Your IP : 216.73.217.79
<?php
$pagetitle="CCE Registration";
include_once("inc_db.php");
$sMsg = "";
$bShowForm = true;
$bCourseFull = false;
function GenPassword() {
// Password generation
$length = 8; // Must be a multiple of 2
$conso=array("b","c","d","f","g","h","j","k","l", "m","n","p","r","s","t","v","w","x","y","z");
$vocal=array("a","e","i","o","u");
$password="";
srand ((double)microtime()*1000000);
$max = $length/2;
for($i=1; $i<=$max; $i++)
{
$password.=$conso[rand(0,19)];
$password.=$vocal[rand(0,4)];
}
return $password;
}
if (isset($_POST["go"]) && ($_POST["go"]==1)) {
$iProgramme = $_REQUEST["programme"];
if (empty($iProgramme)) $iProgramme = 1;
$sql ="SELECT MAX(CCECourseScheduleID) AS Schedule FROM CCECourseSchedules WHERE CCECourseID=".intval($iProgramme);
$recCount = mysql_query($sql);
if ($rowCount = mysql_fetch_assoc($recCount)) {
$iProgrammeSchedule = $rowCount["Schedule"];
}
mysql_free_result($recCount);
$sql ="SELECT MaxStudents, COUNT(*) AS NumStudents FROM CCEStudents INNER JOIN CCEStudentCourses USING (CCEStudentID)
INNER JOIN CCECourseSchedules USING (CCECourseID)
WHERE CCEStudentCourses.CCECourseScheduleID=".$iProgrammeSchedule;
$recCount = mysql_query($sql);
if ($rowCount = mysql_fetch_assoc($recCount)) {
if ($rowCount["MaxStudents"] <= $rowCount["NumStudents"]) $bCourseFull = true;
}
mysql_free_result($recCount);
if ($bCourseFull) {
echo "<p style='color:red'><b>Sorry, this course is full and no more registrations can be accepted.</b></p>";
} else {
if (empty($_POST['FirstName'])) {
$sMsg .= "<li>Please enter your first name</li>";
}
if (empty($_POST['Surname'])) {
$sMsg .= "<li>Please enter your surname</li>";
}
if (empty($_POST['EmailAddress'])) {
$sMsg .= "<li>Please enter your email address</li>";
}
if (empty($_POST['IDNumber'])) {
$sMsg .= "<li>Please enter your ID Number</li>";
}
if ($_POST['ti'] != md5($_POST['security_code'])) {
// The CAPTCHA code was incorrect
$sMsg .= "<li>You have provided an invalid verification code</li>";
}
if (empty($_POST['Accept_Policy'])) {
$sMsg .= "<li>You have not accepted the payment terms and conditions</li>";
}
if (empty($sMsg)) {
$bShowForm = false;
$sql = "SELECT * FROM CCEStudents WHERE IDNumber='".$_REQUEST["IDNumber"]."'";
$recCheck = mysql_query($sql);
if ($rowCheck=mysql_fetch_assoc($recCheck)) {
$sMsg .= "<li>The ID number you provided is already registered.</li>";
}
mysql_free_result($recCheck);
}
if (empty($sMsg)) {
$uploaddir = 'cceadmin/students/';
$uploadfilename1="";
$uploadfilename2="";
$uploadfilename3="";
$uploadfilename4="";
$uploadfilename5="";
$uploadfilename6="";
$uploadfile1="";
$uploadfile2="";
$uploadfile3="";
$uploadfile4="";
$uploadfile5="";
$uploadfile6="";
if (isset($_FILES['CVFile'])) {
$uploadfilename1 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['CVFile']['name']))));
$uploadfile1 = $uploaddir . $uploadfilename1;
