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<?
require_once($_SERVER['DOCUMENT_ROOT'].'/inc/php_header.php');
$categories = get_categories();
$education_questions = get_education_questions();
function sub_question_recursive($q) {
global $education_questions;
if(isset($education_questions['subquestions'][$q])) {
foreach($education_questions['subquestions'][$q] as $s=>$d) { ?>
<div class="<?= $q;?>_sub" style="padding:5px 5px 5px 20px;display:block;clear:both;">
<?= $d['name'];?><br/>
<?php if($d['type']=='bool') {?>
<label><input type="radio" value="1" name="<?= $s;?>" id="<?= $s;?>_yes" /> Yes</label>
<label><input type="radio" value="0" name="<?= $s;?>" id="<?= $s;?>_no" /> No</label>
<br/>
<?php } elseif(strpos($d['type'],'range') > -1) {
$range = array();
$pieces = explode(':',$d['type']);
$range_limits = explode('-',$pieces[1]);
for($i=$range_limits[0]; $i<=$range_limits[1]; $i++) {
$range[$i] = $i;
} ?>
<select name="<?= $s;?>" id="<?= $s;?>">
<option value="">Select</option>
<?php foreach($range as $i=>$j) {?>
<option value="<?= $i;?>"><?= $j;?></option>
<?php }?>
</select>
<?php }
if(isset($education_questions['subquestions'][$s])) {
sub_question_recursive($s);
}?>
</div><?php
}
}
}
$trackerformparams = $tracker->FormParameters();
#$params = $tracker->URLParameters();
#$trackerparams = $tracker->TrackerParameters();
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<script type="text/javascript">var _sf_startpt=(new Date()).getTime()</script>
<script type="text/javascript" charset="utf-8" src="/js/jquery-1.4.2.min.js"></script>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Funding Applications.com - Business Application</title>
<script type="text/javascript">
$(document).ready( function() {
$('.subcategory,.subtext,#education_questions').hide().find('input,select,textarea').attr('disabled','disabled');
$('input[name=category_id]').click( function() {
var show_class = $(this).attr('class');
var subcat_elements = $('.subcategory[class~='+show_class+']');
$('.subcategory').hide().find('input,select,textarea').attr('disabled', 'disabled');
if(subcat_elements.length > 0) {
$('#subcategories').show();
subcat_elements.show().find('input,select,textarea').removeAttr('disabled');
} else {
$('#subcategories').hide().find('input,select,textarea').attr('disabled', 'disabled');
}
var granttype = this.className;
$('#granttype_input').val(granttype);
if(granttype == 'education') {
$('#education_questions').show().find('input,select,textarea').removeAttr('disabled');
} else {
$('#education_questions').hide().find('input,select,textarea').attr('disabled','disabled');
}
});
<?php
foreach($education_questions['subquestions'] as $slug=>$data) {
echo "$('.".$slug."_sub').hide().find('input,select,textarea').attr('disabled','disabled');";
echo "$('#".$slug."_yes').click(function() {
$('.".$slug."_sub').show().find('input,select,textarea').removeAttr('disabled');
});";
echo "$('#".$slug."_no').click(function() {
$('.".$slug."_sub').hide().find('input,select,textarea').attr('disabled','disabled');
});";
}
if(!empty($_REQUEST)) {
echo "$('input:radio[name=category_id]').filter('[value={$_REQUEST['category_id']}]').click();\n";
}
?>
});
// Create an associative array of 'pretty name' values
var prettynames = {
category_id:"Funding Category",
cc_fname:"First Name",
cc_lname:"Last Name",
cc_addr:"Address",
cc_city:"City",
cc_state:"State",
cc_zip:"Zip",
cc_phonearea:"Phone Number Area Code",
cc_phoneprefix:"Phone Number Prefix",
cc_phoneextension:"Phone Number Ending",
cc_email:"Email Address",
app_gender:"Gender",
app_citizenship:"Citizenship",
app_age:"Your age",
app_amount_needed:"The amount needed",
app_usedescription:"Describe what you will use the money for",
app_uniqueness:"Uniqueness",
diploma:"Do you have a high school diploma or GED?",
online_business:"Would you like to start an online business to make money while you go to school if we could help pay for your training?",
serious_scale:"In a scale of 1-10 how serious are you about getting a degree online?",
college:"Have you gone to college?",
degree:"Do you have a degree?",
willing_second_degree:"Are you willing to get a second degree in business?",
have_computer:"Do you have access to a computer for taking the online classes and working on your business?"
