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[ DIR ]
drwxr-sr-x
2013-09-25 09:36
docthumbs
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drwxr-sr-x
2015-07-16 10:47
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2015-05-20 09:39
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2017-10-25 14:17
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2015-07-14 05:06
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2013-09-25 09:35
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2013-09-25 09:36
Guideline 2 - Developing a WPTP.DOCX
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2013-09-25 09:33
ReportMilestones.php
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2014-07-07 06:49
archivedmessages.php
2.69
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2013-10-21 10:34
calendar.js
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2013-09-25 09:33
calendar.php
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2014-01-22 08:36
changedates.php
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2013-09-25 09:33
contacts.php
3.2
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2013-09-25 09:33
details.php
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2013-09-25 09:33
feedback.php
16.68
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2015-09-16 05:17
forgotpwd.php
2.49
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2013-10-14 07:07
gallery.php
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2013-09-25 09:33
guidelines.php
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2014-10-13 08:37
inc_footer.php
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2013-09-25 09:34
inc_functions.php
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2013-10-10 13:34
inc_header.php
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2014-01-22 08:56
inc_sidebar.php
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2018-11-21 13:29
index.php
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2015-07-14 05:07
library.php
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2013-09-25 09:35
login.php
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2014-07-21 09:41
logout.php
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2013-09-25 09:35
messages.php
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2014-01-22 08:56
milestones.php
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2015-07-13 09:14
milestones_backup.php
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2014-01-16 08:07
modcontact.php
5.75
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2014-04-14 08:20
notices.php
2.76
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2013-09-25 09:35
password.php
5.11
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2014-11-03 09:00
pdfthumb.php
230
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2013-09-25 09:48
php_errors.log
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2026-08-20 23:56
profile.php
8.1
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2018-11-23 12:50
readmessage.php
4.21
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2014-01-22 08:56
register.php
79.1
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2014-09-02 10:32
register_step2.php
56.18
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2014-11-03 09:09
sentmessages.php
2.51
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2013-10-21 10:34
style.css
3.72
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2013-09-25 09:36
templates.php
1.91
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2013-09-25 09:36
