403Webshell
Server IP : 10.200.247.200  /  Your IP : 216.73.216.64
Web Server : Apache
System : Linux synergy-usa-sites 6.8.0-138-generic #138-Ubuntu SMP PREEMPT_DYNAMIC Fri Jul 31 22:41:49 UTC 2026 x86_64
User : jeremy ( 1001)
PHP Version : 8.4.25
Disable Function : NONE
MySQL : OFF  |  cURL : ON  |  WGET : ON  |  Perl : ON  |  Python : OFF  |  Sudo : ON  |  Pkexec : OFF
Directory :  /var/www/surf_sites/workathomeapplication.com/

Upload File :
current_dir [ Writeable ] document_root [ Writeable ]

 

Command :


[ Back ]     

Current File : /var/www/surf_sites/workathomeapplication.com//work_from_home_application.php
<?
	$https = $_SERVER['HTTPS'];
	$currentLocation = $_SERVER['REQUEST_URI'];
	if($https != 'on')
	{
		header('Location: https://usbusinessfundingsolutions.com'.$currentLocation); 
	}
	require_once($_SERVER['DOCUMENT_ROOT'].'/inc/dbconfig.php');
	$db = db_connect('surfcrm');
	require_once($_SERVER['DOCUMENT_ROOT'].'/inc/php_header.php');
	require_once($_SERVER['DOCUMENT_ROOT'].'/inc/php_quotes.php');
	$title = 'U.S. Business Funding Solutions - Application'; 
	$body_id = 'lc';
	$no_menu = true;
	require_once('header.php');
	require_once($_SERVER['DOCUMENT_ROOT'].'/applications/layout/inc/ua.php');
?>

<link rel="stylesheet" type="text/css" href="applications/layout/style/font-awesome/css/font-awesome.min.css">
<link href="/js/lightbox/css/lightbox.css" rel="stylesheet">
<link href="/applications/layout/style/common.css" type="text/css" rel="stylesheet" />
<link href="/applications/layout/style/app_style.css" type="text/css" rel="stylesheet" />
<link href="/applications/layout/style/application.css" type="text/css" rel="stylesheet" /> 
<script src="/applications/js/check.js"></script>
<script src="/js/jquery.formatter.min.js"></script>
<script language="javascript" type="application/javascript">
$(document).ready(function(e) {
	$('input.phone_number').formatter({
	  'pattern': '({{999}}) {{999}}-{{9999}}',
	  'persistent': false
	});
});
</script>
<?
if($_POST)
{
	include($_SERVER['DOCUMENT_ROOT'].'/applications/functions/insertApplication.php');
	if(count($applicationData) > 0)
	{
		// set and build PDF file
		include($_SERVER['DOCUMENT_ROOT'].'/applications/functions/pdf.php');
		if(file_exists($filename))
		{
			// if there is a PDF get it's file location
		} 
	}
	?>
    <div id="content" class="size">
        <div id="lc_group" class="padding" style="overflow:hidden;padding-top:15px;">
            <h2 style="font-size:28px;">
                SUBMIT YOUR RECORDING OF THE SCRIPT
            </h2>
            <p style="font-size:16px;">
                To help us determine if you would be a good candidate for selling our service, 
                we need to hear your voice. We have included a section of our script along with 
                a sample recording of that section for you to hear what a call sounds like. Please 
                take a few minutes to listen to the call and practice reading the script before 
                you record it.
            </p>
            <br>
            <h2>
                Step 1: Listen to a Sample Call
            </h2>
            <div class="center" style="height:45px; display:block; width:100%; padding-top:14px;">
                <div class="center" style="display:inline-block; width:100%; padding-left:40px;">
                
                    <audio src="/applications/samples/2 - Program Overview - Good - 01 - Jason.mp3"  
                        style="width:80%; height:35px; border:1px solid rgba(0,0,0,0.4); display:block; border-radius:0px;" class="" controls></audio>
                        
                </div>
            </div>
        </div>
        <div class="padding" style="overflow:hidden; margin-top:20px;">
            <div class="float:right;">
                <h2>
                    Step 2: Practice reading the script until you are comfortable with it
                </h2>
                <div style="padding:0px 40px 0px 40px;">
                    <p style="font-size:16px;">
                        <i>
                            Are you familiar with grants and how they work? Okay, then you know that 
                            grants are monies awarded to you that you don't have to pay back. Usually 
                            John the hardest part of applying for a grant is finding the applications.  
                            We have a team of grant researchers who track down the free-money grants 
                            for you.  They update our site with the newest applications as they become 
                            available.
                        </i>
                    </p>
                    <p style="font-size:16px;">
                        <i>
                            Once you're in our system, John, we give you a user name and password so you 
                            can log in to see those applications and start applying for grants immediately.  
                            The first thing I'll do to get you started is send you an email.  
                            Now is your email _____?  OK.
                        </i>
                    </p>
                    <p style="font-size:16px;">
                        <i>
                            This email will contain a direct link you can click on, and it will log you into 
                            the database of grants automatically.  I always advise people to apply for as many 
                            grants as you can because this increases your odds of receiving a grant.  There 
                            are no limits to the number of grants you can apply for, or the number of grants 
                            you can receive.
                        </i>
                    </p>
                    <p style="font-size:16px;">
                        <i>
                            Also John, there are 2 live teleconferences every week you can be a part of where 
                            a professional grant expert will explain how to move through the entire application 
                            process start to finish. Now, these are live calls, so you can ask questions while 
                            you're on the phone with him and get answers. When you miss a call, don't worry because 
                            they record all of them and archive them on the site. So, you can listen to them at 
                            your convenience.