};
// Utility function that returns true if a string contains only
// whitespace characters
// Taken from "Javascript: The Definitive Guide" pg. 264
function isblank(s)
{
for (var i=0; i < s.length; i++)
{
var c = s.charAt(i);
if ((c!=' ') && (c != '\n') && (c != ''))
{
return false;
}
}
return true;
}
// Credit Card Validation Javascript
// copyright 12th May 2003, by Stephen Chapman, Felgall Pty Ltd
// You have permission to copy and use this javascript provided that
// the content of the script is not changed in any way.
function validateCreditCard(s) {
// remove non-numerics
var v = "0123456789";
var w = "";
for (i=0; i < s.length; i++) {
x = s.charAt(i);
if (v.indexOf(x,0) != -1)
w += x;
}
// validate number
j = w.length / 2;
if (j < 6.5 || j > 8 || j == 7) return false;
k = Math.floor(j);
m = Math.ceil(j) - k;
c = 0;
for (i=0; i<k; i++) {
a = w.charAt(i*2+m) * 2;
c += a > 9 ? Math.floor(a/10 + a%10) : a;
}
for (i=0; i<k+m; i++) c += w.charAt(i*2+1-m) * 1;
return (c%10 == 0);
}
function verify(f)
{
// Taken from "Javascript: The Definitive Guide" pg. 264.
// Modified heavily to suit our needs
// Loop through each element of the form and validate each item
//
// Set the parameters for each field to be valid
// If a field doesn't have any modifiers it is assumed to be
// a text field that can not be blank.
f.cc_phonearea.requiredlength = 3;
f.cc_phonearea.numeric = true;
f.cc_phoneprefix.requiredlength = 3;
f.cc_phoneprefix.numeric = true;
f.cc_phoneextension.requiredlength = 4;
f.cc_phoneextension.numeric = true;
f.cc_zip.requiredlength = 5;
f.cc_zip.numeric = true;
var msg;
var empty_fields = "";
var errors = "";
for (var i=0; i < f.length; i++)
{
var element = f.elements[i];
//document.getElementById('errorconsole').innerHTML += element.name + ":" + element.type + "<br>";
if($(element).is(':hidden')) {
continue;
}
if ((element.type == 'text' || element.type == 'textarea') && (element.name != 'granttype_other'))
{
if ( (element.value == null || element.value == "") || isblank(element.value) )
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
if (element.numeric)
{
var v = parseFloat(element.value);
if (isNaN(v))
{
errors +="- The field " + prettynames[element.name] + " must be a number\n";
}
}
if ( (element.requiredlength > 0) && (element.value.length != element.requiredlength) )
{
errors += "- The field " + prettynames[element.name] + " must be " + element.requiredlength + " digits long\n";
}
}
else if (element.type == 'select-one')
{
// The first option, option[0] can not be selected
if ( (element.value == null || element.value == "" || element.selectedIndex == 0) || isblank(element.value) )
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
}
else if (element.type == 'radio')
{
if (!$('[name='+element.name+']:checked').val() && empty_fields.indexOf(prettynames[element.name]) == -1)
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
}
}
if (!empty_fields && !errors) { return true; }
msg = "__________________________________\n\n";
msg += "The form was not submitted because of the following error(s).\n";
msg += "Please correct these error(s) and re-submit.\n";
msg += "__________________________________\n\n";
if (empty_fields)
{
msg += "- The following required field(s) are empty:" + empty_fields + "\n";
if (errors) { msg += "\n"; }
}
msg += errors;
alert(msg);
return false;
}
function tab_phone(current,next) {
