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PHP Version : 8.4.25
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Current File : /var/www/usa_sites/fundingapplications.com//order_form_old.php
<?php
// The variables used in this page are supplied in order.php

require_once("{$_SERVER["DOCUMENT_ROOT"]}/tracker/client/TrackerLib.php");

$tracker = new TrackerLib("fa");

$trackerformparams = $tracker->FormParameters();

$tc = (! isset($_POST['tc'])) ? 'none': $_POST['tc'];
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
<head>
<script type="text/javascript">var _sf_startpt=(new Date()).getTime()</script>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=UTF-8">
<title>Funding Applications.org - Order Page</title>
<script language="JavaScript1.1">

	// Create an associative array of 'pretty name' values
	var prettynames = {
						cc_fname:"First Name",
						cc_lname:"Last Name",
						cc_addr:"Address",
						cc_city:"City",
						cc_state:"State",
						cc_zip:"Zip",
						cc_country:"Country",
						cc_phonearea:"Phone Number Area Code",
						cc_phoneprefix:"Phone Number Prefix",
						cc_phoneextension:"Phone Number Ending",
						cc_email:"Email Address",
						cc_type:"Credit Card Type",
						cc_num:"Credit Card Number",
						cc_month:"Credit Card Expiration Month",
						cc_year:"Credit Card Expiration Year",
						cc_cvv:"Credit Card CVV"
						};
						
// 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;
	
	f.cc_state.requiredlength = 2;
	
	f.cc_num.numeric = true;
	
	f.cc_month.requiredlength = 2;
	f.cc_month.numeric = true;
	
	f.cc_year.requiredlength = 4;
	f.cc_year.numeric = true;
	f.cc_cvv.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.type == 'text')
		{
			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;
			}
		}

	}
	if (f.agree2terms.checked == false)
	{
		errors += "- You must agree to the terms of this site\n";
	}
	if (! validateCreditCard(f.cc_num.value))
	{
		errors += "- Please enter a valid Credit Card Number\n";
	}
	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;
}


</script>
<style type="text/css">

.thumbnail{
	position: relative;
	z-index: 0;
	text-decoration:none;
}

.thumbnail:hover{
	background-color: transparent;
	z-index: 50;
}

.thumbnail span{ /*CSS for enlarged image*/
	position: absolute;
	background-color: #AAD5FF;
	width: 300px;
	padding: 5px;
	left: 250px;
	border: 2px dashed #003399;
	visibility: hidden;
	color: black;
	text-decoration: none;
}

.thumbnail span img{ /*CSS for enlarged image*/
	border-width: 0;
	padding: 2px;
}

.thumbnail:hover span{ /*CSS for enlarged image on hover*/
	visibility: visible;
	top: 0;
	left: 60px; /*position where enlarged image should offset horizontally */
}

-->
</style>

<style>
<!--
body	{margin:0px auto;background-color:#FFFFFF}
body table	{margin:0px auto}

.header1	{font:bold 12pt verdana}
.header	{font:bold 10pt verdana}
.gray	{width:215px;background-color:#dbd7d6;text-align:center}
.white	{width:485px;background-color:#ffffff;text-align:left;font:8pt verdana;padding-top:10px}


#base	{list-style-type:none;text-align:center;margin:0px auto}
#base li	{display:inline;padding:4px;font:7.5pt/120% verdana}
#base a:link, #base a:visited	{color:#000000;text-decoration:none}
#base a:hover, #base a:active	{color:#666666;text-decoration:underline}

#white	{color:#fff}

.questions		{width:580px;color:#000;margin-bottom:10px; padding: 8px;}
.questions input	{font: 8pt verdana;display:inline;margin:1px 3px;color:#000;background-color:#f8f8f8}
.questions select	{font: 8pt verdana;margin:1px 3px;color:#000;background-color:#f8f8f8}

.q		{font:bold 8pt verdana;}
.a		{font:normal 8pt verdana;}
.s		{font:normal 7pt verdana;}

.gray img	{margin:5px}
.white p	{padding-left:10px}
.white img	{padding:0px 0px 5px 10px;border:0px}

table span	{font:bold 8pt verdana;color:#000}

ol	{margin-left:40px}
-->
</style>
</head>

<? include('header.php'); ?>
<tr>
	<td style="background-color:#ffffff;text-align:left;font:9pt/120% verdana;padding:10px 0px 0px 10px">
	
		<div style="width:650px; margin:0px 0px 10px 40px;">
		
		<div style="text-align:left;">
		<p class="header1">Step 2 of 3: Confirm your Answers &amp; Complete Registration</p>
		<p>Here is the summary of the answers on step 1 of this Funding Application account registration process. Please confirm your 
		answers to be sure they are correct and complete the last step at the bottom of the page. You are 1 step away from beginning 
		the process of applying for funding of every kind if you qualify of course!!</p>
		</div>
		