                        </i>
                    </p>
                    <p style="font-size:16px;">
                        <i>
                            Now, once you're logged into the system, look through grants that are under any categories 
                            related to you or your project. For any questions you have along the way, there's a 24 hour 
                            email support I want you to use.
                        </i>
                    </p>
                </div>
            </div>
            <div class="" style="display:block; height:32px;"></div> 
            <div class="" style="display:block;">
                <div class="relative block left" style="">
                    <div class="">
                        <h2>
                            Step 3: Record yourself reading the script
                        </h2>
                    </div>
                </div>
                <center>
                    <div id="recodingOption" class="" style="padding-top:20px;">
                        <button id="openAudioRecorder" type="button" class="btn btn-primary btn-lg"
                            onclick="	$('#openAudioRecorder').hide(); 
                                        $('#closeAudioRecorder').show();
                                        $('#cannotRecord').hide(); 
                                        $('#audioContainer').attr('src', 'applications/audioRecorder.php?applicationID=<?=$applicationID?>').css('height', '360px');"
                            style="width:300px; height:64px; margin-bottom:8px;">
                            <i class="fa fa-microphone"></i>&nbsp;&nbsp;Open Recorder
                        </button> 
                        <button id="closeAudioRecorder" type="button" class="btn btn-warning btn-lg" 
                            onclick="	$('#openAudioRecorder').show(); 
                                        $('#closeAudioRecorder').hide(); 
                                        $('#cannotRecord').show(); 
                                        $('#audioContainer').attr('src', '').css('height', '0px');"
                            style="width:300px; height:64px; margin-bottom:8px; display:none;">
                            <i class="fa fa-microphone"></i>&nbsp;&nbsp;Close Recorder
                        </button> 
                    </div>
                    <div class="">
                        <div class="relative iblock">
                            <iframe width="310" height="360" src="" id="audioContainer" class="" style="overflow:hidden; border:0px; height:0px;"></iframe>
                        </div>    
                    </div>
                </center>
            </div>
            <div id="applicationComplete" class="" 
                    style="font-size:24px; display:none;">
                Thank you for your application and recording. Our sales manager 
                will get back with you shortly to continue the process.
            </div>
            <div id="applicationSortOfComplete" class="" 
                    style="font-size:24px; display:none;">
                Thank you for your application. Our sales manager 
                will get back with you shortly to continue the process.
            </div>
            <div id="cannotRecord" class="center-center relative block" 
                    style="margin-top:32px;">
                <center>
                    <h2>
                        Unable to submit a recording?
                    </h2>
                    <p style="font-size:18px;">
                        Please let us know why.
                    </p>
                    <br>
                    <div class="relative iblock left">
                        <div id="reasonForm" class="relative iblock left p20 border" style="width:280px;">
                            <form method="post" enctype="multipart/form-data" onsubmit="sendApplication(this); return false;">
                                <div class="relative block">
                                    <label class="f18">
                                        <div class="relative iblock" style="top:8px;">
                                        <input type="checkbox" name="no_device" id="no_device" value="No Device" class="checkbox" 
                                            style="width:26px; height:26px; margin-right:10px;"/> No Microphone
                                        </div>
                                    </label>
                                </div>
                                <br>
                                <div class="relative block">
                                    <label class="f18">
                                        <div class="relative iblock" style="top:8px;">
                                            <input type="checkbox" name="not_working" id="not_working" value="Not Working" class="checkbox" 
                                                style="width:26px; height:26px; margin-right:10px;"/> Recorder Not Working 
                                        </div>
                                    </label>
                                </div>
                                <br>
                                <div class="relative block">
                                    <label class="f18">
                                        <div class="relative iblock" style="top:8px;">
                                            <input type="checkbox" name="bad_place_time" id="bad_place_time" value="Bad Time and Place" class="checkbox" 
                                                style="width:26px; height:26px; margin-right:10px;"/> Bad Time and Place 
                                        </div>
                                    </label>
                                </div>
                                <br>
                                <div class="relative block">
                                    <label class="f18">
                                        <div class="relative iblock" style="top:8px;">
                                            <input type="checkbox" name="too_shy" id="too_shy" value="To Shy" class="checkbox" 
                                                style="width:26px; height:26px; margin-right:10px;"/> Too Shy
                                        </div>
                                    </label>
                                </div>
                                <br>
                                <div class="relative block">
                                    <label class="f18">
                                        <div class="relative iblock" style="top:8px;">
                                            <input type="checkbox" name="other" id="other" value="Other" class="checkbox" 
                                                style="width:26px; height:26px; margin-right:10px;"
                                                onclick="
                                                            if($(this).is(':checked'))
                                                            { 
                                                                $('#otherEntry').show(); 
                                                            } 
                                                            else 
                                                            { 
                                                                $('#otherEntry').hide(); 
                                                            }
                                                           "/> Other
                                        </div>
                                    </label>
                                    <div class="relative block" id="otherEntry" style="display:none; margin-top:32px;">
                                        <label class="f16">
                                            Please give a reason
                                            <br>
                                            <textarea name="other_reason" class="relative block border f18" style="width:270px; height:96px;"></textarea>
                                        </label>
                                    </div>
                                </div>
                                <br>
                                <br>
                                <center>
                                    <button type="submit" id="giveReason" class="btn btn-warning btn-lg" style="width:200px; height:64px;">
                                        Submit Reason
                                    </button>
                                </center>
                                <input type="hidden" name="applicationID" value="<?=$applicationID?>" />
                            </form>
                        </div>
                    </div>
                </center>
            </div>
            <div style="height:200px;"></div>
        </div>
        <br />
        <br />
    </div>
	<?