var currentfield = document.getElementById(current);
var nextfield = document.getElementById(next);
if (currentfield.value.length == 3) { nextfield.focus(); }
}
</script>
<style>
.regform td {text-align:left}
.grant_category { margin-bottom:15px; width:95% }
.grant_category .txt {cursor:pointer; border-bottom:1px dotted #333333; margin-bottom:5px}
.grant_category .img {background-repeat:no-repeat; background-position:0px 2px; padding-left:50px; height:41px !important}
.grant_category .col {width:33%}
.grant_category .hrd {font-weight:bold; text-transform:uppercase; border-bottom:1px solid #333333; height:15px}
.grant_category .hrd span {font-weight:normal; text-transform:none; font-style:italic}
table#main-categories td { border-top:1px dotted #333333; padding:7px 0; }
table#main-categories td.first { border-top:none; }
.category { }
.subcategory { float:left; width:40%; }
.grant_category input { margin:1px 6px 3px 5px; }
.grant_category label { font-weight: normal; text-transform: uppercase; cursor: pointer; }
.grant_category p { font-size: 9px; margin-left:24px; }
.grant_category td { background: #E0E0E0 !important }
</style>
<?
$title = 'Funding Applications.com Registration Form';
$body_id = 'sub';
include('header.php'); ?>
<div style="background-color:#ffffff; padding:15px">
<h2>Who is Applying for the Funding?</h2>
<p><i>The answers to the Research Registration Form below are strictly confidential. They will be made available to the FundingApplication.com Specialist. The information is used to assist our Funding Application Research team in finding new funding opportunities for you.</i></p>
<center>
<form action="https://fundingapplications.com/order.php" method="post" name="application" target="_top" onsubmit="return verify(this);">
<div class="regform">
<table width="600">
<tr>
<td class="q">First Name:</td>
<td class="a"><input type="text" name="cc_fname" size="20"></td>
<td class="q">Last Name:</td>
<td class="a"><input type="text" name="cc_lname" size="20"></td>
</tr>
<tr>
<td class="q">Street Address:</td>
<td class="a"><input type="text" name="cc_addr" size="20"></td>
<td class="q">City:</td>
<td class="a"><input type="text" name="cc_city" size="20"></td>
</tr>
<tr>
<td class="q">State:</td>
<td class="a">
<select name="cc_state">
<option selected>Select</option>
<option value="AK">Alaska</option>
<option value="AL">Alabama</option>
<option value="AR">Arkansas</option>
<option value="AZ">Arizona</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DC">District of Columbia</option>
<option value="DE">Delaware</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="IA">Iowa</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="MA">Massachusetts</option>
<option value="MD">Maryland</option>
<option value="ME">Maine</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MO">Missouri</option>
<option value="MS">Mississippi</option>
<option value="MT">Montana</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="NE">Nebraska</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NV">Nevada</option>
<option value="NY">New York</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VA">Virginia</option>
<option value="VT">Vermont</option>
<option value="WA">Washington</option>
<option value="WI">Wisconsin</option>
<option value="WV">West Virginia</option>
<option value="WY">Wyoming</option>
</select>
</td>
<td class="q">Zip:</td>
