'section_intro', 'where' => "`sn` = 'cv'", 'loadUploads' => true, 'allowSearch' => false, 'limit' => '1', )); $section_introRecord = @$section_introRecords[0]; // get first record if (!$section_introRecord) { dieWith404("Record not found!"); } // show error message if no record found //set for upload form $tableName = 'cvax'; $recordNum = ""; $preSaveTempId = @$_REQUEST['preSaveTempId'] ? $_REQUEST['preSaveTempId'] : uniqid('x'); $errorsAndAlerts = ''; // submit form if (@$_POST['submitForm']) { // error checking $errorsAndAlerts = ""; // if (!@$_REQUEST['phone']) { $errorsAndAlerts .= "You must enter a phone number!
\n"; } // if (!@$_REQUEST['name']) { $errorsAndAlerts .= "Please enter your name!
\n"; } // if (!@$_REQUEST['email']) { $errorsAndAlerts .= "Please enter your email address!
\n"; } // turn off strict mysql error checking for: STRICT_ALL_TABLES mysqlStrictMode(false); // disable Mysql strict errors for when a field isn't defined below (can be caused when fields are added later) error_reporting (E_ALL ^ E_NOTICE); // add record if (!@$errorsAndAlerts) { $tablename = 'cvax'; $colsToValues = array(); $colsToValues['createdDate='] = 'NOW()'; $colsToValues['updatedDate='] = 'NOW()'; $colsToValues['createdByUserNum'] = 0; $colsToValues['updatedByUserNum'] = 0; $colsToValues['first_name'] = $_REQUEST['first_name']; $colsToValues['last_name'] = $_REQUEST['last_name']; $colsToValues['v_status'] = $_REQUEST['v_status']; $colsToValues['vaccine'] = $_REQUEST['vaccine']; $colsToValues['date_shot_1'] = $_REQUEST['date_shot_1']; $colsToValues['date_shot_2'] = $_REQUEST['date_shot_2']; $colsToValues['date_booster'] = $_REQUEST['date_booster']; $colsToValues['req_exemption'] = $_REQUEST['req_exemption']; // $colsToValues['[photo'] = $_REQUEST['photo']; $hideMissingFieldErrors = true; $newRecordNum = mysql_insert($tablename, $colsToValues, $hideMissingFieldErrors); // send email to applicant //$to='chodges@xanitos.com'; //$subject = 'New Headlines Online Story Submitted'; //$headers = "From: $signup_email" . "\r\n"; ////$headers .= "Reply-To: $signup_email" . "\r\n"; //$headers .= "MIME-Version: 1.0\r\n"; //$headers .= "Content-Type: text/html; charset=ISO-8859-1\r\n"; //$message = ''; //$message .= ''; //$message .= ""; //$message .= "

A new headlines online story has been submitted

"; //$message .= ""; // Send //if (mail($to,$subject,$message, $headers)) //{ // $errorsAndAlerts = "Thank You! Your vaccination status was submitted successfully!"; //} else //{ // $errorsAndAlerts = "Error! Your vaccination status was not submitted."; //}; } // clear form $_REQUEST = array(); } ?> Xanitos - Pre-hire Covid Vaccination Record