}
else
{
	?>
	<div id="content" class="size">
		<div id="lc_group" class="padding" style="overflow:hidden">
			<h1 class="lc_title">
				<span class="lc_span">
					U.S. BUSINESS FUNDING SOLUTIONS
				</span>
				<br>
				WORK FROM HOME
			</h1>
			<img class="imgleft" src="WorkFromHome/img/woman.png" style="width:350px;" />
			<p style="font-size:14px;">
				Interested in working from the comfort of your home?  Then this is the job for you!!  
				Here are a few details about the job and what is expected.
			</p>
            <br>
			<h3>
				THE SERVICE YOU WILL BE SELLING
			</h3>
			<p style="font-size:14px;">
				You will be working as an independent contractor from your home selling a service over the 
                phone for a company who has been in business for over 10 years.  This is NOT an MLM opportunity 
                or a home-based business you will be starting.  You will sign people up over the phone for a 
                monthly grant application service.  The customers pay a monthly fee to have access to a list 
                of thousands of grant applications listed on one of our websites. 
				We have hired a team of grant researchers who locate the funding applications so these people 
				don't have to. They update the websites with the newest funding applications as they become 
				available. Once they sign up with our service, we give them a username and password so they 
				can start filling out the applications. Your job is to sell them the Application Service for 
				the full price listed on the websites or for a discounted amount if you feel this is the only 
				way to get them to buy.
			</p>
            <br>
			<p style="font-size:14px;">
				The people you will call will be people who have expressed an interest over the Internet in 
				applying for a grant of some kind and who are happy to have someone call them back. Some want 
				to apply for a grant to go back to school, fund an invention, write a book, restore a historical 
				or cultural building or site, invest in real estate, expand a current business or start a new 
				business, and they need a grant, or some type of funding, to help them do so. In other words, 
				you would be calling "warm" leads, people who are interested in our service. You would not be 
				"cold" calling!
			</p>
			<p style="font-size:14px;">
				These warm leads have started the online registration process but have stopped for one reason 
				or another. They usually stop once they are asked for the processing fee. You will be calling 
				them within minutes of filling out their initial information if they don't pay for it online. 
				The processing fee pays our grant researchers to find and post all new grant funding proposals 
				and for out 24-hour support team that can help if they have any questions.
			</p>
            <br>
			<h3>
				PHONE:
			</h3>
			<p style="font-size:14px;">
				You will be using a softphone on your computer that includes a recording device that allows all 
				the calls to be recorded. It is tied in to our main phone system, which allows us to monitor your 
				calls at any time. The phone cannot be used for personal phone calls or other business calls for 
				any reason, as the Synergy has to pay for the phone time. You would also need to sign a security 
				agreement which stipulates conditions under which the phone can be used and procedures to follow 
				regarding the return of the phone to the company if you were to quit or if you are terminated for 
				any reason.
			</p>
            <br>
			<img class="imgright" src="WorkFromHome/img/man.png" style="width:350px;" />
			<h3>
				PHONE TIME EXPECTATIONS:
			</h3> 
			<p style="font-size:14px;">
				Ideally we would like the employee to work 30-40 hours per week on the phone. During the training 
				period we will be flexible with the hours you are able to work in order to accommodate your schedule.
			</p>
            <br>
			<h3>
				AVERAGE DIALS PER HOUR:
			</h3>
			<p style="font-size:14px;">
				As a guideline, the average person working in house makes 20 dials per hour. There is no minimum 
				or maximum dials required per hour when you work from home.
			</p>
            <br>
			<h3>
				FLEXIBLE WORK HOURS:
			</h3> 
			<p style="font-size:14px;">
				There are no specific work hours you are required to work. You are free to call at different times 
				of the day as long as you strictly adhere to the telemarketing time zone requirements for each of 
				the 6 time zones you will be calling. You will be given those hours in your training.
			</p>
            <br>
			<h3>
				HIGH SPEED INTERNET &amp; COMPUTER
			</h3> 
			<p style="font-size:14px;">
				You will be required to have high speed internet capabilities with a 1 megabit upload speed and a computer 
				in order to work from home.
			</p>
            <br>
			<h3>
				HEAD SETS AND BACKGROUND NOISE
			</h3>
			<p style="font-size:14px;">
				You will need to have to have a quiet place to call, where you will not be interrupted with background 
				noise from children or other individuals who might enter the room while you are calling. You will be required 
				to wear a headset to block out any unforeseen noises.
			</p>
            <br>
			<h3>
				QUALITY CONTROL
			</h3>
			<p style="font-size:14px;">
				In order to receive compensation for each person you sign up, every sale will be listened to for quality 
				control purposes and you will either "pass" or "fail" the call. You will only fail the call if you mislead 
				the customer, were not completely honest with your sales presentation, or did not give them all the 
				information required by the company or by law which you were trained to do. If you fail the call you will 
				have the opportunity to call the client back and correct the issue.  Once we have verified you have 
				corrected the problem, you will then be paid on the sale.
			</p>
            <br>
			<h3>
				COMPENSATION
			</h3>
			<p style="font-size:14px;">
				You will be paid an hourly wage based on the number of sales you make per hour. Your checks will be deposited 
                directly into your checking account as a direct deposit once a week. You will receive your first paycheck on 
                the 2nd Friday after your first full week of employment.