<td class="a"><input type="text" name="cc_zip" size="10"></td>
</tr>
<tr>
<td class="q">Gender:</td>
<td class="a">
<select name="app_gender">
<option selected>Select...</option>
<option value="M">Male</option>
<option value="F">Female</option>
</select>
</td>
<td class="q">What is<br />your age?</td>
<td class="a">
<select name="app_age">
<option selected>Select...</option>
<option value="18-25">18-25</option>
<option value="26-34">26-34</option>
<option value="35-49">35-49</option>
<option value="50-65">50-65</option>
<option value="66-80">66-80</option>
<option value="80+">80 +</option>
</select>
</td>
</tr>
<tr>
<td class="q">Day Phone:</td>
<td class="a"><input type="text" id="cc_phonearea" name="cc_phonearea" size="3" maxlength="3" onkeyup="tab_phone('cc_phonearea','cc_phoneprefix');">-<input type="text" id="cc_phoneprefix" name="cc_phoneprefix" size="3" maxlength="3" onkeyup="tab_phone('cc_phoneprefix','cc_phoneextension');">-<input type="text" id="cc_phoneextension" name="cc_phoneextension" size="4" maxlength="4"></td>
<td colspan="2" class="q"> </td>
</tr>
<tr>
<td class="q">Citizenship Status:</td>
<td class="a"><select name="app_citizenship">
<option selected>Select...</option>
<option value="U.S. Citizen">U.S. Citizen</option>
<option value="Resident Alien">Resident Alien</option>
<option value="Green Card Holder">Green Card Holder</option>
<option value="Permanent Resident">Permanent Resident</option>
<option value="Not Sure">Not Sure</option>
</select>
</td>
</tr>
</table>
</div>
<div class="regform" style="margin:20px 0">
<table cellpadding="2" cellspacing="0" border="1px solid black" width="600">
<tr>
<td colspan="2" class="q">Check all funding areas you are interested in</td>
</tr>
<tr>
<td>
<?
if(!empty($categories['categories'])) {
?><table id="main-categories" cellpadding="2" cellspacing="0" class="grant_category" style="border:none;"><?
$first = true;
foreach ($categories['categories'] as $id => $cat) { ?>
<tr>
<td <?= ($first) ? 'class="first"' : null; $first = false; ?>>
<input type="radio" name="category_id" id="<?=$id.'-'.$cat['slug'];?>" class="<?=$cat['slug'];?>" value="<?=$id;?>" />
<label for="<?=$id.'-'.$cat['slug'];?>" title="<?=$cat['name'];?><?=($cat['description'] != '') ? ' - '.$cat['description'] : null;?>"><?=$cat['name'];?></label>
<?=($cat['description'] != '') ? '<p>'.$cat['description'].'</p>' : null;?>
<?php if($cat['slug']=='personal') { ?>
<p class="subtext" style="clear:left;padding-top: 5px;margin: 0px 10px;font-size: 10px;font-style: italic;">*There are many Personal Assistance Programs that you can apply for as long as you meet the criteria, however there are no Government Grants to pay off your credit cards or debt.</p>
<?php }?>
</td>
</tr>
<?
}
?></table><?
}
if(!empty($categories['subcategories'])) { ?>
<table id="subcategories" class="grant_category" cellpadding="2" cellspacing="0" style="display:none; border:none;">
<tr>
<td class="hrd" >Suggested Sub-Categories <span>(Check all that apply)</span></td>
</tr>
<tr><td style="padding-top:5px;"><?
foreach ($categories['subcategories'] as $sub_id => $subcat) { ?>
<div class="subcategory <?=implode(' ', $subcat['categories']);?>">
<input id="<?=$sub_id.'-'.$subcat['slug'];?>" type="checkbox" name="subcategories[]" value="<?=$subcat['id'];?>" />
<label for="<?=$sub_id.'-'.$subcat['slug'];?>" style="color:#333333"><?=$subcat['name'];?></label>
</div>
<?
} ?>
</td></tr>
</table><?
