SIZE= 20></TD></TR>



<tr><td>
Gender:</td><td valign=top align=left>
<input type="radio" name="gender" value="M" <? if ($gender=="M") { ?> checked <? } ?> > Male
&nbsp;&nbsp;
<input type="radio" name="gender" value="F" <? if ($gender=="F") { ?> checked <? } ?> > Female
</td></tr>

<tr><td>
Date of Birth :</td><td align=left>
<input name="year" value="<? echo $year ?>" size=4>-<input name="month" value="<? echo $month ?>" size=2>-<input name="day" value="<? echo $day ?>" size=2></td></tr>
<tr><td>&nbsp;</td><td align=left><font face=Arial,helvetica size=1>Year &nbsp; &nbsp; &nbsp; &nbsp; Month &nbsp;&nbsp;&nbsp;Day</td></tr>



<tr><td>Marital Status:</td><td align=left>
<select NAME="marital" WIDTH=13 value="<? echo $Marital ?>">
<option value="" <? if ($marital=="") { ?> selected <? } ?>>Choose
<option value="single" <? if ($marital=="single") { ?> selected <? } ?>>Single
<option value="married" <? if ($marital=="married") { ?> selected <? } ?>>Married
<option value="divorced" <? if ($marital=="divorced") { ?> selectd <? } ?>>Divorced
<option value="widowed" <? if ($marital=="widowed") { ?> selected <? } ?>>Widowed
<option value="thefifth" <? if ($marital=="thefifth") { ?> selected <? } ?>>I'd prefer not to specify.
</select></td></tr>
<tr><td colspan=2>Current Education or Employment status:</td> </tr><tr>
<td colspan=2 align=right><select NAME="occupation" WIDTH=13 value="<? echo $Occupation ?>">
<option value="" <? if ($occupation=="") { ?> selected <? } ?>>Choose
<option value="student" <? if ($occupation=="student") { ?> selected <? } ?>>Student (through high school)
<option value="college" <? if ($occupation=="college") { ?> selected <? } ?>>College (Undergraduate)
<option value="grad" <? if ($occupation=="grad") { ?> selected <? } ?>>Graduate / Post-Doctoral Student
<option value="employed" <? if ($occupation=="employed") { ?> selected <? } ?>>Employed (or Seeking Employment)
<option value="homemaker" <? if ($occupation=="homemaker") { ?> selected <? } ?>>Home Maker / Full-time Parent
<option value="retired" <? if ($occupation=="retired") { ?> selected <? } ?>>Retired
<option value="thefifth" <? if ($occupation=="thefifth") { ?> selected <? } ?>>I'd prefer not to specify.
</select>
  </td>
</tr>

</table>
<p>
<TABLE BORDER=0 align=center width=70% style="font-family:verdana,arial;font-size:9pt;">
<tr><td colspan=2>
Please enter a password here. You will use it - along with your email
address as entered above - for any future updates
to your user information, and for access to any special
sections of our web space which Project Genesis might make available to you.<p>

</td></tr>
<TR>
<TD>Choose a Password:</TD>
<TD>Enter again to confirm:</TD>
</TR>
<TR>
<TD><inPUT type="password" name="password" SIZE=20 MAXSIZE=15 value=<? echo $password ?>></TD>
<TD><inPUT type="password" name="cpassword" SIZE=20 MAXSIZE=15 value=<? echo $cpassword ?>></TD>
</TR>
</TABLE>
<p>
<CENTER>
<TABLE CELLPADDING=4>
<TR><TD align=center><input type=submit value="Submit"></TD> <TD align=center><input type="RESET" value="Clear Form"></TD></TR>
</TABLE>
</CENTER>
<p>
</blockquote>
<input type="Hidden" name="referorg" value="<? echo $referorg ?>">
<input type="Hidden" name="mo" value="<? echo $mo ?>">
<input type="Hidden" name="yr" value="<? echo $yr ?>">
<input type="Hidden" name="dy" value="<? echo $dy ?>">
<input type="hidden" name="demorecord" value=<? echo $demorecord ?>>
<input type="hidden" name="loggedin" value=<? echo $loggedin ?>>
<input type="hidden" name="submit" value="yes">
<input type="hidden" name="oldpassword" value="<? echo $oldpassword ?>">
<input type="hidden" name="regID" value="<? echo $regID ?>">
<input type="hidden" name="url" value="<? if (isset($url)) echo $url; else echo $HTTP_REFERER; ?>">
<input type="hidden" name="querystring" value="<? echo $QUERY_STRING ?>">
<input type="hidden" name="oid" value="<? echo $oid ?>">
<input type="hidden" name="pid" value="<? echo $pid ?>">
<?

if (! isset($h_referer))
{
$h_referer=getenv("HTTP_REFERER") ;
}

?>
<input type="hidden" name="h_referer" value="<? echo $h_referer ?>">
<input type="hidden" name="gotreferer" value="yes">


</FORM>

<?
//echo "<FONT COLOR=white SIZE='-2'>$HTTP_REFERER hi";
require ('footers/footer.php3'); ?>

