Skip to content

Instantly share code, notes, and snippets.

@accessomnath
Last active June 29, 2016 12:56
Show Gist options
  • Save accessomnath/483aece63bd04829e172628fdc5117eb to your computer and use it in GitHub Desktop.
Save accessomnath/483aece63bd04829e172628fdc5117eb to your computer and use it in GitHub Desktop.
<?php
/**
* Created by PhpStorm.
* User: somnath
* Date: 21/6/16
* Time: 7:38 PM
*
* Template Name: registration
*/
get_header();
if (isset($_POST['submit'])) {
// EDIT THE 2 LINES BELOW AS REQUIRED
$email_to = "nsomnathswadesh@gmail.com";
$email_subject = "Online Application";
function died($error)
{
// your error code can go here
echo "We are very sorry, but there were error(s) found with the form you submitted. ";
echo "These errors appear below.<br /><br />";
echo $error . "<br /><br />";
echo "Please go back and fix these errors.<br /><br />";
die();
}
$title = $_POST['title'];
if (isset($title) && count($title) > 0) {
$title = implode(',', $title);
} else {
$title = '';
}
$first_name = $_POST['fore_name']; // required
$last_name = $_POST['sur_name']; // required
$addressOne = $_POST['address_1']; // required
$postal_code = $_POST['postal_code']; // required
$daytime_telephone = $_POST['daytime_telephone']; // required
$mobile_no = $_POST['mobile_no']; // required
$email = $_POST['email']; // required
$mahram_name = $_POST['mahram_name']; // required
$mahram_relationship = $_POST['maharam_reltionship']; // required
$passport_no = $_POST['passport_no']; // required
$authority = $_POST['authority']; // required
$package = $_POST['package1'];
if (isset($package) && count($package) > 0) {
$package = implode(',', $package);
} else {
$package = '';
}
$roomoccupancy = $_POST['roomoccupancy'];
if (isset($roomoccupancy) && count($roomoccupancy) > 0) {
$roomoccupancy = implode(',', $roomoccupancy);
} else {
$roomoccupancy = '';
}
$contact1_fullName = $_POST['fullName1']; // required
$contact1_address = $_POST['contact1_address']; // required
$contact1_postal_code = $_POST['contact1_postal_code']; // required
$contact1_daytime_telephone = $_POST['conatact1_daytime_telephone']; // required
$contact1_mobile = $_POST['conatact1_mobile_no']; // required
$contact1_email = $_POST['contact1_email']; // required
$contact1_relation = $_POST['contact1_reltionship']; // required
$contact2_fullName = $_POST['fullName2']; // required
$contact2_address = $_POST['contact2_address']; // required
$contact2_postal_code = $_POST['contact2_postal_code']; // required
$contact2_mobile = $_POST['contact2_mobile_no']; // required
$contact2_daytime_telephone = $_POST['contact2_daytime_telephone']; // required
$contact2_email = $_POST['contact2_email']; // required
$contact2_relation = $_POST['contact2_reltionship']; // required
$first_price = $_POST['price']; // required
$date = $_POST['date']; // required
$second_price = $_POST['under_price']; // required
$attachments = array();
move_uploaded_file($_FILES["sign"]["tmp_name"], WP_CONTENT_DIR . '/uploads/' . basename($_FILES['sign']['name']));
array_push($attachments, WP_CONTENT_DIR . "/uploads/" . $_FILES["sign"]["name"]);
move_uploaded_file($_FILES["under_sign"]["tmp_name"], WP_CONTENT_DIR . '/uploads/' . basename($_FILES['under_sign']['name']));
array_push($attachments, WP_CONTENT_DIR . "/uploads/" . $_FILES["under_sign"]["name"]);
$p_name = $_POST['p_name']; // required
$under_date = $_POST['under_date']; // required
$error_message = "";
$email_exp = '/^[A-Za-z0-9._%-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,4}$/';
if (!preg_match($email_exp, $email)) {
$error_message .= 'The Email Address you entered does not appear to be valid.<br />';
}
$string_exp = "/^[A-Za-z .'-]+$/";
if (!preg_match($string_exp, $first_name)) {
$error_message .= 'The First Name you entered does not appear to be valid.<br />';
}
if (strlen($error_message) > 0) {
died($error_message);
}
$email_message = "Form details below.\n\n";
function clean_string($string)
{
$bad = array("content-type", "bcc:", "to:", "cc:", "href");
return str_replace($bad, "", $string);
}
$email_message = "Hello Admin, You have got a new Application with following details: \n\n";
$email_message .= "Title : " . clean_string($title) . "\n";
$email_message .= "First Name : " . clean_string($first_name) . "\n";
$email_message .= "Last Name : " . clean_string($last_name) . "\n";
$email_message .= "Address one : " . clean_string($addressOne) . "\n";
$email_message .= "Postal code : " . clean_string($postal_code) . "\n";
$email_message .= "Email : " . clean_string($email) . "\n";
$email_message .= "Daytime Telephone : " . clean_string($daytime_telephone) . "\n";
$email_message .= "Mobile No : " . clean_string($mobile_no) . "\n";
$email_message .= "Mahram Name : " . clean_string($mahram_name) . "\n";
$email_message .= "Mahram Relationship : " . clean_string($mahram_relationship) . "\n";
$email_message .= "Passport Nn : " . clean_string($passport_no) . "\n";
$email_message .= "Authority : " . clean_string($authority) . "\n";