			</p>
		</div>
		<div id="content" class="size">
			<form action="<?=$_SERVER['REQUEST_URI']?>" method="post" onsubmit="return check_required(this);">
				<div id="lc_group" class="padding" style="overflow:hidden">
					<div class="roundBox">
						<div class="roundData">
							<h1 style="text-align:center; font-size:24pt;">
								Application
							</h1>
						</div>
					</div>
					<input type="hidden" name="position_applying_for[]" value="position_work_from_home" />
					<div class="roundBox">
						<div class="roundData" style="margin:0">
							<h1>
								Personal Information
							</h1>
							<table class="info">
								<tr>
									<td>
										How did you hear about us: 
									</td>
									<td>
										<select name="methodofmedia" req_one_label="How did you hear about us?" class="selected req" 
											onchange="	if($(this).val()=='other') 
														{ $('#howdidyouhear_other').show(); } 
														else 
														{ $('#howdidyouhear_other').hide(); }">
											<option value="">--Select--</option>
											<option value="Indeed.com">Indeed.com</option>
											<option value="Workforce Services">Workforce Services</option>
											<option value="Craigslist">Craigslist</option>
											<option value="LDS Employment">LDS Employment</option>
											<option value="SouthernUtahHelpWanted.com">SouthernUtahHelpWanted.com</option>
											<option value="Dixie State University">Dixie State University</option>
											<option value="other">Other</option>
										</select>
									</td>
									<td>
										<input type="text" id="howdidyouhear_other" name="other" style="display:none;" 
											placeholder="If Other Please Explain" value="<?=$_POST['other']?>" />
									</td>
								</tr>
							</table>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td width="110" class="text">
										First Name
									</td>
									<td width="175">
										<input type="text" name="first_name" req_one_label="First Name" class="req" value="<?=$_POST['first_name']?>" />
									</td>
									<td width="110" class="text">
										Last Name
									</td>
									<td width="175">
										<input type="text" name="last_name" req_one_label="Last Name" class="req" value="<?=$_POST['last_name']?>" />
									</td>
									<td width="110" class="text">
										Email Address
									</td>
									<td width="175">
										<input type="text" name="email_address" req_one_label="Email Address" class="req" value="<?=$_POST['email_address']?>" />
									</td>
								</tr>
								<tr>
									<td class="text">
										Address
									</td>
									<td>
										<input type="text" name="address" value="<?=$_POST['address']?>" />
									</td>
									<td class="text">
										City
									</td>
									<td>
										<input type="text" name="city" value="<?=$_POST['city']?>" />
									</td>
									<td class="text">
										State
									</td>
									<td>
										<input type="text" name="state" value="<?=$_POST['state']?>" />
									</td>
							   </tr>
								<tr class="req_one" req_one_label="Phone Number">
									<td class="text">
										Home Phone
									</td>
									<td>
										<input type="text" name="day_phone" value="<?=$_POST['day_phone']?>" class="phone_number" />
									</td>
									<td class="text">
										Mobile Phone
									</td>
									<td>
										<input type="text" name="cell_phone" value="<?=$_POST['cell_phone']?>" class="phone_number" />
									</td>
									<td class="text">
										<!--Evening Phone-->
									</td>
									<td>
										<? /*<input type="text" name="evening_phone" value="<?=$_POST['evening_phone']?>" class="phone_number" />*/ ?>
									</td>
								</tr>
							 </table>
							<table class="info">
								<tr>
									<td class="text" width="110">
									Birthday <span class="f10">(MM/DD/YYYY)</span>
									</td>
									<td class="text" width="110" colspan="6">
										<label>
											<input type="date" name="birthday" id="birthday" value="" placeholder="MM/DD/YYYY" style="margin-left:-2px; margin-bottom:-4px;"/>
										</label>
									</td>
									<?
                                    /*
									<td class="text" width="110">
										<label for="26-30">
											26-30 <input type="radio" name="age" id="26-30" value="26-30" <?=($_POST['age']=='26-30') ? 'checked' : ''?> />
										</label>
									</td>
									<td class="text" width="110">
										<label for="31-40">
											31-40 <input type="radio" name="age" id="31-40" value="31-40" <?= ($_POST['age']=='31-40') ? 'checked' : ''?> />
										</label>
									</td>
									<td class="text" width="110">
										<label for="41-50">
											41-50 <input type="radio" name="age" id="41-50" value="41-50" <?=($_POST['age']=='41-50') ? 'checked' : ''?> />
										</label>
									</td>
									<td class="text" width="110">
										<label for="51-60">
											51-60 <input type="radio" name="age" id="51-60" value="51-60" <?=($_POST['age']=='51-60') ? 'checked' : '';?> />
										</label>
									</td>
									<td class="text" width="110">
										<label for="over-60">
											over 60 <input type="radio" name="age" id="over-60" value="over-60" <?=($_POST['age']=='over-60') ? 'checked' : ''?> />
										</label>
									</td>
									*/
									?>
								</tr>
							</table>
						</div>
						<div class="roundData">
							<h1>
								Education Information
							</h1>
							<table class="info">
								<tr>
									<td class="text" width="220">
										Have you graduated High School?
