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membership_form.html.in
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membership_form.html.in
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<form method="POST" id="membership_form" class="reg_form" action="membership_form.php">
<p class="title">Royal Scottish Country Dance Society, Portland Ore. Branch:<br />Membership Form 2019-2020</p>
<table id="field_box">
<tr><td><label for="name">Name(s):</label></td><td><input type="text" class="text" id="name" name="name"/></td></tr>
<tr><td><label for="children">Children under 16:</label></td><td><input type="text" class="text" id="children" name="children"/></td></tr>
<tr><td><label for="address">Address:</label></td><td><input type="text" class="text" id="address" name="address"/></td></tr>
<tr><td><label for="phone">Phone:</label></td><td><input type="text" class="text" id="phone" name="phone"/></td></tr>
<tr><td><label for="email">Email:</label></td><td><input type="text" class="text" id="email" name="email"/></td></tr>
<tr><td></td><td><input type="checkbox" id="email_list" name="email_list"/> <label for="email_list" class="wrap">Please ensure that I am subscribed to the members’ email list.</label></td></tr>
</table>
<table id="type_box">
<tr><th colspan="2">Membership Type:</th></tr>
<tr><td class="narrow_column"><input type="radio" name="type" id="type_single" value="single"/> <label for="type_single">Single RSCDS</label></td><td>$32</td></tr>
<tr><td class="narrow_column"><input type="radio" name="type" id="type_family" value="family"/> <label for="type_family">Family RSCDS</label></td><td>$47</td></tr>
<tr><td class="narrow_column"><input type="radio" name="type" id="type_local" value="local"/> <label for="type_local">Secondary</label></td><td>$5</td></tr>
<tr id="primary_branch_row"><td colspan="2" class="wide_column"><label for="primary_branch">Primary Branch:</label> <input type="text" class="text" name="primary_branch" id="primary_branch"/></td></tr>
<tr><td class="narrow_column"><input type="radio" name="type" id="type_gg_only" value="gg_only"/> <label for="type_gg_only">Ghillie Gazette Only</label></td><td>$5</td></tr>
</table>
<p><b>Note for families: Join at the family rate <i>only</i> if there
are two adults; a single adult should join at the single rate.</b></p>
<p>A “secondary” membership is for people who already have their RSCDS
membership through another branch and want to become members of our branch.
The “Ghillie Gazette Only” option is for people who have not yet decided to
join the branch but would like to receive the newsletter.</p>
<p>Please make check payable to <b>“RSCDS Portland OR Branch”</b> and mail or give to
%MEMBERSHIP_CHAIR_MAIL%
. We cannot process your membership request until we receive your check.</p>
<div class="isfun">Is Scottish Country Dance fun? <input type="checkbox" id="org" name="org"/> <label for="org">Yes, and my registration check is on its way!</label></div>
<div id="errors"></div>
<input type="submit" value="Register" disabled="disabled"/>
<input type="reset" value="Start Over"/>
</form>
<script type="text/javascript">
$(document).ready(setup_membership_form);
</script>