-<?PHP
-if (isset($_POST)){
- $web_first_name='';
- if (isset($_POST['web_first_name'])){
- $web_first_name = $_POST['web_first_name'];
- setcookie("web_first_name", $web_first_name, time()+300);
- }
- $web_last_name='';
- if (isset($_POST['web_last_name'])){
- $web_last_name = $_POST['web_last_name'];
- setcookie("web_last_name", $web_last_name, time()+300);
- }
- $web_house_number='';
- if (isset($_POST['web_house_number'])){
- $web_house_number = $_POST['web_house_number'];
- setcookie("web_house_number", $web_house_number, time()+300);
- }
- $web_zip_code='';
- if (isset($_POST['web_zip_code'])){
- $web_zip_code = $_POST['web_zip_code'];
- setcookie("web_zip_code", $web_zip_code, time()+300);
- }
- setcookie("web_name", $web_first_name.' '.$web_last_name, time()+300);
- header('is_the_information_correct.php');
-}
-include_once('header.php');
-?>
-
-<form method='POST'>
-
- <div class='col-sm-12' style='height:100px; text-align:center;'><h3>Please enter your Name and ZIP Code as it appears on your Maryland Voter Registration</h3></div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><h3>First Name</h3></div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><h3>Last Name</h3></div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><input name='web_first_name'> </div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><input name='web_last_name'> </div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><h3>House Number</h3></div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><h3>ZIP Code</h3></div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><input name='web_house_number'> </div>
-
- <div class='col-sm-6' style='height:50px; text-align:center;'><input name='web_zip_code'> </div>
-
- <div class='col-sm-12' style='height:50px; text-align:center;'><button type="submit" class="btn btn-success">Next</button></div>
-
- <div class='col-sm-12' style='height:50px; text-align:center;'><button type="reset" class="btn btn-warning">Clear</button></div>
-</form>
-
-<?PHP include_once('footer.php');
+<?PHP
+if (empty($_COOKIE['signature_status'])){
+ setcookie("signature_status", 'unverified');
+}
+if (isset($_POST['web_first_name'])){
+ $DOB='';
+ if (isset($_POST['DOB'])){
+ if ($_POST['DOB'] != ''){
+ $DOB = $_POST['DOB'];
+ setcookie("pDOB", $DOB);
+ }
+ }
+ $web_first_name='';
+ if (isset($_POST['web_first_name'])){
+ if ($_POST['web_first_name'] != ''){
+ $web_first_name = $_POST['web_first_name'];
+ setcookie("web_first_name", $web_first_name);
+ }
+ }
+ $web_last_name='';
+ if (isset($_POST['web_last_name'])){
+ if ($_POST['web_last_name'] != ''){
+ $web_last_name = $_POST['web_last_name'];
+ setcookie("web_last_name", $web_last_name);
+ }
+ }
+ if(isset($_POST['web_last_name']) && isset($_POST['web_first_name'])){
+ setcookie("web_name", $web_first_name.' '.$web_last_name);
+ }
+ $web_house_number='';
+ if (isset($_POST['web_house_number'])){
+ if ($_POST['web_house_number'] != ''){
+ $web_house_number = $_POST['web_house_number'];
+ setcookie("web_house_number", $web_house_number);
+ }
+ }
+ $web_zip_code='';
+ if (isset($_POST['web_zip_code'])){
+ if ($_POST['web_zip_code'] != ''){
+ $web_zip_code = $_POST['web_zip_code'];
+ setcookie("web_zip_code", $web_zip_code);
+ }
+ }
+ $contact_phone='';
+ if (isset($_POST['contact_phone'])){
+ if ($_POST['contact_phone'] != ''){
+ $contact_phone = $_POST['contact_phone'];
+ setcookie("pPHONE", $contact_phone);
+ }
+ }
+ header('Location: is_the_information_correct.php');
+}
+include_once('header.php');
+slack_general('Entering Information','md-petition');
+ $qX = "select * from website_text where id = '2'";
+ $rX = $petition->query($qX);
+ $dX = mysqli_fetch_array($rX);
+?>
+<script>document.title = "MEPS - Enter Information";</script>
+<form method='POST'>
+
+ <div class='row'>
+ <div class='col-sm-8' style='text-align:center;'><h1><?PHP echo $dX['text_title'];?></h1><h2 style="margin:25px; padding25px; background-color:lightyellow;"><?PHP echo $dX['text_block'];?></h2></div>
+ </div>
+
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>First Name</h2></div>
+ <div class='col-sm-5' style='text-align:left;'><input class="form-control input-lg" name='web_first_name'></div>
+ </div>
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>Last Name</h2></div>
+ <div class='col-sm-5' style='text-align:left;'><input class="form-control input-lg" name='web_last_name'></div>
+ </div>
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>Date of Birth</h2></div>
+ <div class='col-sm-5'>
+ <div class="input-group date">
+ <span class="input-group-addon"><i class="glyphicon glyphicon-th"></i></span><input name='DOB' type="text" class="form-control">
+ </div>
+ <script>
+ var $d = jQuery.noConflict();
+ $d('.input-group.date').datepicker({
+ format: "mm/dd/yyyy",
+ clearBtn: true
+ });
+ </script>
+ </div>
+ </div>
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>Phone Number</h2></div>
+ <div class='col-sm-5' style='text-align:left;'><input class="form-control input-lg" name='contact_phone' type='tel'> </div>
+ </div>
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>House Number</h2></div>
+ <div class='col-sm-5' style='text-align:left;'><input class="form-control input-lg" name='web_house_number' type='number'> </div>
+ </div>
+
+ <div class='row'>
+ <div class='col-sm-3' style='text-align:right;'><h2>ZIP Code</h2></div>
+ <div class='col-sm-5' style='text-align:left;'><input class="form-control input-lg" name='web_zip_code' type='number'> </div>
+ </div>
+
+
+ <div class='row'>
+ <div class='col-sm-4' style='text-align:center;'><button type="reset" class="btn btn-warning btn-lg btn-block">Clear</button></div>
+ <div class='col-sm-4' style='text-align:center;'><button type="submit" class="btn btn-success btn-lg btn-block">Next</button></div>
+ </div>
+
+</form>
+
+<?PHP include_once('footer.php');
HCoop / clinton / MarylandElectronicPetitionSignature.git / blobdiff