									</td>
									<td class="text" width="70">
										<label for="highschool_yes">
										Yes <input type="radio" name="highschool" id="highschool_yes" value="highschool_yes" 
												<?=($_POST['highschool']=='highschool_yes') ? 'checked' : ''?> 
                                                onClick="
                                                			if($('#highschool_yes').is('checked'))
                                                            { 
                                                            	$('#graduated_highschool').show(); 
                                                                $('#graduated_year').hide(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#graduated_highschool').hide(); 
                                                                $('#graduated_year').show(); 
                                                            }"/>
										</label>
									</td>
									<td class="text" width="70">
										<label for="highschool_no">
										No <input type="radio" name="highschool" id="highschool_no" value="highschool_no" 
												<?=($_POST['highschool']=='highschool_no') ? 'checked' : ''?> 
                                                onClick="
                                                			if($('#highschool_no').is('checked'))
                                                            { 
                                                            	$('#graduated_highschool').hide(); 
                                                                $('#graduated_year').show(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#graduated_highschool').show(); 
                                                                $('#graduated_year').hide(); 
                                                            }"/>
										</label>
									</td>
									<td>
                                    	<label class="" id="graduated_year" style="display:none; top:-2px;">
                                        	Year Graduated 
                                            <input id="" type="number" name="graduated_year" placeholder="Year Graduated" 
                                                value="<?=$_POST['graduated_year']?>" style="top:0px;" />
                                        </label>
                                        <label class="" id="graduated_highschool" style="display:none; top:-2px;">
                                        	Do you have a GED
                                            <input id="" type="text" name="graduated_highschool" placeholder="GED?" 
                                                value="<?=$_POST['graduated_highschool']?>" style="top:0px;" />
                                		</label>
									</td>
								</tr>
								<tr>
									<td class="text">
										Have you graduated College?
									</td>
									<td class="text">
										<label for="college_yes">
											Yes <input type="radio" name="college" id="college_yes" value="college_yes" <?=($_POST['college']=='college_yes') ? 'checked' : ''?> 
                                            		onClick="
                                                			if($('#college_yes').is('checked'))
                                                            { 
                                                            	$('#graduated_college').hide();
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#graduated_college').show();
                                                            }"/>
										</label>
									</td>
									<td class="text">
										<label for="college_no">
											No <input type="radio" name="college" id="college_no" value="college_no" <?=($_POST['college']=='college_no') ? 'checked' : ''?> 
                                            		onClick="
                                                			if($('#college_no').is('checked'))
                                                            { 
                                                            	$('#graduated_college').show(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#graduated_college').hide(); 
                                                            }"/>
										</label>
									</td>
									<td>
                                        <label class="" id="graduated_college" style="display:none;">
                                        	College Name
                                            <input id="" type="text" name="graduated_college" placeholder="College Name" 
                                                value="<?=$_POST['graduated_college']?>" style="top:0px;" />
                                		</label>
									</td>
								</tr>
							</table>
						</div>
						<div class="roundData">
							<h1>
								Position Information
							</h1>
							<table class="info">
								<tr class="req_one" req_one_label="Are you legally authorized to work in the U.S.?">
									<td class="text" width="260">
										Are you legally authorized to work in the U.S.?
									</td>
									<td class="text" width="70">
										<label for="legal_yes">
											Yes <input type="radio" name="legal" id="legal_yes" value="legal_yes" <?=($_POST['legal']=='legal_yes') ? 'checked' : ''?> 
                                            		onClick="
                                                			if($('#legal_yes').is('checked'))
                                                            { 
                                                            	$('#ifHired').hide(); 
                                                                $('#ifNotHired').show(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#ifHired').show(); 
                                                                $('#ifNotHired').hide(); 
                                                            } "/>
										</label>
									</td>
									<td class="text" width="70">
										<label for="legal_no">
											No <input type="radio" name="legal" id="legal_no" value="legal_no" <?=($_POST['legal']=='legal_no') ? 'checked' : ''?>
                                            		onClick="
                                                			if($('#legal_no').is('checked'))
                                                            { 
                                                            	$('#ifHired').show();
                                                                $('#ifNotHired').hide(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#ifHired').hide();
                                                                $('#ifNotHired').show();
                                                            } "/>
										</label>
									</td>
									<td>
                                        <span id="ifHired" style="display:none;">
                                            If hired, you will be required to submit proof of your identity and legal work 
                                            authorization as a condition of your employment.
                                        </span>
                                        <span id="ifNotHired" style="display:none;">
                                            Please explain why you are not authorized to work in the U.S.
                                            <input id="legally_authorized" type="text" name="legally_authorized" placeholder="Please explain." 
                                            	value="<?=$_POST['legally_authorized']?>"/>
                                        </span>
									</td>
								</tr>
								<tr class="req_one" req_one_label="Have you ever been convicted of a felony?">
									<td class="text">
										Have you ever been convicted of a felony?
									</td>
									<td class="text">
										<label for="convicted_yes">
											Yes <input type="radio" name="convicted_yesno" id="convicted_yes" value="convicted_yes" 
													<?=($_POST['convicted_yesno']=='convicted_yes') ? 'checked' : ''?> 
                                                    onClick="
                                                			if($('#convicted_yes').is('checked'))
                                                            { 
                                                            	$('#convictedExplain').hide(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#convictedExplain').show(); 
                                                            } "/> 
										</label>
									</td>
									<td class="text">
										<label for="convicted_no">
											No <input type="radio" name="convicted_yesno" id="convicted_no" value="convicted_no" 
													<?=($_POST['convicted_yesno']=='convicted_no') ? 'checked' : ''?> 
                                                    onClick="
                                                			if($('#convicted_no').is('checked'))
                                                            { 
                                                            	$('#convictedExplain').show(); 
                                                            } 
                                                            else 
                                                            { 
                                                            	$('#convictedExplain').hide(); 
                                                            } "/>
										</label>
									</td>
									<td>
										<input id="convictedExplain" type="text" name="convicted" placeholder="Please explain." value="<?=$_POST['convicted']?>" 
                                        	style="display:none;" />
									</td>
								</tr>
							</table>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td class="text" width="260">
										How many hours per week are you looking to work?