	<?= (isset($error_message)) ? "<p style='margin:0px auto;width:90%;border:3px solid #FF0000'>
			The following error has occured: <em>$error_message</em></p>" : NULL; 
	?> 
	<form action="https://fundingapplications.com/order.php" method="post" name="orderform" onsubmit="return verify(this);">
		
		<div class="regform" style="margin:15px 0px;">
		<table cellpadding="0" cellspacing="0">
			<tr>
				<td colspan="4">
					<p class="header">Personal Information Summary</p>
				</td>
			</tr>
        	<tr>
           	  	<td class="q">First Name:</td>
            	<td class="a"><?= $cc_fname; ?><input type="hidden" name="cc_fname" value="<?= $cc_fname; ?>" /></td>
            	<td class="q">Last Name:</td>
           	  	<td class="a"><?= $cc_lname; ?><input type="hidden" name="cc_lname" value="<?= $cc_lname; ?>" /></td>
            </tr>
        	<tr>
            	<td class="q">Street Address:</td>
           	  	<td class="a"><?= $cc_addr; ?><input type="hidden" name="cc_addr" value="<?= $cc_addr; ?>" /></td>
				<td class="q">City:</td>
           	  	<td class="a"><?= $cc_city; ?><input type="hidden" name="cc_city" value="<?= $cc_city; ?>" /></td>
           </tr>
        	<tr>
            	<td class="q">State:</td>
           	  	<td class="a"><?= $cc_state; ?><input type="hidden" name="cc_state" value="<?= $cc_state; ?>" /></td>
				<td class="q">Zip:</td>
            	<td class="a"><?= $cc_zip; ?><input type="hidden" name="cc_zip" value="<?= $cc_zip; ?>" /></td>
            </tr>
        	
            <tr>
            	<td class="q">Gender:</td>
            	<td class="a"><?= $app_gender; ?><input type="hidden" name="app_gender" value="<?= $app_gender; ?>" /></td>
            	<td class="q">What is<br />your age?</td>
            	<td class="a"><?= $app_age; ?><input type="hidden" name="app_age" value="<?= $app_age; ?>" /></td>
            </tr>
			<tr>
            	<td class="q">Day Phone:</td>
                <td class="a">
                	<?= $cc_phonearea; ?>-<?= $cc_phoneprefix; ?>-<?= $cc_phoneextension; ?>
                	<input type="hidden" name="cc_phonearea" value="<?= $cc_phonearea; ?>" />
                	<input type="hidden" name="cc_phoneprefix" value="<?= $cc_phoneprefix; ?>" />
                	<input type="hidden" name="cc_phoneextension" value="<?= $cc_phoneextension; ?>" />
                </td>
				<td colspan="2" class="q">&nbsp;</td>
            </tr>
        </table>
		</div>
        <? 
        	if (! isset($error_message))
        	{
        ?>
		
		<div class="regform" style="margin:15px 0px;">
			<table>
				<tr>
					<td colspan="2"><p class="header">Application Question Summary</p></td>
				</tr>
				<tr>
					<td class="q">Citizenship Status:</td>
					<td class="a"><?= $app_citizenship; ?></td>
				</tr>
				<? if(!empty($types_of_grants)) { ?>
					<tr>
						<td class="q" colspan="2">Funding areas you are interested in?</td>
					</tr>
					<tr>
					<?
						$counter = 0;
						foreach ($types_of_grants as $grant)
						{
							echo "<td class=\"a\">$grant</td>";
							$counter++;
							if ($counter % 2 == 0)
							{
								echo "</tr><tr>";
							}
						}
					?>
					</tr>
				<? } ?>
				<tr>
					<td class="q">How much money do you need?</td>
					<td class="a"><?= $app_amount_needed; ?></td>
				</tr>
				<tr>
					<td class="q" colspan="2">Describe what you will use the money for:</td>
				</tr>
				<tr>
					<td class="a" colspan="2"><p><?= $app_usedescription; ?></p></td>
				</tr>
				
				<tr>
					<td class="q" colspan="2">What unique things would separate you from other applicants applying for this money?</td>
				</tr>
				<tr>
					<td class="a" colspan="2"><p><? echo stripslashes($app_uniqueness); ?></p></td>
				</tr>
			</table>
		</div>

