Public feed #598591

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public text v1 · immutable
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·published 2007-07-01 13:46 UTC
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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<!-- saved from url=(0014)about:internet -->
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Blackpool YOF @ rubothered.co.uk</title>
<?
include("include/yellow.inc");
include("include/settings.php");
$page=$_GET['page']; 
?>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<style type="text/css">
d img {display: block;}
d img {display: block;}td img {display: block;}a:link {
	color: #000000;
}
a:visited {
	color: #000000;
}
a:hover {
	color: #FFFF00;
}
a:active {
	color: #000000;
}
a {
	font-family: Verdana, Arial, Helvetica, sans-serif;
}
</style>
<!--Fireworks 8 Dreamweaver 8 target.  Created Tue May 29 18:05:25 GMT+0100 (GMT Standard Time) 2007-->
</head>
<body bgcolor="#ffffff">
<font face="Verdana, Arial, Helvetica, sans-serif"><b>
	<marquee bgcolor="#0066FF" scrollamount="3">R U Bothered Latest News :: <? echo $cmsMOTD; 
	if($ukypvote==1){ echo " :: <a href='http://ukyp.rubothered.co.uk/vote.php' target='_blank'>Vote for your UKYP now!</a>";
	} ?> :: <? echo $tickerText; ?></marquee></b></font><br />
<table width="735" border="0" align="center" cellpadding="0" cellspacing="0">
<!-- fwtable fwsrc="Untitled" fwbase="top.jpg" fwstyle="Dreamweaver" fwdocid = "1912419231" fwnested="0" -->
  <tr>
   <td><img src="img/spacer.gif" width="109" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="103" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="103" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="104" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="103" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="103" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="110" height="1" border="0" alt="" /></td>
   <td><img src="img/spacer.gif" width="1" height="1" border="0" alt="" /></td>
  </tr>

  <tr>
   <td colspan="7"><img name="top_r1_c1" src="img/top_r1_c1.jpg" width="735" height="235" border="0" id="top_r1_c1" alt="" /></td>
   <td><img src="img/spacer.gif" width="1" height="235" border="0" alt="" /></td>
  </tr>
  <tr>
   <td><a href="http://www.rubothered.co.uk"><img name="top_r2_c1" src="img/top_r2_c1.jpg" width="109" height="49" border="0" id="top_r2_c1" alt="" /></a></td>
   <td><a href="http://bypc.rubothered.co.uk"><img name="top_r2_c2" src="img/top_r2_c2.jpg" width="103" height="49" border="0" id="top_r2_c2" alt="" /></a></td>
   <td><a href="http://blackpoolvoice.rubothered.co.uk"><img name="top_r2_c3" src="img/top_r2_c3.jpg" width="103" height="49" border="0" id="top_r2_c3" alt="" /></a></td>
   <td><a href="http://biffy.rubothered.co.uk"><img name="top_r2_c4" src="img/top_r2_c4.jpg" width="104" height="49" border="0" id="top_r2_c4" alt="" /></a></td>
   <td><a href="http://yc.rubothered.co.uk"><img name="top_r2_c5" src="img/top_r2_c5.jpg" width="103" height="49" border="0" id="top_r2_c5" alt="" /></a></td>
   <td><a href="#"><img name="top_r2_c6" src="img/top_r2_c6.jpg" width="103" height="49" border="0" id="top_r2_c6" alt="" /></a></td>
   <td><a href="http://ukyp.rubothered.co.uk"><img name="top_r2_c7" src="img/top_r2_c7.jpg" width="110" height="49" border="0" id="top_r2_c7" alt="" /></a></td>
   <td><img src="img/spacer.gif" width="1" height="49" border="0" alt="" /></td>
  </tr>
  <tr>
  <td bordercolor="#0066FF" bgcolor="#FFFF33" valign="top"><font face="Verdana, Arial, Helvetica, sans-serif"><?