$ifilenum=1;
while (file_exists($uploadfile1) && !empty($uploadfilename1)) {
$uploadfile1 = $uploaddir . $ifilenum."_".$uploadfilename1;
$ifilenum++;
}
move_uploaded_file($_FILES['CVFile']['tmp_name'], $uploadfile1);
}
if (isset($_FILES['QualCertificate1'])) {
$uploadfilename2 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate1']['name']))));
$uploadfile2 = $uploaddir . $uploadfilename2;
$ifilenum=1;
while (file_exists($uploadfile2) && !empty($uploadfilename2)) {
$uploadfile2 = $uploaddir . $ifilenum."_".$uploadfilename2;
$ifilenum++;
}
move_uploaded_file($_FILES['QualCertificate1']['tmp_name'], $uploadfile2);
}
if (isset($_FILES['QualCertificate2'])) {
$uploadfilename3 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate2']['name']))));
$uploadfile3 = $uploaddir . $uploadfilename3;
$ifilenum=1;
while (file_exists($uploadfile3) && !empty($uploadfilename3)) {
$uploadfile3 = $uploaddir . $ifilenum."_".$uploadfilename3;
$ifilenum++;
}
move_uploaded_file($_FILES['QualCertificate2']['tmp_name'], $uploadfile3);
}
if (isset($_FILES['QualCertificate3'])) {
$uploadfilename4 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate3']['name']))));
$uploadfile4 = $uploaddir . $uploadfilename4;
$ifilenum=1;
while (file_exists($uploadfile4) && !empty($uploadfilename4)) {
$uploadfile4 = $uploaddir . $ifilenum."_".$uploadfilename4;
$ifilenum++;
}
move_uploaded_file($_FILES['QualCertificate3']['tmp_name'], $uploadfile4);
}
if (isset($_FILES['IDFile'])) {
$uploadfilename5 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['IDFile']['name']))));
$uploadfile5 = $uploaddir . $uploadfilename5;
$ifilenum=1;
while (file_exists($uploadfile5) && !empty($uploadfilename5)) {
$uploadfile5 = $uploaddir . $ifilenum."_".$uploadfilename5;
$ifilenum++;
}
move_uploaded_file($_FILES['IDFile']['tmp_name'], $uploadfile5);
}
if (isset($_FILES['PhotoFile'])) {
$uploadfilename6 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['PhotoFile']['name']))));
$uploadfile6 = $uploaddir . $uploadfilename6;
$ifilenum=1;
while (file_exists($uploadfile6) && !empty($uploadfilename6)) {
$uploadfile6 = $uploaddir . $ifilenum."_".$uploadfilename6;
$ifilenum++;
}
move_uploaded_file($_FILES['PhotoFile']['tmp_name'], $uploadfile6);
}
$sql = "INSERT INTO CCEStudents (`FirstName`, `Surname`, `KnownAs`, `IDNumber`, `Telephone`, `Cellphone`,
`EmailAddress`, `HomeAddress`, `WorkAddress`, `PostalAddress`, `Title`, `Designation`, `Department`,
`Age`, `HighestQual`, `AreaDiscipline`,
`Organisation`, `ECSANumber`, `DietaryRequirements`, `OrganisationType`, `OrderNo`, `CESAAccountNo`,
`VATNo`, `BookedByName`, `BookedByDesignation`, `BookedByTelNo`, `BookedByFaxNo`, `BookedByCellNo`, `BookedByEmail`,
`MentorName`, `MentorDesig`, `MentorTel`, `MentorCell`, `MentorEmail`, `HRManagerName`, `HRManagerDesignation`,