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<html> <head> <title>MentaNet</title> <link href="style.css" rel="stylesheet" type="text/css" /> <style> p, td { font: 12px Verdana, sans-serif; } </style> </head> <body class="twoColFixLtHdr"> <div id="container"> <?php include("inc_header.php"); ?> <div id="mainContent"> <?php $bCourseFull = false; if (isset($_GET["override"]) && ($_GET["override"]==1)) $bCourseFull = false; if ($bCourseFull) { ?> <p style='color:red'><b>Sorry, no more registrations can be accepted.</b></p> <?php } else { //error_reporting(E_ALL); //ini_set("display_errors", 1); $pagetitle="CCM Registration"; include("../php/inc_db.php"); $sMsg = ""; $bShowForm = true; 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 $password; } function WriteOptions($sSelName, $arr) { global $row; for ($a=0; $a<count($arr); $a++) { $sel=""; if (($row[$sSelName]==$arr[$a]) || $_REQUEST[$sSelName]==$arr[$a]) $sel=" selected"; echo "<option value='".addslashes($arr[$a])."'".$sel.">".$arr[$a]."</option>"; } } if (isset($_POST["go"]) && ($_POST["go"]==1)) { $bShowForm = true; $bWrongID=false; $sql = "SELECT * FROM CCMStudents WHERE IDNumber='".$_REQUEST["IDNumber"]."'"; $recCheck = mysql_query($sql); if (mysql_num_rows($recCheck)==0) { $sMsg .= "<li>The ID number you provided does not exist.</li>"; $bShowForm=true; $bWrongID=true; } mysql_free_result($recCheck); } elseif (isset($_POST["go"]) && ($_POST["go"]==2)) { // $bCourseFull = true; if ($bCourseFull) { echo "<p style='color:red'><b>Sorry, no more registrations can be accepted.</b></p>"; } else { if (empty($sMsg)) { $bShowForm = false; $uploaddir = '../ccmadmin/uploads/'; $uploadID=""; $uploadCV=""; $uploadqual1=""; $uploadqual2=""; $uploadqual3=""; $uploadmentor=""; $uploadcandu=""; $uploadpolicy=""; $uploaddisability=""; $uploadpayslip=""; $uploadbank=""; $uploadphoto=""; $uploadfileID=""; $uploadfileCV=""; $uploadfilequal1=""; $uploadfilequal2=""; $uploadfilequal3=""; $uploadfilementor=""; $uploadfilecandu=""; $uploadfilepolicy=""; $uploadfiledisability=""; $uploadfilepayslip=""; $uploadfilebank=""; $uploadfilephoto=""; if (isset($_FILES['IDFile'])) { $uploadID = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['IDFile']['name'])))); $uploadfileID = $uploaddir . $uploadID; $ifilenum=1; while (file_exists($uploadfileID) && !empty($uploadID)) { $uploadfileID = $uploaddir . $ifilenum."_".$uploadID; $ifilenum++; } move_uploaded_file($_FILES['IDFile']['tmp_name'], $uploadfileID); } if (isset($_FILES['CVFile'])) { $uploadCV = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['CVFile']['name'])))); $uploadfileCV = $uploaddir . $uploadCV; $ifilenum=1; while (file_exists($uploadfileCV) && !empty($uploadCV)) { $uploadfileCV = $uploaddir . $ifilenum."_".$uploadCV; $ifilenum++; } move_uploaded_file($_FILES['CVFile']['tmp_name'], $uploadfileCV); } if (isset($_FILES['QualCertificate1'])) { $uploadqual1 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate1']['name'])))); $uploadfilequal1 = $uploaddir . $uploadqual1; $ifilenum=1; while (file_exists($uploadfilequal1) && !empty($uploadqual1)) { $uploadfilequal1 = $uploaddir . $ifilenum."_".$uploadqual1; $ifilenum++; } move_uploaded_file($_FILES['QualCertificate1']['tmp_name'], $uploadfilequal1); } if (isset($_FILES['QualCertificate2'])) { $uploadqual2 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate2']['name'])))); $uploadfilequal2 = $uploaddir . $uploadqual2; $ifilenum=1; while (file_exists($uploadfilequal2) && !empty($uploadqual2)) { $uploadfilequal2 = $uploaddir . $ifilenum."_".$uploadqual2; $ifilenum++; } move_uploaded_file($_FILES['QualCertificate2']['tmp_name'], $uploadfilequal2); } if (isset($_FILES['QualCertificate3'])) { $uploadqual3 = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['QualCertificate3']['name'])))); $uploadfilequal3 = $uploaddir . $uploadqual3; $ifilenum=1; while (file_exists($uploadfilequal3) && !empty($uploadqual3)) { $uploadfilequal3 = $uploaddir . $ifilenum."_".$uploadqual3; $ifilenum++; } move_uploaded_file($_FILES['QualCertificate3']['tmp_name'], $uploadfilequal3); } if (isset($_FILES['MentorUndertaking'])) { $uploadmentor = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['MentorUndertaking']['name'])))); $uploadfilementor = $uploaddir . $uploadmentor; $ifilenum=1; while (file_exists($uploadfilementor) && !empty($uploadmentor)) { $uploadfilementor = $uploaddir . $ifilenum."