$email_message .= "Package : " . clean_string($package) . "\n";
$email_message .= "Room Occupancy : " . clean_string($roomoccupancy) . "\n";
$email_message .= "Contact 1 Name : " . clean_string($contact1_fullName) . "\n";
$email_message .= "Contact 1 Postal Code : " . clean_string($contact1_postal_code) . "\n";
$email_message .= "Contact 1 Mobile: " . clean_string($contact1_mobile) . "\n";
$email_message .= "Contact 1 Email: " . clean_string($contact1_email) . "\n";
$email_message .= "Contact 1 Daytime Telephone: " . clean_string($contact1_daytime_telephone) . "\n";
$email_message .= "Contact 1 Relationship: " . clean_string($contact1_relation) . "\n";
$email_message .= "Contact 2 Name : " . clean_string($contact2_fullName) . "\n";
$email_message .= "Contact 2 Postal Code : " . clean_string($contact2_postal_code) . "\n";
$email_message .= "Contact 2 Mobile: " . clean_string($contact2_mobile) . "\n";
$email_message .= "Contact 2 Email: " . clean_string($contact2_email) . "\n";
$email_message .= "Contact 2 Daytime Telephone: " . clean_string($contact2_daytime_telephone) . "\n";
$email_message .= "Contact 2 Relationship: " . clean_string($contact2_relation) . "\n";
$email_message .= "Above 18 Price: " . clean_string($first_price) . "\n";
$email_message .= "Above 18 Date: " . clean_string($date) . "\n";
$email_message .= "Below 18 Price: " . clean_string($second_price) . "\n";
$email_message .= "Print Name: " . clean_string($p_name) . "\n";
$email_message .= "Below 18 date: " . clean_string($under_date) . "\n";
$email_message .= "Thanks & Regards, \n" . $first_name . " " . $last_name;
$headers = "From: " . $email . "\r\n";
$headers .= "Reply-To: " . $email . "\r\n";
$headers .= "X-Mailer: PHP/" . phpversion();
$headers .= "MIME-Version: 1.0" . "\r\n";
$mail = wp_mail($email_to, $email_subject, $email_message, $headers, $attachments);
echo $mail ? "Thank you for connecting with us! We will contact you shortly!" : " Mail failed";
}
?>
<!-- Main -->
<div class="clear"></div>
<div class="main" role="main">
<!-- Slider -->
<?php /* <section class="slider-holder">
<div class="flexslider carousel">
<ul class="slides">
<li class="flex-active-slide" style="width: 100%; float: left; margin-right: -100%; position: relative; display: block; z-index: 2; opacity: 1;"> <img src="<?php echo get_stylesheet_directory_uri();?>/images/slide2.jpg" alt="" draggable="false"> </li>
<!-- <li style="width: 100%; float: left; margin-right: -100%; position: relative; display: block; z-index: 1; opacity: 0;" class=""> <img src="<?php //echo get_template_directory_uri();?>/images/slide2.jpg" alt="" draggable="false"> </li>
<li style="width: 100%; float: left; margin-right: -100%; position: relative; display: block; z-index: 1; opacity: 0;" class=""> <img src="<?php //echo get_template_directory_uri();?>/images/slide3.jpg" alt="" draggable="false"> </li> -->
</ul>
<!-- <ol class="flex-control-nav flex-control-paging">
<li><a class="flex-active">1</a></li>
<li><a class="">2</a></li>
<li><a class="">3</a></li>
</ol> -->
</div>
</section> */ ?>
<section class="page-heading">
<div class="container">
<div class="row">
<div class="col-md-6">
<h1><?php the_title(); ?></h1>
</div>
<div class="col-md-6">
<?php if (have_posts()) : while (have_posts()) : the_post(); ?>
<?php the_content(); ?>
<?php endwhile; endif; ?>
</div>
</div>
</div>
</section>
<section class="page-content">
<div class="container">
<form id="regd_form" enctype="multipart/form-data" method="post"
action="">
<div class="row">
<div class="col-md-6">
<label>
<p><b>Personal Details :</b></p><br>
</label>
</div>
<div class="col-md-6">
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label class="control-label" for="title">Title</label>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="checkbox-inline">
<input type="checkbox" name="title[]" value="Dr">
Dr
</label>
<label class="checkbox-inline">
<input type="checkbox" name="title[]" value="Mr">
Mr
</label>
<label class="checkbox-inline">
<input type="checkbox" name="title[]" value="Mrs">
Mrs
</label>
<label class="checkbox-inline">
<input type="checkbox" name="title[]" value="Miss">
Miss
</label>
<label class="checkbox-inline">
<input type="checkbox" name="title[]" value="Ms">
Ms
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Forenames
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="fore_name" id="fore_name">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Surname
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="sur_name" id="sur_name">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Address 1
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<!-- <input type="text" class="form-control" name="address_1" id="address_1">-->
<textarea rows="4" cols="77" name="address_1" style="width: 100%"></textarea>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Postal Code
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="postal_code" id="postal_code">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Daytime Telephone