`HRManagerTelNo`, `HRManagerCellNo`, `HRManagerEmail`, `CVFile`, `QualCertificate1`, `QualCertificate2`, `QualCertificate3`, IDFile, PhotoFile, LengthEmploy, Archived)
VALUES ('".$_REQUEST["FirstName"]."', '".$_REQUEST["Surname"]."', '".$_REQUEST["KnownAs"]."',
'".$_REQUEST["IDNumber"]."', '".$_REQUEST["Telephone"]."', '".$_REQUEST["Cellphone"]."',
'".$_REQUEST["EmailAddress"]."', '".$_REQUEST["HomeAddress"]."', '".$_REQUEST["WorkAddress"]."',
'".$_REQUEST["PostalAddress"]."', '".$_REQUEST["Title"]."', '".$_REQUEST["Designation"]."', '".$_REQUEST["Department"]."',
'".$_REQUEST["Age"]."', '".$_REQUEST["HighestQual"]."', '".$_REQUEST["AreaDiscipline"]."',
'".$_REQUEST["Organisation"]."', '".$_REQUEST["ECSANumber"]."', '".$_REQUEST["DietaryRequirements"]."', '".$_REQUEST["OrganisationType"]."',
'".$_REQUEST["OrderNo"]."', '".$_REQUEST["CESAAccountNo"]."', '".$_REQUEST["VATNo"]."', '".$_REQUEST["BookedByName"]."',
'".$_REQUEST["BookedByDesignation"]."', '".$_REQUEST["BookedByTelNo"]."', '".$_REQUEST["BookedByFaxNo"]."',
'".$_REQUEST["BookedByCellNo"]."', '".$_REQUEST["BookedByEmail"]."',
'".$_REQUEST["MentorName"]."', '".$_REQUEST["MentorDesig"]."', '".$_REQUEST["MentorTel"]."', '".$_REQUEST["MentorCell"]."',
'".$_REQUEST["MentorEmail"]."', '".$_REQUEST["HRManagerName"]."', '".$_REQUEST["HRManagerDesignation"]."',
'".$_REQUEST["HRManagerTelNo"]."', '".$_REQUEST["HRManagerCellNo"]."', '".$_REQUEST["HRManagerEmail"]."',
'".str_replace($uploaddir, '', $uploadfile1)."',
'".str_replace($uploaddir, '', $uploadfile2)."',
'".str_replace($uploaddir, '', $uploadfile3)."',
'".str_replace($uploaddir, '', $uploadfile4)."',
'".str_replace($uploaddir, '', $uploadfile5)."',
'".str_replace($uploaddir, '', $uploadfile6)."',
'".$_REQUEST["LengthEmploy"]."', 1)";
mysql_query($sql);
$iStudentID = mysql_insert_id();
$sStudentNumber = "CCE".str_pad($iStudentID, 6, "0", STR_PAD_LEFT);
$WebUsername = $sStudentNumber;
$WebPassword = GenPassword();
$sql = "UPDATE CCEStudents SET StudentNumber='".$sStudentNumber."', WebUsername='".$WebUsername."', WebPassword='".$WebPassword."'
WHERE CCEStudentID=".$iStudentID;
mysql_query($sql);
$sql = "INSERT INTO CCEStudentCourses (`CCECourseID`, `CCEStudentID`, `OrderNo`, `BookedByName`, `BookedByDesignation`,
`BookedByTelNo`, `BookedByFaxNo`, `BookedByCellNo`, `BookedByEmail`, CCECourseScheduleID)
VALUES ('".$iProgramme."', '".$iStudentID."', '".$_REQUEST["OrderNo"]."', '".$_REQUEST["BookedByName"]."',
'".$_REQUEST["BookedByDesignation"]."', '".$_REQUEST["BookedByTelNo"]."', '".$_REQUEST["BookedByFaxNo"]."',
'".$_REQUEST["BookedByCellNo"]."', '".$_REQUEST["BookedByEmail"]."', '".$iProgrammeSchedule."')";
mysql_query($sql);
$sql = "INSERT INTO CCEStudentSessions (`CCEStudentID`, `CCESessionScheduleID`)
SELECT '".$iStudentID."', CCESessionSchedules.CCESessScheduleID
FROM CCESessions, CCESessionSchedules
WHERE CCESessions.CCECourseID='".$iProgramme."'