$self = $_SERVER['PHP_SELF'];
	
// Connect
$conn 	= mysql_connect($hnam,$unam,$pnam) or die(mysql_error());
$rs 		= mysql_select_db($dnam, $conn) or die(mysql_error());

// Select Data
$sql = "select * from cms_menu where menuCategory='yof' order by menuOrder asc";

// Execute Query
$rs = mysql_query( $sql, $conn ) or die(mysql_error());
echo "<p align='left'>";
while( $row = mysql_fetch_array( $rs ) )
{
echo ( "<a href='" . $row["menuUrl"] . "'><img src='" . $row["menuIMG"] . "' border='0' alt='" . $row["menuName"] . "'></a><br>" );
}
echo "</p>";
?></font></td>
   <td colspan="6" valign="top">
     <blockquote>
       <p>
         <font face="Verdana, Arial, Helvetica, sans-serif" color="#000000">
<?		 
		 
        $self = $_SERVER['PHP_SELF'];
        $appName = $_POST['appName'];
		$appDOB_Day = $_POST['appDOB_Day'];
		$appDOB_Mon = $_POST['appDOB_Mon'];
		$appDOB_Year = $_POST['appDOB_Year'];
		$appWard = $_POST['appWard'];
		$appPhone = $_POST['appPhone'];
		$appEmail = $_POST['appEmail'];
		$appType = $_POST['appType'];
		$appCompleting = $_POST['appCompleting'];
		$appAmount = $_POST['appAmount'];
		$appFullCost = $_POST['appFullCOst'];
		$appDescription = $_POST['appDescription'];
		$appBreakdown = $_POST['appBreakdown'];
		$appSporting = $_POST['appSporting'];
		$appCultural = $_POST['appCultural'];
		$appRecreational = $_POST['appRecreational'];
		$appVolunteering = $_POST['appVolunteering'];
		$appSafe = $_POST['appSafe'];
		$appHealth = $_POST['appHealth'];
		$appEnjoy = $_POST['appEnjoy'];
		$appEconomic = $_POST['appEconomic'];
		$appPositive = $_POST['appPositive'];
		$appHowInvolved = $_POST['appHowInvolved'];
		$appYPBenefit = $_POST['appYPBenefit'];
		$appBefore = $_POST['appBefore'];
		$appBeforeHow = $_POST['appBeforeHow'];
		$appChequeTo = $_POST['appChequeTo'];
		$appSupportWorker = $_POST['appSupportWorker'];
		$appAgency = $_POST['appAgency'];
		$appSupportContact = $_POST['appSupportContact'];
?>

<form action="<? echo( $self ); ?>" method="post">

<table><tr><td valign="top">Applicant Name:</td>
<td valign="top"><input type="text" name="appName" size="8"></td></tr>

<td valign="top">Date of Birth: </td>
<td valign="top"><input type="text" name="appDOB_Day" size="3"> <input type="text" name="appDOB_Mon" size="3"> <input type="text" name="appDOB_Year" size="5"> (DD/MM/YYYY)</td></tr>

<td valign="top">Ward: </td>
<td valign="top"></td></tr>

<td valign="top">Contact Phone Number: </td>
<td valign="top"><input type="text" name="appPhone" size="14"></td></tr>

<td valign="top">Email: </td>
<td valign="top"><input type="text" name="appEmail" size="30"></td></tr>

<td valign="top">Grant Type: </td>
<td valign="top"><select name="appType"><option value="individual">Individual Grant</option><option value="group">Group Grant</option></select></td></tr>

<td valign="top">Number of young people completing this form: </td>
<td valign="top"><input type="text" name="appCompleting" size="5"></td></tr>

<td valign="top">Amount Applying For: </td>
<td valign="top"><input type="text" name="appAmount" size="8"></td></tr>

<td valign="top">Is this the full cost of the project: </td>
<td valign="top"><select name="appFullCost"><option value="yes">Yes</option><option value="no">No</option></select></td></tr>

<td valign="top">Give a brief description of the project: </td>
<td valign="top"><textarea name="appDescription" rows="5" cols="40"></textarea></td></tr>

<td valign="top">Please give a list of expenditure: </td>
<td valign="top"><textarea name="appBreakdown" rows="5" cols="40"></textarea></td></tr>

<td valign="top">Which of the following does the project include: </td>
<td valign="top"><input name="appSporting" type="checkbox" value="yes"> - Sports<br />
<input name="appCultural" type="checkbox" value="yes"> - Culture<br />
<input name="appRecreational" type="checkbox" value="yes"> - Recreation<br />
<input name="appVolunteering" type="checkbox" value="yes"> - Volunteering</td></tr>