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="daytime_telephone" id="daytime_telephone">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
Mobile
</label>
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<input type="text" class="form-control" name="mobile_no" id="mobile_no">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Email
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="email" class="form-control" name="email" id="email">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Mahram's Name<br>
( Female's Only )
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="mahram_name" id="mahram_name">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
Relation of ( Mahram )
</label>
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<input type="text" class="form-control" name="maharam_reltionship" id="maharam_reltionship">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Passport number
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="passport_no" id="passport_no">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
Authority
</label>
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<input type="text" class="form-control" name="authority" id="authority">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label class="control-label" for="package1">Package</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label class="checkbox-inline">
<input type="checkbox" name="package1[]" value="2week">
2 week
</label>
<label class="checkbox-inline">
<input type="checkbox" name="package1[]" value="3week">
3 week
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3" id="type_of_business">
<div class="form-group">
<div class="form-group">
<label class="control-label" for="roomoccupancy">Room occupancy</label>
</div>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label class="checkbox-inline">
<input type="checkbox" name="roomoccupancy[]" value="Double">
Double
</label>
<label class="checkbox-inline">
<input type="checkbox" name="roomoccupancy[]" value="Triple">
Triple
</label>
<label class="checkbox-inline">
<input type="checkbox" name="roomoccupancy[]" value="Quadruple">
Quadruple
</label>
</div>
</div>
</div>
<!--//=======================================================contact details (1)=========================================================================//-->
<div class="row">
<div class="col-md-6 upload-form">
<div class="form-group">
<p><b> Emergency Contact Details</b></p>
<p>In case of an emergency please provide contact details:</p>
<p><b>Contact (1)</b></p>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Full Name
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="fullName1" id="fullName1">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Address
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<!-- <input type="text" class="form-control" name="address_1" id="address_1">-->
<textarea rows="4" cols="77" name="contact1_address" style="width: 100%"></textarea>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Postal Code
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="contact1_postal_code"
id="contact1_postal_code">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Daytime Telephone
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="conatact1_daytime_telephone"
id="conatact1_daytime_telephone">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
Mobile
</label>
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<input type="text" class="form-control" name="conatact1_mobile_no" id="conatact1_mobile_no">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Email
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="email" class="form-control" name="contact1_email" id="contact1_email">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Relation
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="contact1_reltionship"
id="contact1_reltionship">
</div>
</div>
</div>
<!--//=======================================================end contact detailsvc(1)================================================================//-->
<!--//=======================================================contact details (2)=========================================================================//-->
<div class="row">
<div class="col-md-6 upload-form">
<div class="form-group">
<p><b>Contact (2)</b></p>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Full Name
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="fullName2" id="fullName2">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Address
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<!-- <input type="text" class="form-control" name="address_1" id="address_1">-->
<textarea rows="4" cols="77" name=contact2_address" style="width: 100%"></textarea>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Postal Code
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="contact2_postal_code"
id="contact2_postal_code">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Daytime Telephone