_".$uploadmentor; $ifilenum++; } move_uploaded_file($_FILES['MentorUndertaking']['tmp_name'], $uploadfilementor); } if (isset($_FILES['CandUUndertaking'])) { $uploadcandu = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['CandUUndertaking']['name'])))); $uploadfilecandu = $uploaddir . $uploadcandu; $ifilenum=1; while (file_exists($uploadfilecandu) && !empty($uploadcandu)) { $uploadfilecandu = $uploaddir . $ifilenum."_".$uploadcandu; $ifilenum++; } move_uploaded_file($_FILES['CandUUndertaking']['tmp_name'], $uploadfilecandu); } if (isset($_FILES['CompanyCandidatePolicy'])) { $uploadpolicy = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['CompanyCandidatePolicy']['name'])))); $uploadfilepolicy = $uploaddir . $uploadpolicy; $ifilenum=1; while (file_exists($uploadfilepolicy) && !empty($uploadpolicy)) { $uploadfilepolicy = $uploaddir . $ifilenum."_".$uploadpolicy; $ifilenum++; } move_uploaded_file($_FILES['CompanyCandidatePolicy']['tmp_name'], $uploadfilepolicy); } if (isset($_FILES['DisabilityCertificate'])) { $uploaddisability = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['DisabilityCertificate']['name'])))); $uploadfiledisability = $uploaddir . $uploaddisability; $ifilenum=1; while (file_exists($uploadfiledisability) && !empty($uploaddisability)) { $uploadfiledisability = $uploaddir . $ifilenum."_".$uploaddisability; $ifilenum++; } move_uploaded_file($_FILES['DisabilityCertificate']['tmp_name'], $uploadfiledisability); } if (isset($_FILES['Payslip'])) { $uploadpayslip = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['Payslip']['name'])))); $uploadfilepayslip = $uploaddir . $uploadpayslip; $ifilenum=1; while (file_exists($uploadfilepayslip) && !empty($uploadpayslip)) { $uploadfilepayslip = $uploaddir . $ifilenum."_".$uploadpayslip; $ifilenum++; } move_uploaded_file($_FILES['Payslip']['tmp_name'], $uploadfilepayslip); } if (isset($_FILES['BankAccountProof'])) { $uploadbank = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['BankAccountProof']['name'])))); $uploadfilebank = $uploaddir . $uploadbank; $ifilenum=1; while (file_exists($uploadfilebank) && !empty($uploadbank)) { $uploadfilebank = $uploaddir . $ifilenum."_".$uploadbank; $ifilenum++; } move_uploaded_file($_FILES['BankAccountProof']['tmp_name'], $uploadfilebank); } if (isset($_FILES['Photograph'])) { $uploadphoto = strtolower(str_replace(array("'","\"","(",")","#"," "), "_", basename(stripslashes($_FILES['Photograph']['name'])))); $uploadfilephoto = $uploaddir . $uploadphoto; $ifilenum=1; while (file_exists($uploadfilephoto) && !empty($uploadphoto)) { $uploadfilephoto = $uploaddir . $ifilenum."_".$uploadphoto; $ifilenum++; } move_uploaded_file($_FILES['Photograph']['tmp_name'], $uploadfilephoto); } $sql = "REPLACE INTO `CCMStudents` (CCMStudentID, `Organisation`, `Title`, `FirstName`, `Surname`, `KnownAs`, `JobTitle`, `Department`, `IDNumber`, `DateofBirth`, `PlaceofBirth`, `CountryofBirth`, `MaleorFemale`, `RaceGroup`, `Disability`, `DisabilityNature`, `ProfessionalCouncil`, `CategoryReg`, `CouncilRegNumber`, `LengthCandidateReg`, `YearsToProfReg`, `FirstJobStart`, `VolAssociations`, `AreaDiscipline`, `AreaSubDiscipline`, `Telephone`, `Cellphone`, `EmailAddress`, `WorkAddress`, `PostalAddress`, `VATNo`, `Salary`, `BankAccountName`, `BankAccountBank`, `BankAccountBranch`, `BankAccountNo`, `Funding`, `CWDTP`, `MentorName`, `MentorDesig`, `MentorProfRegNo`, `MentorRegNo`, `MentorTel`, `MentorCell`, `MentorEmail`, `SupervisorName`, `SupervisorDesig`, `SupervisorProfRegNo`, `SupervisorTelNo`, `SupervisorCellNo`, `SupervisorEmail`, `HRManagerName`, `HRManagerDesignation`, `HRManagerTelNo`, `HRManagerCellNo`, `HRManagerEmail`, `BookedByName`, `BookedByDesignation`, `BookedByTelNo`, `BookedByFaxNo`, `BookedByCellNo`, `BookedByEmail`, `EducationalInst`, `Qualifications`, `DateFinalExam`, `BelongsTo`, `CESA_SABTACO_MemNum`, WebUsername, WebPassword, MentorID, EmployerID, `IDFile`, `CVFile`, `QualCertificate1`, `QualCertificate2`, `QualCertificate3`, `MentorUndertaking`, `CandUUndertaking`, `CompanyCandidatePolicy`, `DisabilityCertificate`, `Payslip`, `BankAccountProof`, `Photograph`) VALUES (".