}
?>
<table cellpadding="0" cellspacing="0" border="0" class="form_table" id="education_questions">
<?php foreach($education_questions['questions'] as $slug=>$data) {?>
<tr>
<td><?= $data['name'];?></td>
</tr>
<tr>
<td>
<?php if($data['type']=='bool') {?>
<label><input type="radio" value="1" name="<?= $slug;?>" id="<?= $slug;?>_yes" /> Yes</label>
<label><input type="radio" value="0" name="<?= $slug;?>" id="<?= $slug;?>_no" /> No</label>
<?php } elseif(strpos($data['type'],'range') > -1) {
$range = array();
$pieces = explode(':',$data['type']);
$range_limits = explode('-',$pieces[1]);
if($range_limits[0] > $range_limits[1]) {
for($i=$range_limits[0]; $i>=$range_limits[1]; $i--) {
$range[$i] = $i;
}
} else {
for($i=$range_limits[0]; $i<=$range_limits[1]; $i++) {
$range[$i] = $i;
}
}
?>
<select name="<?= $slug;?>" id="<?= $slug;?>">
<option value="">Select</option>
<?php foreach($range as $i=>$j) {?>
<option value="<?= $i;?>"><?= $j;?></option>
<?php }?>
</select>
<?php }
sub_question_recursive($slug);
?>
</td>
</tr>
<?php } ?>
</table>
</td>
</tr>
</table>
</div>
<div class="regform">
<table cellpadding="1" cellspacing="0" class="questions" width="600">
<tr>
<td class="q">How much money for your project are you looking for?
<select name="app_amount_needed">
<option selected>Select...</option>
<option value="$500-$10,000">$500 - $10,000</option>
<option value="$10,000 - $25,000">$10,000 - $25,000</option>
<option value="$25,000 - $50,000">$25,000 - $50,000</option>
<option value="$50,000 - $100,000">$50,000 - $100,000</option>
<?
if ($granttype != 'business')
{
echo "<option value=\"$100,000 or More\">\$100,000 or More</option>";
}
else
{
?>
<option value="$100,000 - $250,000">$100,000 - $250,000</option>
<option value="$250,000 - $500,000">$250,000 - $500,000</option>
<option value="$500,000 - $1,000,000">$500,000 - $1,000,000</option>
<option value="$1,000,000 +">$1,000,000 +</option>
<?
}
?>
</select>
</td>
</tr>
</table>
</div>
<div class="regform">
<table cellpadding="2" cellspacing="0" class="questions" width="600">
<tr>
<td class="q">What are you going to use the money for?</td>
</tr>
<tr>
<td class="a"><textarea name="app_usedescription" cols="64" rows="6"></textarea></td>
</tr>
<tr>
<td class="q">What are some unique characteristics that would potentially distinguish you from the competition?</td>
</tr>
<tr>
<td class="a"><textarea name="app_uniqueness" cols="64" rows="6"></textarea></td>
</tr>
</table>
</div>
<div class="regform">
<table cellpadding="2" cellspacing="0" class="questions" width="600">
<tr>
<td class="q">What Email do you want to use for your account with FundingApplications.com?<br />This will be you’re your username when you checking new application sources in the future.</td>
</tr>
<tr>
<td class="a" style="padding:10px"><center><input type="text" name="cc_email" size="30"> <i>(ie. johndoe@yahoo.com)</i></center></td>
</tr>
<tr>
<td class="s"><i>** Don’t worry; we hate email spam as much as you do! Your email address is completely safe!</i></td>
</tr>
<tr>
<td style="padding:10px"><center><input id="inform_me" type="checkbox" name="inform_me" value="1" checked="checked" />Yes, I would like to receive additional information for grant opportunities!</center></td>
</tr>
</table>
<center><input type="submit" value="" style="background:url(images/submit.jpg) top center no-repeat;width:144px;height:63px;border:0px;margin:20px auto;cursor:pointer"></center>
<input type="hidden" name="application" value="application">
<input type="hidden" name="tc" value="<?= $tc; ?>">
<?= $trackerformparams; ?>
</form>
</div>
</center>
</div>
<? include('footer.php'); ?>