<td valign="top">Which of the following areas does the project fit into: </td>
<td valign="top"><input name="appSafe" type="checkbox" value="yes"> - Staying Safe<br />
<input name="appHealth" type="checkbox" value="yes"> - Being Healthy<br />
<input name="appEnjoy" type="checkbox" value="yes"> - Enjoying and Achieving<br />
<input name="appEconomic" type="checkbox" value="yes"> - Economic Wellbeing<br />
<input name="appPositive" type="checkbox" value="yes"> - Making a Positive Contribution</td></tr>

<td valign="top">How have young people been involved: </td>
<td valign="top"><textarea name="appHowInvolved" rows="5" cols="40"></textarea></td></tr>

<td valign="top">How many young people aged 13-19 will benefit from this project: </td>
<td valign="top"><textarea name="appYPBenefit" rows="5" cols="40"></textarea></td></tr>

<td valign="top">Has you or your group applied for money before: </td>
<td valign="top"><input name="appBefore" type="checkbox" value="no"> - No<br />
<textarea name="appBeforeHow" rows="5" cols="40">If yes please describe?</textarea></td></tr>

<td valign="top">If successful who would you like the cheque payable to: </td>
<td valign="top"><textarea name="appChequeTo" rows="5" cols="40"></textarea></td></tr>

<td valign="top" colspan="2"><i>(Applicants under the age of 18 must nominate a parent/legal guardian/group)</i></td></tr>

<td valign="top">Support Worker Name: </td>
<td valign="top"><input type="text" name="appSupportWorker" size="20"></td></tr>

<td valign="top">Agency/Organisation: </td>
<td valign="top"><input type="text" name="appAgency" size="20"></td></tr>

<td valign="top">Contact Phone Number: </td>
<td valign="top"><input type="text" name="appSupportContact" size="20"></td></tr>

<td align="center">
<input type="submit" value="Apply Now"></td></tr></table></form>

<?
  if( $appName and $appDOB_Day and $appDOB_Mon and $appDOB_Year and $appWard and $appPhone and $appType and $appCompleting and $appAmount and $appFullCost and $appDescription and $appBreakdown and $appHowInvolved and $appYPBenefit and $appBefore and $appBeforeHow and $appChequeTo )
{
    $conn=mysql_connect( "$hnam", "$unam", "$pnam" )
              or die(mysql_error());

    $rs = mysql_select_db( "$dnam", $conn )
              or die(mysql_error());

    $sql="insert into cms_yof_apps ( appName, appDOB_Day, appDOB_Mon, appDOB_Year, appWard, appPhone, appEmail, appType, appCompleting, appAmount, appFullCost, appDescription, appBreakdown, appSporting, appCultural, appRecreational, appVolunteering, appSafe, appHealth, appEnjoy, appEconomic, appPositive, appHowInvolved, appYPBenefit, appBefore, appBeforeHow, appChequeTo, appSupportWorker, appAgency, appSupportContact )
              values ( '$appName', '$appDOB_Day', '$appDOB_Mon', '$appDOB_Year', '$appWard', '$appPhone', '$appEmail', '$appType', '$appCompleting', '$appAmount', '$appFullCost', '$appDescription', '$appBreakdown', '$appSporting', '$appCultural', '$appRecreational', '$appVolunteering', '$appSafe', '$appHealth', '$appEnjoy', '$appEconomic', '$appPositive', '$appHowInvolved', '$appYPBenefit', '$appBefore', '$appBeforeHow', '$appChequeTo', '$appSupportWorker', '$appAgency', '$appSupportContact' )";

    $rs = mysql_query( $sql, $conn );

if($rs){ echo( "Application Submitted" ); }
}
?>
		 
		 </font>
         </p>
    </blockquote></td>
		 </tr>
  <tr>
    <td colspan="7"><div align="center"><font size="-2" face="Verdana, Arial, Helvetica, sans-serif">Designed by <? echo ( $designby ) ?><br />
      Copyright <? echo ( $copyright ) ?><br />
    Version <? echo ( $version ) ?></font></div></td>
  </tr>
</table>
</body>
</html>