									</td>
									<td class="text" width="70" colspan="2">&nbsp;
										<label>
                                            <input id="" type="number" name="salary_needs" placeholder="Hours Per Week" 
                                                    value="<?=$_POST['salary_needs']?>" style="top:0px; width:64px;" />
										</label>
									</td>
									<td>

                                    </td>
									<td>&nbsp;</td>
								</tr>
								<tr>
									<td class="text">
										When can you start working?
									</td>
									<td>
										<input type="date" name="start_date">
									</td>
									<td>&nbsp;</td>
									<td>&nbsp;</td>
									<td>&nbsp;</td>
								</tr>
								<tr class="req_one" req_one_label="What type of employment are you looking for?">
									<td class="text">
										What type of employment are you looking for?
									</td>
									<td class="text">
										<label for="employement_type_full">
											Full <input type="radio" name="employement_type" id="employement_type_full" value="full" 
													<?=($_POST['employement_type']=='full') ? 'checked' : ''?> />
										</label>
									</td>
									<td class="text">
										<label for="employement_type_part">
											Part <input type="radio" name="employement_type" id="employement_type_part" value="part" 
													<?=($_POST['employement_type']=='part') ? 'checked' : ''?> />
										</label>
									</td>
									<td>&nbsp;</td>
									<td>&nbsp;</td>
								</tr>
								<tr>
									<td class="text">
										Why do you want to work from home?
									</td>
									<td class="text" colspan="2">
                                        <input id="why_work_from_home" type="text" name="why_work_from_home" placeholder="" 
                                            style="top:0px;" value="<?=$_POST['why_work_from_home']?>" /> 
									</td>
									<td>&nbsp;</td>
								</tr>
							</table>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td class="text" width="260">
										Have you every worked from home before?
									</td>
									<td class="text" width="70">
										<label for="haveworkedfromhome_yes">
											Yes <input type="radio" name="haveworkedfromhome" id="haveworkedfromhome_yes" value="haveworkedfromhome_yes" 
													<?=($_POST['haveworkedfromhome']=='haveworkedfromhome_yes') ? 'checked' : ''?> 
													onclick="$(this).parents('tr:first').find('.display_yes').show(); $(this).parents('tr:first').find('.display_no').hide();" />
										</label>
									</td>
									<td class="text" width="70">
										<label for="haveworkedfromhome_no">
											No <input type="radio" name="haveworkedfromhome" id="haveworkedfromhome_no" value="haveworkedfromhome_no" 
													<?=($_POST['haveworkedfromhome']=='haveworkedfromhome_no') ? 'checked' : ''?> 
													onclick="$(this).parents('tr:first').find('.display_no').show(); $(this).parents('tr:first').find('.display_yes').hide();" />
										</label>
									</td>
									<td colspan="2">
										<div style="display:none;" class="display_no">
											<?
                                            /*
												<input id="why_work_from_home" type="text" name="why_work_from_home" 
													placeholder="Why do you want to work from home?" 
														value="<?=$_POST['why_work_from_home']?>" style="width:100%;" class="" />
											*/
											?>
										</div>
										<div style="display:none;" class="display_yes">
											<input id="what_type_of_work_from_home" type="text" name="what_type_of_work_from_home" 
                                            	placeholder="What type of work did you do?" 
													value="<?=$_POST['what_type_of_work_from_home']?>" style="width:100%;" class="" />
										</div>
									</td>
								</tr>
								<tr>
									<td class="text" width="260">
										Have you ever sold a product over the phone?
									</td>
									<td class="text" width="70">
										<label for="havesoldoverphone_yes">
											Yes <input type="radio" name="havesoldoverphone" id="havesoldoverphone_yes" value="havesoldoverphone_yes" 
														<?=($_POST['havesoldoverphone']=='havesoldoverphone_yes') ? 'checked' : ''?> 
														onclick="
                                                        			$(this).parents('tr:first').find('.display_yes').show();
                                                                    $(this).parents('tr:first').find('.display_no').hide();
                                                                 " />
										</label>
									</td>
									<td class="text" width="70">
										<label for="havesoldoverphone_no">
											No <input type="radio" name="havesoldoverphone" id="havesoldoverphone_no" value="havesoldoverphone_no" 
														<?=($_POST['havesoldoverphone']=='havesoldoverphone_no') ? 'checked' : ''?> 
														onclick="
                                                        			$(this).parents('tr:first').find('.display_no').show(); 
                                                                    $(this).parents('tr:first').find('.display_yes').hide();
                                                                 " />
										</label>
									</td> 
									<td colspan="2">
										<div style="display:none;" class="display_no">
											No problem! The script is easy and the training is excellent!
										</div>
										<div style="display:none;" class="display_yes">
											<input id="what_sold" type="text" name="what_sold" placeholder="What did you sell?" value="<?=$_POST['what_sold']?>"
                                            	 style="width:100%;" />
										</div>
									</td>
								</tr>
								<tr>
									<td class="text" width="260">
										Do you have a quiet place to call, where you will not be interrupted with background noise from children or other individuals?