AND CCESessions.CCESessionID = CCESessionSchedules.CCESessionID
AND CCESessionSchedules.CCECourseScheduleID=".$iProgrammeSchedule;
mysql_query($sql);
$sForm = '
<h3>REGISTRATION FOR THE CERTIFICATE IN CONSULTING ENGINEERING</h3>
<h4>Your Student Number: '.$sStudentNumber.'</h4>
<h4>Programme: Business of Consulting Engineering</h4>
<h4>Dates: 2013-02-04 to 2013-11-26</h4>
<table border="1" cellpadding="5" cellspacing="0">
<tbody>
<tr>
<td width="233"><p>Title:</p></td>
<td width="349"><p>'.$_REQUEST["Title"].'</p></td>
</tr>
<tr>
<td width="233"><p>First Name:</p></td>
<td width="349"><p>'.$_REQUEST["FirstName"].'</p></td>
</tr>
<tr>
<td><p>Surname:</p></td>
<td><p>'.$_REQUEST["Surname"].'</p></td>
</tr>
<tr>
<td><p>Preferred Name (Known As):</p></td>
<td><p>'.$_REQUEST["KnownAs"].'</p></td>
</tr>
<tr>
<td><p>ECSA Number:</p></td>
<td><p>'.$_REQUEST["ECSANumber"].'</p></td>
</tr>
<tr>
<td><p>ID Number:</p></td>
<td><p>'.$_REQUEST["IDNumber"].'</p></td>
</tr>
<tr>
<td><p>Your Age:</p></td>
<td><p>'.$_REQUEST["Age"].'</p></td>
</tr>
<tr>
<td><p>Highest Qualification:</p></td>
<td><p>'.$_REQUEST["HighestQual"].'</p></td>
</tr>
<tr>
<td><p>Area of Discipline:</p></td>
<td><p>'.$_REQUEST["AreaDiscipline"].'</p></td>
</tr>
<tr>
<td>How long have you worked in a Consulting Engineering Firm?</td>
<td><p>'.$_REQUEST["LengthEmploy"].'</p></td>
</tr>
<tr>
<td><p>Telephone No:</p></td>
<td><p>'.$_REQUEST["Telephone"].'</p></td>
</tr>
<tr>
<td><p>Cell No. :</p></td>
<td><p>'.$_REQUEST["Cellphone"].'</p></td>
</tr>
<tr>
<td><p>E-mail Address:</p></td>
<td><p>'.$_REQUEST["EmailAddress"].'</p></td>
</tr>
<tr>
<td valign="top"><p>Home Address:</p></td>
<td><p>'.nl2br(stripslashes($_REQUEST["HomeAddress"])).'</p></td>
</tr>
<tr>
<td valign="top"><p>Work Address:</p></td>
<td><p>'.nl2br(stripslashes($_REQUEST["WorkAddress"])).'</p></td>
</tr>
<tr>
<td valign="top"><p>Postal Address:</p></td>
<td><p>'.nl2br(stripslashes($_REQUEST["PostalAddress"])).'</p></td>
</tr>
<tr>
<td valign="top">Organisation:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["Organisation"])).'</p></td>
</tr>
<tr>
<td>Designation:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["Designation"])).'</p></td>
</tr>
<tr>
<td valign="top">Organisation Type:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["OrganisationType"])).'</p></td>
</tr>
<tr>
<td valign="top">VAT No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["VATNo"])).'</p></td>
</tr>
<tr>
<td valign="top">Order No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["OrderNo"])).'</p></td>
</tr>
<tr>
<td valign="top">CESA Account No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["CESAAccountNo"])).'</p></td>
</tr>
<tr>
<td valign="top">Programme:</td>
<td>Business of Consulting Engineering</td>
</tr>
<tr>
<td valign="top"><strong>Mentor:</strong></td>
<td>'.nl2br(stripslashes($_REQUEST["MentorName"])).'</td>
</tr>
<tr>
<td valign="top">Designation:</td>
<td>'.nl2br(stripslashes($_REQUEST["MentorDesig"])).'</td>
</tr>
<tr>
<td valign="top">Tel No:</td>
<td>'.nl2br(stripslashes($_REQUEST["MentorTel"])).'</td>
</tr>
<tr>
<td valign="top">Cell No:</td>
<td>'.nl2br(stripslashes($_REQUEST["MentorCell"])).'</td>
</tr>
<tr>
<td valign="top">Email Address:</td>
<td>'.nl2br(stripslashes($_REQUEST["MentorEmail"])).'</td>
</tr>
<tr>
<td valign="top"><strong>HR Manager:</strong></td>
<td>'.nl2br(stripslashes($_REQUEST["HRManagerName"])).'</td>
</tr>
<tr>
<td valign="top">Designation:</td>
<td>'.nl2br(stripslashes($_REQUEST["HRManagerDesignation"])).'</td>
</tr>
<tr>
<td valign="top">Tel No:</td>
<td>'.nl2br(stripslashes($_REQUEST["HRManagerTelNo"])).'</td>
</tr>
<tr>
<td valign="top">Cell No:</td>