		<?
			}
		?>
		
		<div class="regform" style="margin:15px 0px;">
		<table cellpadding="1" cellspacing="0" style="margin-bottom: 0px;">
			<tr>
				<td colspan="2"><p class="header">Funding Application User Account Info:</p></td>
			</tr>
			<tr>
				<td class="q">Username for Online Funding Application:</td>
				<td class="a"><?= $cc_email; ?><input type="hidden" name="cc_email" value="<?= $cc_email; ?>" /></td>
			</tr>
			<tr>
				<td class="s">
				<i>** The Website and Password for the Members site will be given to you at the completion of the registration process</i>
				</td>
			</tr>
		</table>
		</div>
		
		<div class="regform" style="margin:15px 0px;">
			<table>
				<tr>
					<td colspan="3">
						<p class="header">Payment Information for the $<?= $initial_subscription_fee; ?> Access Fee:</p>
		<p class="a">Our accountant tells us we have to charge a registration fee to help pay for the Internet advertising we have to do to get this information out to you and to cover administration expenses. <strong>So we have settled on $<?= $initial_subscription_fee; ?>,</strong> which we feel is a fair price to pay for such valuable information, which is updated on a regular basis. <strong>WE ALSO HAVE A GUARANTEE. <u>If you don't qualify for a Funding Program, you will be refunded immediately</u></strong>.  Just provide us with the funding application you applied for and the response letter from the funder. <strong>So Start Applying Today!</strong></p>
					
					</td>
				</tr>
				<tr>
					<td class="q">Credit Card Number:</td>
					<td class="a"><input type="text" name="cc_num" size="20" maxlength="16" value="<?= ($cc_num != '') ? $cc_num : NULL; ?>" /></td>
					<td>
						<img src="/images/creditcards.jpg" />&nbsp;<img src="/images/logo_ccDiscover.gif" />
					</td>
				</tr>
				<tr>
					<td class="q">Exp:</td>
					<td>
						<select name="cc_month">
							<option value="MM">MM</option>
							<? 
								for($i = 1; $i <= 12; $i++) {
									$month = sprintf('%02s',$i);
									$selected = (strcmp($month, $cc_month) == 0) ? "selected" : NULL; 
									echo "\n<option value='$month' $selected>$month</option>";
								}	
							?>
						</select> &nbsp;
						<select name="cc_year">
							<option value="YYYY">YYYY</option>
							<? 
								$years = range(date('Y'), date('Y')+20);
								foreach($years as $year) {
									$selected = (strcmp($year, $cc_year) == 0) ? "selected" : NULL; 
									echo "\n<option value='$year' $selected>$year</option>";
								}
							?>
						</select> 
					</td>
					<td>&nbsp;</td>
				</tr>
				<tr>
					<td class="q">3 Digit Verification Code<br />on back of Card:</td>
					<td class="a"><input size=5 maxlength="4" name="cc_cvv" value="<?php echo $cc_cvv ?>" /></td>
					<td colspan="2">&nbsp;</td>
				</tr>
			</table>
			
		</div>
		
		<div style="text-align:center;">
		<p align="center">
			<label for="agree2terms" title="I agree to the terms of this site">
				<input type="checkbox" id="agree2terms" name="agree2terms" value="agreed" />I agree to the terms of this site
			</label>
		</p>
	
		<input type="submit" value="CLICK HERE TO APPLY" />
		<p>Your Order is Protected by SSL Security</p>
		<input type="hidden" name="submitted" value="submitted" />
		<input type="hidden" name="cc_lead_id" value="<? echo $cc_lead_id; ?>" />
		<input type="hidden" name="tc" value="<?= $tc; ?>" />
		<?= $trackerformparams; ?>
		</div>
		
		</form>
	
	<br />
	<br />
	<center>
	<table border="0">
	<tr>
		<!--
		<td><img src="/images/privacy.jpg"></td>
		//-->
		<td>
			<span id="siteseal"><script type="text/javascript" src="https://seal.godaddy.com/getSeal?sealID=Q32E3zI17VD3Kh7Q1IqBOsnP0rdpumrvuSARgIU9mm3Hhy2KI2qOzUjAOCuh"></script><br/>
			<a style="font-family: arial; font-size: 9px" href="https://www.godaddy.com/gdshop/ssl/ssl_opensource.asp" target="_blank">SSL Certificates</a></span>
		</td>
		<!--
			<td><img src="/images/security.jpg"></td>
		//-->
	</tr>
	</table>
    
	</center>
	
	</div>
</td>
</tr>
<? if($use_vsa) { ?>
	<script language="javascript" src="/vsa/callagent.php?cid=1"></script>
<? } ?>
<? include_once("{$_SERVER["DOCUMENT_ROOT"]}/footer.php"); ?>


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