<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title>Opgave Formulier Karatedo Academie Hans Harthoorn</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<script type="text/javascript">
<!--
function Show(div)
{
var thisLevel = document.getElementById(div);
thisLevel.style.display = "block";
}
function Hide(div)
{
var thisLevel = document.getElementById(div);
thisLevel.style.display = "none";
}
function CheckValues(formul)
{
var inputarray
= new Array(11);
inputarray[0] = "voornaam";
inputarray[1] = "achternaam";
inputarray[2] = "adres";
inputarray[3] = "postcode";
inputarray[4] = "woonplaats";
inputarray[5] = "telefoonnummer";
inputarray[6] = "email";
inputarray[7] = "geboortedatum";
inputarray[8] = "les startdatum";
inputarray[9] = "datum";
inputarray[10] = "handtekening";
for (var i = 0; i < document.formul.groep[].length; i++)
{
if (document.formul.groep[i].value == "")
{
alert("Je hebt geen " + inputarray[i] + " ingevuld!");
}
}
if (document.formul.auto_bet.checked == false and document.formul.per_5.checked == false and document.formul.los_bet.checked == false)
{
alert('Kies een betalingsmethode!');
}
}
//-->
</script>
<style type="text/css">
<!--
input.vak {
width: 200px;
}
#handtekdiv {
position: absolute;
left:144px;
top:381px;
width:200px;
background:#CC0000;
color:#FFFFFF;
background-color: #FF0000;
}
-->
</style>
</head>
<body>
<form action="inschrijf.php" method="post" name="inschrijfform">
<table width="320" border="0">
<tr>
<td height="26">Voornaam</td>
<td><input name="groep[0]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Achternaam</td>
<td><input name="groep[1]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Adres</td>
<td><input name="groep[2]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Postcode</td>
<td><input name="groep[3]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Woonplaats</td>
<td><input name="groep[4]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Telefoonnummer</td>
<td><input name="groep[5]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Email</td>
<td><input name="groep[6]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Geboortedatum</td>
<td><input name="groep[7]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Lessen gestart op</td>
<td><input name="groep[8]" type="text" class="vak" ></td>
</tr>
<tr>
<td>Betaling</td>
<td rowspan="3" class="cel"><p>
<input name="auto_bet" type="radio" value="radiobutton">
Automatisch per maand</p>
<p>
<input name="per_5" type="radio" value="radiobutton">
Per periode van 5 maanden</p>
<p>
<input name="los_bet" type="radio" value="radiobutton">
Losse betalingen </p></td>
</tr>
<tr><td> </td></tr>
<tr><td> </td></tr>
<tr>
<td height="26">Datum</td>
<td><input name="groep[9]" type="text" class="vak" ></td>
</tr>
<tr>
<td height="26">Handtekening</td>
<td><input name="groep[10]" type="text" class="vak" onFocus="Show('handtekdiv');"></td>
</tr>
<tr>
<td height="28"><input name="reset" type="reset" id="reset" value="Reset"></td>
<td><input type="button" name="Submit" value="Submit" onClick="javascript:CheckValues('inschrijfform')"></td>
</tr>
</table>
</form>
<div id="handtekdiv" style="display: none;" > NB: Een ingevulde naam geldt als handtekening!!! </div>
</body>
</html>