<td>'.nl2br(stripslashes($_REQUEST["HRManagerCellNo"])).'</td>
</tr>
<tr>
<td valign="top">Email Address:</td>
<td>'.nl2br(stripslashes($_REQUEST["HRManagerEmail"])).'</td>
</tr>
<tr>
<td valign="top"><strong>Booked By:</strong></td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByName"])).'</p></td>
</tr>
<tr>
<td valign="top">Designation:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByDesignation"])).'</p></td>
</tr>
<tr>
<td valign="top">Tel No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByTelNo"])).'</p></td>
</tr>
<tr>
<td valign="top">Fax No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByFaxNo"])).'</p></td>
</tr>
<tr>
<td valign="top">Cell No:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByCellNo"])).'</p></td>
</tr>
<tr>
<td valign="top">Email Address:</td>
<td><p>'.nl2br(stripslashes($_REQUEST["BookedByEmail"])).'</p></td>
</tr>
</tbody>
</table>';
// To send HTML mail, the Content-type header must be set
$headers = 'MIME-Version: 1.0' . "\r\n";
$headers .= 'Content-type: text/html; charset=iso-8859-1' . "\r\n";
// Additional headers
$headers .= 'From: '.$_REQUEST["EmailAddress"] . "\r\n";
$headers .= 'CC: brenda@cesa.co.za' . "\r\n";
$headers .= 'CC: athromethm@cesa.co.za' . "\r\n";
// $headers .= 'CC: Celia.Mullane@gmail.com' . "\r\n";
// $headers .= 'CC: craigclarke@telkomsa.net' . "\r\n";
$sSendFormTo = "cce@cesa.co.za";
// $sSendFormTo = "julia@xe.co.za";
mail($sSendFormTo, "REGISTRATION FOR CCE", $sForm, $headers);
?>
<p><b>Your student number is: <?php echo $sStudentNumber; ?></b></p>
<p><b>Your form has been submitted to CESA.</b> Please email <a href="mailto:sce@cesa.co.za">sce@cesa.co.za</a> if you have any questions. A copy of your form appears below.</p>
<hr />
<?php echo $sForm; ?>
<?php
}
}
}
if ($bShowForm) {
?>
<form action="/node/173" method="post" enctype="multipart/form-data" name="form1" id="form1">
<input type="hidden" name="go" value="1" />
<h3>REGISTRATION FOR THE CERTIFICATE IN CONSULTING ENGINEERING</h3>
<?php
if (!empty($sMsg)) echo "<p style='color:red'><b>Error:<br /><ul style='color:red'>".$sMsg."</ul></b></p>";
?>
<p>Please complete the on-line application form below.
<p>NB: Please ensure you have a copy of your CV and proof of qualification/s ready for upload in an electronic format.
<table border="1" cellpadding="5" cellspacing="0">
<tbody>
<tr>
<td>Title:</td>
<td><input name="Title" type="text" id="Title" size="50" value="<?php echo $_REQUEST["Title"]; ?>" /></td>
</tr>
<tr>
<td width="233"><p>First Name:</p></td>
<td width="349"><p>
<input name="FirstName" type="text" id="FirstName" size="50" value="<?php echo $_REQUEST["FirstName"]; ?>" />
</p></td>
</tr>
<tr>
<td><p>Surname:</p></td>
<td><input name="Surname" type="text" id="Surname" size="50" value="<?php echo $_REQUEST["Surname"]; ?>" /></td>
</tr>
<tr>
<td><p>Preferred Name (Known As):</p></td>
<td><p>
<input name="KnownAs" type="text" id="KnownAs" size="50" value="<?php echo $_REQUEST["KnownAs"]; ?>" />
</p></td>
</tr>
<tr>
<td>ECSA Number:</td>
<td><input name="ECSANumber" type="text" id="ECSANumber" size="30" value="<?php echo $_REQUEST["ECSANumber"]; ?>" /></td>
</tr>
<tr>
<td>ID Number:</td>
<td><input name="IDNumber" type="text" id="IDNumber" size="30" value="<?php echo $_REQUEST["IDNumber"]; ?>" /></td>
</tr>
<tr>
<td>Your Age:</td>
<td><input name="Age" type="text" id="Age" size="30" value="<?php echo $_REQUEST["Age"]; ?>" /></td>
</tr>
<tr>
<td>Highest Qualification:</td>
<td><input name="HighestQual" type="text" id="HighestQual" size="50" value="<?php echo $_REQUEST["HighestQual"]; ?>" /></td>
</tr>
<tr>
<td>Area of Discipline:</td>
