rendered paste body<?PHP
if(isset($_POST['submit'])) {
$new_user_first_name = $_POST['new_user_first_name'];
$new_user_last_name = $_POST['new_user_last_name'];
$new_user_middle_name = $_POST['new_user_middle_name'];
$new_user_requestors_name = $_POST['new_user_requestors_name'];
$new_user_requestors_email = $_POST['new_user_requestors_email'];
$new_user_requestors_ext = $_POST['new_user_requestors_ext'];
$new_user_apps_domain = $_POST['new_user_apps_domain'];
$new_user_apps_email = $_POST['new_user_apps_email'];
$new_user_apps_jabber = $_POST['new_user_apps_jabber'];
$new_user_apps_siebel = $_POST['new_user_apps_siebel'];
$new_user_apps_google_cal = $_POST['new_user_apps_google_cal'];
$new_user_apps_projectpath = $_POST['new_user_apps_projectpath'];
$new_user_apps_my_synertx_com = $_POST['new_user_apps_my.synertx.com'];
$new_user_apps_phone = $_POST['new_user_apps_phone'];
$new_user_apps_phone_ext = $_POST['new_user_apps_phone_ext'];
$new_user_apps_other = $_POST['new_user_apps_other'];
$new_user_apps_special_inst = $_POST['new_user_apps_special_inst'];
$new_user_apps_other_info = $_POST['new_user_apps_other_info'];
$new_user_apps_Special_Inst = $_POST['new_user_apps_Special_Inst'];
$new_user_dup_user = $_POST['new_user_dup_user'];
$new_user_printers = $_POST['new_user_printers'];
$year = date("Y");
$month = date("m");
$day = date("d");
$hours2 = date("H");
if ($hours2 == "00") {$hours = "10";}
elseif ($hours2 == "01") {$hours = "11";}
elseif ($hours2 == "02") {$hours = "00";}
else {$hours = $hours2;};
$time = date("$hours:i");
echo "<b>Your request has been sent to the IT Staff!</b>
<p>
You should be contact back shortly";
$to = "admins@gerbitz.org";
$subject = "IT SERVICES REQUEST FOR NEW HIRE";
$message = "A New hire request has just been submitted by: $new_user_requestors_name
The New Hires Information is the following:
Name: $new_user_first_name $new_user_middle_name $new_user_last_name
Applications Needed for this new hire are:
<li>$new_user_apps_domain
<li>$new_user_apps_email
<li>$new_user_apps_jabber
<li>$new_user_apps_siebel
<li>$new_user_apps_google_cal
<li>$new_user_apps_projectpath
<li>$new_user_apps_my.synertx.com
<li>$new_user_apps_phone
<li>$new_user_apps_phone_ext
<li>$new_user_apps_other
<li>$new_user_apps_special_inst
<li>$new_user_apps_other_info
<li>$new_user_apps_Special_Inst
<li>$new_user_dup_user
<li>$new_user_printers
$headers = "From: $new_user_requestors_email";
$ok = @mail($to, $subject, $message, $headers);
if ($ok) {
echo "";}
};
?>
} else {
?>
<div align="center">
<h2><strong>Corporate New User Request Page</strong>
</h2>
</div>
<p>This page is used, when you would request IT Services for a new hire. Please complete this page.</p>
<p><strong><u>New User Information</u></strong></p>
<table width="600" border="0">
<form method="post" name="myform" action="<?php echo $_SERVER['PHP_SELF']; ?>" >
<tr>
<td>First Name: </td>
<td><input name="new_user_first_name" type="text" id="new_user_first_name" size="25" /></td>
</tr>
<tr>
<td>Last Name:</td>
<td><input name="new_user_last_name" type="text" id="new_user_last_name" size="25" /></td>
</tr>
<tr>
<td>Middle Name
:</td>
<td><input name="new_user_middle_name" type="text" id="new_user_middle_name" size="25" /></td>
</tr>
</table>
<p><strong><u>Requestors Information:</u></strong></p>
<table width="600" border="0">
<tr>
<td>Requestors Name:</td>
<td><input name="new_user_requestors_name" type="text" id="new_user_requestors_name" size="25" maxlength="25" /></td>
</tr>
<tr>
<td>Requestors Email:</td>
<td><input name="new_user_requestors_email" type="text" id="new_user_requestors_email" size="25" maxlength="25" /></td>
</tr>
<tr>
<td>Requestors Phone Ext:</td>
<td><input name="new_user_requestors_ext" type="text" id="new_user_requestors_ext" size="5" maxlength="5" /></td>
</tr>
</table>
<p><u><strong>A</strong></u><strong><u>pplications/Programs that the new user would need access to:</u></strong></p>
<table width="595" border="0">
<tr>
<td width="287"><input name="new_user_apps_domain" type="checkbox" id="new_user_apps_domain" value="checkbox" />
Domain/Computer Login</td>
<td width="298"><input name="new_user_apps_email" type="checkbox" id="new_user_apps_email" value="checkbox" />
Email </td>
</tr>
<tr>
<td><input name="new_user_apps_jabber" type="checkbox" id="new_user_apps_jabber" value="checkbox" />
Spark/Jabber</td>
<td><input name="new_user_apps_siebel" type="checkbox" id="new_user_apps_siebel" value="checkbox" />
Siebel </td>
</tr>
<tr>
<td><input name="new_user_apps_google_cal" type="checkbox" id="new_user_apps_google_cal" value="checkbox" />
Google Calendar</td>
<td><input name="new_user_apps_projectpath" type="checkbox" id="new_user_apps_projectpath" value="checkbox" />
synertx.projectpath.com login </td>
</tr>
<tr>
<td><input name="new_user_apps_my_synertex_com" type="checkbox" id="new_user_apps_my_synertex_com" value="checkbox" />
my.synertx.com login</td>
<td><input name="new_user_apps_phone" type="checkbox" id="new_user_apps_phone" value="checkbox" />
Phone: Ext:
<input name="new_user_apps_phone_ext" type="text" id="new_user_apps_phone_ext" size="5" maxlength="5" /></td>
</tr>
<tr>
<td><input name="new_user_apps_other" type="checkbox" id="new_user_apps_other" value="checkbox" />
Other, Please specify below:</td>
<td><input name="new_user_apps_special_inst" type="checkbox" id="new_user_apps_special_inst" value="checkbox" />
Special Instructions, Please specify below: </td>
</tr>
<tr>
<td><textarea name="new_user_other_info" cols="50" rows="10" id="new_user_other_info"></textarea></td>
<td><textarea name="new_user_Special_Inst" cols="50" rows="10" id="new_user_Special_Inst"></textarea></td>
</tr>
<tr>
<td>Which users should this duplictate: </td>
<td><input name="new_user_dup_user" type="text" id="new_user_dup_user" /></td>
</tr>
<tr>
<td height="30">What printers should this person need access to: </td>
<td height="30"><input name="new_user_printers" type="text" id="new_user_printers" /></td>
</tr>
</table><br><br>
<center><input type="submit" name="submit" value="Submit"></center>
<p><br />
</p>
<?php
}
?>