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="contact2_daytime_telephone"
id="contact2_daytime_telephone">
</div>
</div>
<div class="col-md-1">
<div class="form-group">
<label>
Mobile
</label>
</div>
</div>
<div class="col-md-5">
<div class="form-group">
<input type="text" class="form-control" name="contact2_mobile_no" id="contact2_mobile_no">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Email
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="email" class="form-control" name="contact2_email" id="contact2_email">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Relation
</label>
</div>
</div>
<div class="col-md-9">
<div class="form-group">
<input type="text" class="form-control" name="contact2_reltionship"
id="contact2_reltionship">
</div>
</div>
</div>
<!--//=======================end contact detailsvc(2)==================================================//-->
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>
<p><b>Declaration</b></p>
<p> I declare that all the information on this booking form is correct to the best of my
knowledge. I accept and abide by the booking terms and conditions, available at
www.hajjltd.com/terms, which I have read and understood.</p>
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
I have paid a deposit of
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="price" id="price">
</div>
</div>
</div>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label>
<p><b>Please attach the following with this application:</b></p>
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
</div>
</div>
<div class="col-md-7">
<div class="form-group">
<label>
<br>
<ul style="list-style-type: square;">
<li><p> Copy of your Passport (valid for at least 6 months from the date of
departure).</p></li>
<li><p> 2 passport sized photos with your name printed at the back of each
photo. </p></li>
</ul>
</label>
<label>
<br>
<p><b>Please Note:</b>Pilgrim must not have travelled to perform Hajj within the past 5
years (to attach old passport) Birth Certificates/Marriage certificates need to be
submitted with passports as proof of relationship status for
women/children with a Mahram</p>
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-group">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Signature :
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="file" class="form-control" name="sign" id="sign">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Date:
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="date" class="form-control" name="date" id="date">
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>
<p><b>For applicants under 18 years of age:</b></p>
<p>I declare as the parent/ guardian of the child named on this booking form, take full
responsibility that the information I provided is correct to the best of my
knowledge. I accept and abide by the booking terms and conditions, available at
www.hajjltd.com/terms, which I have read and understood.</p>
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
I have paid a deposit of
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="under_price" id="price">
</div>
</div>
</div>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label>
<p><b>Please attach the following with this application:</b></p>
</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
</div>
</div>
<div class="col-md-7">
<div class="form-group">
<label>
<br>
<ul style="list-style-type: square;">
<li><p> Copy of the Childs Passport.</p></li>
<li><p> 2 passport sized photos with the name printed at the back of each
photo. </p></li>
</ul>
</label>
<label>
<br>
<p><b>Please Note:</b>Pilgrim must not have travelled to perform Hajj within the past 5
years (to attach old passport) Birth Certificates/Marriage certificates need to be
submitted with passports as proof of relationship status for
women/children with a Mahram</p>
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-group">
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Signature :
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="file" class="form-control" name="under_sign" id="sign">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Print Name:
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="text" class="form-control" name="p_name" id="p_name">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label>
Date:
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<input type="date" class="form-control" name="under_date" id="date">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6"><input type="submit" name="submit" value="Submit" id="submit"
class="btn btn-primary" style="margin-left: 376px;"></div>
<div class="col-md-6"><input type="button"
onclick="window.location.href='http://178.62.55.80/hajjltd/'"
name="button" value="Back" id="reset1"
class="btn btn-primary" style="margin-left: 470px;"></div>
</div>
</form>
</div>
</section>
<div class="clear"></div>
<?php get_footer(); ?>
Sign up for free to join this conversation on GitHub. Already have an account? Sign in to comment