<?
if(!empty($POST))
{
$hidden = '';
echo '<form action="formscript.php" method="post">';
foreach($POST as $var=>$val)
{
*if($var != 'submit')
{
**$hidden .= '<input type="hidden" name="'.$var.'" value="'.$val.'">';
echo '<b>'.ucwords($var).':</b> '.$val.'<br>';
*}
}
echo $hidden.= '<input type="submit" name="submit" value="Submit">
</form>';
}
?>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"
"http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<title>Registration</title>
<script language="JavaScript" type="text/JavaScript">
<!--
function MM_preloadImages() { //v3.0
var d=document; if(d.images){ if(!d.MM_p) d.MM_p=new Array();
var i,j=d.MM_p.length,a=MM_preloadImages.arguments; for(i=0; i<a.length; i++)
if (a.indexOf("#")!=0){ d.MM_p[j]=new Image; d.MM_p[j++].src=a;}}
}
function MM_swapImgRestore() { //v3.0
var i,x,a=document.MM_sr; for(i=0;a&&i<a.length&&(x=a)&&x.oSrc;i++) x.src=x.oSrc;
}
function MM_findObj(n, d) { //v4.01
var p,i,x; if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[n];
for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers.document);
if(!x && d.getElementById) x=d.getElementById(n); return x;
}
function MM_swapImage() { //v3.0
var i,j=0,x,a=MM_swapImage.arguments; document.MM_sr=new Array; for(i=0;i<(a.length-2);i+=3)
if ((x=MM_findObj(a))!=null){document.MM_sr[j++]=x; if(!x.oSrc) x.oSrc=x.src; x.src=a[i+2];}
}
function MM_openBrWindow(theURL,winName,features) { //v2.0
window.open(theURL,winName,features);
}
//-->
</script>
</head>
<body bgcolor="#F3F1DF" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0" onLoad="MM_preloadImages('images/reg_contact_over.gif','images/reg_samples_over.gif','images/reg_programs_over.gif','images/reg_about_over.gif','images/reg_home_over.gif')">
<div align="center">
<table width="800" border="0" cellpadding="0" cellspacing="0">
<!--DWLayoutTable-->
<tr>
<td width="800" height="111" align="left" valign="top"><img src="images/registration_top.gif" name="Image1" width="800" height="111" border="0" usemap="#Map" id="Image1"></td>
</tr>
<tr>
<td height="123" valign="top"><img src="formgifs/top.gif" width="800" height="123"></td>
</tr>
</table>
<table width="800" border="0" cellpadding="0" cellspacing="0">
<form method= "post" action= "formscript.php">
<!--DWLayoutTable-->
<tr>
<td width="14" align="left" valign="bottom" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td width="172" height="18" align="left" valign="bottom" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman">Salon/Spa Name:</font> </strong></div></td>
<td width="9" align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td width="226" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[spaname]"; ?> </font></td>
<td width="122" align="left" valign="top" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman">Card Type: </font></strong></div></td>
<td width="10" align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td width="247" align="left" valign="top" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[CreditCard]"; ?> </font></td>
</tr>
<tr>
<td align="left" valign="bottom" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td height="18" align="left" valign="bottom" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman">Contact Name:</font></strong></div></td>
<td align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td align="left" valign="top" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[contactname]"; ?> </font></td>
<td align="left" valign="top" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman">Card Number: </font></strong></div></td>
<td align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td align="left" valign="top" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[cardnumber]"; ?> </font></td>
</tr>
<tr>
<td align="left" valign="bottom" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td height="18" align="left" valign="bottom" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman">Phone:</font></strong></div></td>
<td align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td align="left" valign="top" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[phone]"; ?> </font></td>
<td align="left" valign="top" bgcolor="#D21033"><div align="right"><strong><font color="#FFFFFF" face="Myriad Roman"> Exp Date:</font></strong></div></td>
<td align="left" valign="top" bgcolor="#D21033"><!--DWLayoutEmptyCell--> </td>
<td align="left" valign="top" bgcolor="#D21033"><font color="#FFFFFF" face="Myriad Roman"><? echo "$POST[expdate]"; ?> </font></td>
</tr>
<tr>