<td><input name="AreaDiscipline" type="text" id="AreaDiscipline" size="50" value="<?php echo $_REQUEST["AreaDiscipline"]; ?>" /></td>
</tr>
<tr>
<td>How long have you worked in a Consulting Engineering Firm?</td>
<td><input name="LengthEmploy" type="text" id="LengthEmploy" size="50" value="<?php echo $_REQUEST["LengthEmploy"]; ?>" /></td>
</tr>
<tr>
<td><p>Telephone No:</p></td>
<td><p>
<input name="Telephone" type="text" id="Telephone" size="30" value="<?php echo $_REQUEST["Telephone"]; ?>" />
</p></td>
</tr>
<tr>
<td><p>Cell No. :</p></td>
<td><p>
<input name="Cellphone" type="text" id="Cellphone" size="30" value="<?php echo $_REQUEST["Cellphone"]; ?>" />
</p></td>
</tr>
<tr>
<td><p>E-mail Address:</p></td>
<td><p>
<input name="EmailAddress" type="text" id="EmailAddress" size="50" value="<?php echo $_REQUEST["EmailAddress"]; ?>" />
</p></td>
</tr>
<tr>
<td valign="top">Organisation:</td>
<td><input name="Organisation" type="text" id="Organisation" size="50" value="<?php echo $_REQUEST["Organisation"]; ?>" /></td>
</tr>
<tr>
<td>Designation:</td>
<td><input name="Designation" type="text" id="Designation3" size="50" value="<?php echo $_REQUEST["Designation"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Organisation Type:</td>
<td><input name="OrganisationType" type="text" id="OrganisationType" size="50" value="<?php echo $_REQUEST["OrganisationType"]; ?>" /></td>
</tr>
<tr>
<td valign="top">VAT No:</td>
<td><input name="VATNo" type="text" id="VATNo" size="30" value="<?php echo $_REQUEST["VATNo"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Order No:</td>
<td><input name="OrderNo" type="text" id="OrderNo" size="30" value="<?php echo $_REQUEST["OrderNo"]; ?>" /></td>
</tr>
<tr>
<td valign="top">CESA Account No:</td>
<td><input name="CESAAccountNo" type="text" id="CESAAccountNo" size="30" value="<?php echo $_REQUEST["CESAAccountNo"]; ?>" /></td>
</tr>
<tr>
<td valign="top"><p>Home Address:</p></td>
<td><p>
<textarea name="HomeAddress" id="HomeAddress" cols="45" rows="5"><?php echo stripslashes($_REQUEST["HomeAddress"]); ?>
</textarea>
</p></td>
</tr>
<tr>
<td valign="top"><p>Work Address:</p></td>
<td><p>
<textarea name="WorkAddress" id="WorkAddress" cols="45" rows="5"><?php echo stripslashes($_REQUEST["WorkAddress"]); ?>
</textarea>
</p></td>
</tr>
<tr>
<td valign="top"><p>Postal Address:</p></td>
<td><p>
<textarea name="PostalAddress" id="PostalAddress" cols="45" rows="5"><?php echo stripslashes($_REQUEST["PostalAddress"]); ?>
</textarea>
</p></td>
</tr>
<tr>
<td valign="top">Programme:</td>
<td><label>
<input name="programme" type="checkbox" id="programme" value="1" checked="checked" />
</label>
Business of Consulting Engineering</td>
</tr>
<tr>
<td valign="top"><strong>Mentor:</strong></td>
<td> </td>
</tr>
<tr>
<td valign="top">Full Name:</td>
<td><input name="MentorName" type="text" id="MentorName" size="50" value="<?php echo $_REQUEST["MentorName"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Designation:</td>
<td><input name="MentorDesig" type="text" id="MentorDesig" size="50" value="<?php echo $_REQUEST["MentorDesig"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Tel No:</td>
<td><input name="MentorTel" type="text" id="MentorTel" size="30" value="<?php echo $_REQUEST["MentorTel"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Cell No:</td>
<td><input name="MentorCell" type="text" id="MentorCell" size="30" value="<?php echo $_REQUEST["MentorCell"]; ?>" /></td>
</tr>
<tr>
<td valign="top">Email Address:</td>
<td><input name="MentorEmail" type="text" id="MentorEmail" size="50" value="<?php echo $_REQUEST["MentorEmail"]; ?>" /></td>
</tr>
<tr>
<td valign="top"><strong>HR Manager:</strong></td>
<td> </t