[Summary view] [Print] [Text view]

   1  <?php
   2  if ($script_name = basename($HTTP_SERVER_VARS["SCRIPT_NAME"]) != "index.php" ) {
   3   print "<meta http-equiv=\"refresh\" content=\"0; URL=../index.php\">";
   4   exit;
   5  }
   6  
   7  print "<p><center><form action=./index.php method=POST>";
   8  print "<table cellpadding=1 cellspacing=1 border=0 width=30%>";
   9  print "<tr valign=middle><td width=50% align=right>First Name:</td>
  10          <td width=50% align=left><input type=text name=first size=15 maxlength=15 value=$first></td></tr>";
  11  print "<tr valign=middle><td width=50% align=right>Last Name:</td>
  12          <td width=50% align=left><input type=text name=lastname size=15 maxlength=25 value=$last></td></tr>";
  13  print "<tr valign=middle><td width=50% align=right>Address:</td>
  14          <td width=50% align=left><input type=text name=first size=15 maxlength=50 value=$address></td></tr>";
  15  print "<tr valign=middle><td width=50% align=right>City:</td>
  16          <td width=50% align=left><input type=text name=city size=15 maxlength=40 value=$city></td></tr>";
  17  print "<tr valign=middle><td width=50% align=right>State:</td>
  18          <td width=50% align=left><input type=text name=state size=2 maxlength=2 value=$state></td></tr>";
  19  print "<tr valign=middle><td width=50% align=right>Zip:</td>
  20          <td width=50% align=left><input type=text name=zip size=5 maxlength=5 value=$zip></td></tr>";
  21  print "<tr valign=middle><td width=50% align=right>Home Phone:</td>
  22          <td width=50% align=left><input type=text name=phone size=15 maxlength=20 value=$phone></td></tr>";
  23  print "<tr valign=middle><td width=50% align=right>E-mail Address:</td>
  24          <td width=50% align=left><input type=text name=email size=15 maxlength=50 value=$email></td></tr>";
  25  print "<tr valign=middle><td width=50% align=right>Birth Date:</td>
  26          <td width=50% align=left><input type=text name=birthdate size=10 maxlength=10 value=$birthdate> (YYYY-MM-DD)</td></tr>";
  27  print "<tr valign=middle><td width=50% align=right>Assignment:</td>
  28          <td width=50% align=left><input type=text name=assignment size=30 maxlength=30 value=$assignment></td></tr>";
  29  print "<tr valign=middle><td width=50% align=right>Patrol:</td>
  30          <td width=50% align=left><input type=text name=patrol size=30 maxlength=30 value=$patrol></td></tr>";
  31  print "</table><input name=Submit value=Submit type=submit><input type=hidden name=rowid value=$record_key>
  32          </form>";
  33  
  34  ?>