Created
February 16, 2014 01:24
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<form class="dataForm" action="" method="post"> | |
<div class="studentInfo"> | |
<h1>Student Information</h1> | |
<label for="PantherID">Panther Id</label> <input type="text" value="<?php echo $PantherID;?>" name="PantherID"/> | |
<label for="First_Name">First Name</label> <input type="text" value="<?php echo $First_Name;?>" name="First_Name"/> <br> | |
<label for="Last_Name">Last Name</label> <input type="text" value="<?php echo $Last_Name;?>" name="Last_Name"/> | |
<label for="Middle_Name">Middle Name</label> <input type="text" value="<?php echo $nMiddle_Name;?>" name="Middle_Name"/> <br> | |
<label for="Age">Age</label> <input type="text" value="<?php echo $Age;?>" name="Age"/> | |
<label for="Gender">Gender</label> <input type="text" value="<?php echo $Gender;?>" name="Gender"/> <br> | |
<label for="Social_Security">Social Security</label> <input type="text" value="<?php echo $Social_Security;?>" name="Social_Security"/> | |
<label for="Address_ONE">Address One</label> <input type="text" value="<?php echo $Address_ONE;?>" name="Address_ONE"/> <br> | |
<label for="Address_TWO">Address Two</label> <input type="text" value="<?php echo $Address_TWO;?>" name="Address_TWO"/> | |
<label for="city">City</label> <input type="text" value="<?php echo $City;?>" name="City"/><br> | |
<label for="state_region">State</label> <input type="text" value="<?php echo $state_region;?>" name="state_region"/> | |
<label for="zipcode">Zip Code</label> <input type="text" value="<?php echo $zipcode;?>" name="zipcode"/> <br> | |
<label for="Primary_Tel">Primary Tel#</label> <input type="tel" value="<?php echo $Primary_Tel;?>" name="Primary_Tel"/> | |
<label for="Secondary_tel">Secondary Tel#</label> <input type="tel" value="<?php echo $Secondary_tel;?>" name="Secondary_tel"/> <br> | |
<label for="Email">Email</label> <input type="email" value="<?php echo $Email;?>" name="Email"/> | |
</div> | |
<br> | |
<br> | |
<div class="eContact"> | |
<h1>Emergency Contact</h1> | |
<label for="ecPantherID">Panther Id</label> <input type="text" value="<?php echo $ecPantherID;?>" name="ecPantherID"/> | |
<label for="ecFirst_Name">First Name</label> <input type="text" value="<?php echo $ecFirst_Name;?>" name="ecFirst_Name"/> <br> | |
<label for="ecLast_Name">Last Name</label> <input type="text" value="<?php echo $ecLast_Name;?>" name="ecLast_Name"/> | |
<label for="ecMiddle_Name">Middle Name</label> <input type="text" value="<?php echo $ecMiddle_Name;?>" name="ecMiddle_Name"/> <br> | |
<label for="ecAge">Age</label> <input type="text" value="<?php echo $ecAge;?>" name="ecAge"/> | |
<label for="ecGender">Gender</label> <input type="text" value="<?php echo $ecGender;?>" name="ecGender"/> <br> | |
<label for="ecSocial_Security">Social Security</label> <input type="text" value="<?php echo $ecSocial_Security;?>" name="ecSocial_Security"/> | |
<label for="ecAddress_ONE">Address One</label> <input type="text" value="<?php echo $ecAddress_ONE;?>" name="ecAddress_ONE"/> <br> | |
<label for="ecAddress_TWO">Address Two</label> <input type="text" value="<?php echo $ecAddress_TWO;?>" name="ecAddress_TWO"/> | |
<label for="eccity">City</label> <input type="text" value="<?php echo $eccity;?>" name="eccity"/><br> | |
<label for="ecstate_region">State</label> <input type="text" value="<?php echo $ecstate_region;?>" name="ecstate_region"/> | |
<label for="eczipcode">Zip Code</label> <input type="text" value="<?php echo $eczipcode;?>" name="eczipcode"/> <br> | |
<label for="ecPrimary_Tel">Primary Tel#</label> <input type="tel" value="<?php echo $ecPrimary_Tel;?>" name="ecPrimary_Tel"/> | |
<label for="ecSecondary_tel">Secondary Tel#</label> <input type="tel" value="<?php echo $ecSecondary_tel;?>" name="ecSecondary_tel"/> <br> | |
<label for="ecEmail">Email</label> <input type="email" value="<?php echo $ecEmail;?>" name="ecEmail"/> | |
</div> | |
<br> | |
<br> | |
<div class="buttons"> | |
<input type="submit" name="button" id="button" value="<?php echo $button = 'Delete';?>"/> | |
<input type="submit" name="button" id="button" value="<?php echo $button = 'Find';?>"/> | |
<input type="submit" name="button" id="button" value="<?php echo $button = 'Save';?>"/> | |
<input type="submit" name="button" id="button" value="<?php echo $button = 'Modify';?>"/> | |
<?php echo $button;?> | |
</div> | |
<input type="hidden" name="button" vale="<?php echo $button;?>"/> | |
</form> |
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