									</td>
									<td class="text" width="70">
										<label for="havequietplace_yes">
											Yes <input type="radio" name="havequietplace" id="havequietplace_yes" value="havequietplace_yes" 
													<?=($_POST['havequietplace']=='havequietplace_yes') ? 'checked' : ''?> 
													onclick="
                                                    			$(this).parents('tr:first').find('.display_yes').show(); 
                                                                $(this).parents('tr:first').find('.display_no').hide();
                                                             " />
										</label>
									</td>
									<td class="text" width="70">
										<label for="havequietplace_no">
											No <input type="radio" name="havequietplace" id="havequietplace_no" value="havequietplace_no" 
													<?=($_POST['havequietplace']=='havequietplace_no') ? 'checked' : ''?> 
													onclick="
                                                    			$(this).parents('tr:first').find('.display_no').show(); 
                                                                $(this).parents('tr:first').find('.display_yes').hide();
                                                             " />
										</label>
									</td>
									<td colspan="2">
										<div style="display:none;" class="display_yes">
											<input id="quietplacedescribe" type="text" name="quietplacedescribe" placeholder="Please describe" 
													value="<?=$_POST['quietplacedescribe']?>"
                                                     style="width:100%;" />
										</div>
									</td>
								</tr>
								<tr>
									<td class="text" width="260">
										What is your Internet Speed? Go to <a target="_blank" href="http://www.speedtest.net">www.speedtest.net</a> 
										and test your internet connection. Please enter in your download and upload speeds:
									</td>
									<td class="text" colspan="2">
										<label for="download_speeds">
											Download:
											<br>
											<input id="download_speeds" type="text" name="download_speeds" placeholder="2.2 Mbps" 
													value="<?= $_POST['download_speeds'];?>" />
										</label>
									</td>
									<td class="text" colspan="2">
										<label for="upload_speeds">
											Upload:
											<br>
											<input id="upload_speeds" type="text" name="upload_speeds" placeholder="2.2 Mbps" 
													value="<?= $_POST['upload_speeds'];?>" />
										</label>
									</td>
									<td colspan="2">&nbsp;</td>
								</tr>
								<tr>
									<td class="text" width="260">
										Can we do a background check if we feel you would be a good fit to work from home?
									</td>
									<td class="text" width="70">
										<label for="candobackgroundcheck_yes">
										Yes <input type="radio" name="candobackgroundcheck" id="candobackgroundcheck_yes" value="candobackgroundcheck_yes" 
												<?=($_POST['candobackgroundcheck']=='candobackgroundcheck_yes') ? 'checked' : ''?> />
										</label>
									</td>
									<td class="text" width="70">
										<label for="candobackgroundcheck_no">
										No <input type="radio" name="candobackgroundcheck" id="candobackgroundcheck_no" value="candobackgroundcheck_no" 
												<?=($_POST['candobackgroundcheck']=='candobackgroundcheck_no') ? 'checked' : ''?> />
										</label>
									</td>
									<td colspan="2"></td>
								</tr>
							</table>
							<div class="clear"></div>
						</div>
					</div>
					<div style="clear:both"></div>
					<div class="roundBox">
						<div class="roundData" style="margin:0">
							<h1>
								Previous Employers
							</h1>
							<h2>
								Employer #1
							</h2>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td width="110" class="text">
										Company Name
									</td>
									<td width="175">
										<input type="text" name="company1_name" value="<?=$_POST['company1_name']?>" />
									</td>
									<td width="110" class="text">
										Company City
									</td>
									<td width="175">
										<input type="text" name="company1_city" value="<?=$_POST['company1_city']?>" />
									</td>
									<td width="110" class="text">
										Company State
									</td>
									<td width="175">
										<input type="text" name="company1_state" value="<?=$_POST['company1_state']?>" />
									</td>
								</tr>
								<tr>
									<td class="text">
										Company Phone
									</td>
									<td>
										<input type="text" name="company1_phone" value="<?=$_POST['company1_phone']?>" class="phone_number" />
									</td>
									<td class="text">
                                    	Supervisor Name
									</td>
									<td>
                                    	<input type="text" name="company1_supervisor" value="<?=$_POST['company1_supervisor']?>" />
									</td>
									<td class="text">										
									</td>
									<td>										
									</td>
							   </tr>
								<tr>
									<td class="text">
										Job Title
									</td>
									<td>
										<input type="text" name="company1_job_title" value="<?=$_POST['company1_job_title']?>" />
									</td>
									<td class="text">
										Salary
									</td>
									<td>
										<input type="text" name="company1_salary" value="<?=$_POST['company1_salary']?>" />
									</td>
									<td class="text">
										Employed from
									</td>
									<td>
										<input style="width:60px; display:inline" id="employed_from" type="text" name="employed_from" 
											value="<?=$_POST['employed_from']?>" placeholder="MM/YY" />
										to
										<input style="width:60px; display:inline" id="employed_to" type="text" name="employed_to" 
											value="<?=$_POST['employed_to']?>" placeholder="MM/YY" />
									</td>
								</tr>
								<tr>
									<td>
										Why did you leave?
									</td>
									<td colspan="5">
										<input type="text" name="company1_leave" value="<?=$_POST['company1_leave']?>" />
									</td>
								</tr>
							</table>
							<div style="clear:both"></div>
							<h2>
								Employer #2
							</h2>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td width="110" class="text">
										Company Name 
									</td>
									<td width="175">
										<input type="text" name="company2_name" value="<?=$_POST['company2_name']?>" />
									</td>
									<td width="110" class="text">
										Company City 
									</td>
									<td width="175">
										<input type="text" name="company2_city" value="<?=$_POST['company2_city']?>" />
									</td>
									<td width="110" class="text">
										Company State 
									</td>
									<td width="175"> 
										<input type="text" name="company2_state" value="<?=$_POST['company2_state']?>" />
									</td>
								</tr>
								<tr>
									<td class="text">
										Company Phone 
									</td>
									<td>
										<input type="text" name="company2_phone" value="<?=$_POST['company2_phone']?>" class="phone_number" />
									</td>
									<td class="text">
										Supervisor Name 
									</td>
									<td>
                                    	<input type="text" name="company2_supervisor" value="<?=$_POST['company2_supervisor']?>" />
									</td>
									<td class="text">
										
									</td>
									<td>
										
									</td>
								</tr>
								<tr>
									<td class="text">
										Job Title 
									</td>
									<td>
										<input type="text" name="company2_job_title" value="<?= $_POST['company2_job_title'];?>" />
									</td>
									<td class="text">
										Salary 
									</td>
									<td>
										<input type="text" name="company2_salary" value="<?= $_POST['company2_salary'];?>" />
									</td>
									<td class="text">
										Employed from 
									</td>
									<td>
										<input style="width:60px; display:inline" id="employed_from2" type="text" name="employed_from2" 
											value="<?=$_POST['employed_from2']?>" placeholder="MM/YY" />
										to
										<input style="width:60px; display:inline" id="employed_to2" type="text" name="employed_to2" 
											value="<?=$_POST['employed_to2']?>" placeholder="MM/YY" />
									</td>
								</tr>
								<tr>
									<td>
										Why did you leave?
									</td>
									<td colspan="5">
										<input type="text" name="company2_leave" value="<?=$_POST['company2_leave']?>" />
									</td>
								</tr>
							</table>
						</div>
						<div class="roundData" style="margin:0">
							<h1>
								References Employers
							</h1>
							<h2>
								Reference #1
							</h2>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td width="110" class="text">
									Full Name
									</td>
									<td width="175">
										<input type="text" name="reference1_name" value="<?=$_POST['reference1_name']?>" />
									</td>
									<td width="110" class="text">
										City
									</td>
									<td width="175">
										<input type="text" name="reference1_city" value="<?=$_POST['reference1_city']?>" />
									</td>
									<td width="110" class="text">
										State
									</td>
									<td width="175">
										<input type="text" name="reference1_state" value="<?=$_POST['reference1_state']?>" />
									</td>
								</tr>
								<tr>
									<td class="text">
										Occupation
									</td>
									<td>
										<input type="text" name="reference1_occupation" value="<?=$_POST['reference1_occupation']?>" />
									</td>
									<td class="text">
										Phone
									</td>
									<td>
										<input type="text" name="reference1_phone" value="<?=$_POST['reference1_phone']?>" class="phone_number" />
									</td>
									<td class="text">
										Email
									</td>
									<td>
										<input type="text" name="reference1_email" value="<?=$_POST['reference1_email']?>" />
									</td>
								</tr>
								<tr>
									<td>
										Relationship
									</td>
									<td>
										<input type="text" name="reference1_relationship" value="<?=$_POST['reference1_relationship']?>" />
									</td>
                                    <td width="110" class="text">
										Years Known
									</td>
									<td width="175" colspan="3">
										<input type="text" name="reference1_years_known" value="<?=$_POST['reference1_years_known']?>" />
									</td>
								</tr>
							</table>
							<div style="clear:both"></div>
							<h2>
								Reference #1
							</h2>
							<div class="clear"></div>
							<table class="info">
								<tr>
									<td width="110" class="text">
										Full Name
									</td>
									<td width="175">
										<input type="text" name="reference2_name" value="<?=$_POST['reference2_name']?>" />
									</td>
									<td width="110" class="text">
										City
									</td>
									<td width="175">
										<input type="text" name="reference2_city" value="<?=$_POST['reference2_city']?>" />
									</td>
									<td width="110" class="text">
										State
									</td>
									<td width="175">
										<input type="text" name="reference2_state" value="<?=$_POST['reference2_state']?>" />
									</td>
								</tr>
								<tr>
									<td class="text">
										Occupation
									</td>
									<td>
										<input type="text" name="reference2_occupation" value="<?=$_POST['reference2_occupation']?>" />
									</td>
									<td class="text">
										Phone
									</td>
									<td>
										<input type="text" name="reference2_phone" value="<?=$_POST['reference2_phone']?>" class="phone_number" />
									</td>
									<td class="text">
										Email
									</td>
									<td>
										<input type="text" name="reference2_email" value="<?=$_POST['reference2_email']?>" />
									</td>
								</tr>
								<tr>
									<td>
										Relationship
									</td>
									<td>
										<input type="text" name="reference2_relationship" value="<?=$_POST['reference2_relationship']?>" />
									</td>
                                    <td width="110" class="text">
										Years Known
									</td>
									<td width="175" colspan="3">
										<input type="text" name="reference2_years_known" value="<?=$_POST['reference2_years_known']?>" />
									</td>
								</tr>
							</table>
						</div>
					</div>
					<center>
						<input type="submit" class="submit" value="Submit Your Application" />
					</center>
				</div>
			</form>
		</div>
	</div>
	<?
}

require_once('footer.php');
?>

Youez - 2016 - github.com/yon3zu
LinuXploit