$_POST['CCMStudentID'].", '".addslashes(stripslashes($_POST['Organisation']))."', '".addslashes(stripslashes($_POST['Title']))."', '".addslashes(stripslashes($_POST['FirstName']))."', '".addslashes(stripslashes($_POST['Surname']))."', '".addslashes(stripslashes($_POST['KnownAs']))."', '".addslashes(stripslashes($_POST['JobTitle']))."', '".addslashes(stripslashes($_POST['Department']))."', '".addslashes(stripslashes($_POST['IDNumber']))."', '".addslashes(stripslashes($_POST['DateofBirth']))."', '".addslashes(stripslashes($_POST['PlaceofBirth']))."', '".addslashes(stripslashes($_POST['CountryofBirth']))."', '".addslashes(stripslashes($_POST['MaleorFemale']))."', '".addslashes(stripslashes($_POST['RaceGroup']))."', '".addslashes(stripslashes($_POST['Disability']))."', '".addslashes(stripslashes($_POST['DisabilityNature']))."', '".addslashes(stripslashes($_POST['ProfessionalCouncil']))."', '".addslashes(stripslashes($_POST['CategoryReg']))."', '".addslashes(stripslashes($_POST['CouncilRegNumber']))."', '".addslashes(stripslashes($_POST['LengthCandidateReg']))."', '".addslashes(stripslashes($_POST['YearsToProfReg']))."', '".addslashes(stripslashes($_POST['FirstJobStart']))."', '".addslashes(stripslashes($_POST['VolAssociations']))."', '".addslashes(stripslashes($_POST['AreaDiscipline']))."', '".addslashes(stripslashes($_POST['AreaSubDiscipline']))."', '".addslashes(stripslashes($_POST['Telephone']))."', '".addslashes(stripslashes($_POST['Cellphone']))."', '".addslashes(stripslashes($_POST['EmailAddress']))."', '".addslashes(stripslashes($_POST['WorkAddress']))."', '".addslashes(stripslashes($_POST['PostalAddress']))."', '".addslashes(stripslashes($_POST['VATNo']))."', '".addslashes(stripslashes($_POST['Salary']))."', '".addslashes(stripslashes($_POST['BankAccountName']))."', '".addslashes(stripslashes($_POST['BankAccountBank']))."', '".addslashes(stripslashes($_POST['BankAccountBranch']))."', '".addslashes(stripslashes($_POST['BankAccountNo']))."', '".addslashes(stripslashes($_POST['Funding']))."', '".addslashes(stripslashes($_POST['CWDTP']))."', '".addslashes(stripslashes($_POST['MentorName']))."', '".addslashes(stripslashes($_POST['MentorDesig']))."', '".addslashes(stripslashes($_POST['MentorProfRegNo']))."', '".addslashes(stripslashes($_POST['MentorRegNo']))."', '".addslashes(stripslashes($_POST['MentorTel']))."', '".addslashes(stripslashes($_POST['MentorCell']))."', '".addslashes(stripslashes($_POST['MentorEmail']))."', '".addslashes(stripslashes($_POST['SupervisorName']))."', '".addslashes(stripslashes($_POST['SupervisorDesig']))."', '".addslashes(stripslashes($_POST['SupervisorProfRegNo']))."', '".addslashes(stripslashes($_POST['SupervisorTelNo']))."', '".addslashes(stripslashes($_POST['SupervisorCellNo']))."', '".addslashes(stripslashes($_POST['SupervisorEmail']))."', '".addslashes(stripslashes($_POST['HRManagerName']))."', '".addslashes(stripslashes($_POST['HRManagerDesignation']))."', '".addslashes(stripslashes($_POST['HRManagerTelNo']))."', '".addslashes(stripslashes($_POST['HRManagerCellNo']))."', '".addslashes(stripslashes($_POST['HRManagerEmail']))."', '".addslashes(stripslashes($_POST['BookedByName']))."', '".addslashes(stripslashes($_POST['BookedByDesignation']))."', '".addslashes(stripslashes($_POST['BookedByTelNo']))."', '".addslashes(stripslashes($_POST['BookedByFaxNo']))."', '".addslashes(stripslashes($_POST['BookedByCellNo']))."', '".addslashes(stripslashes($_POST['BookedByEmail']))."', '".addslashes(stripslashes($_POST['EducationalInst']))."', '".addslashes(stripslashes($_POST['Qualifications']))."', '".addslashes(stripslashes($_POST['DateFinalExam']))."', '".addslashes(stripslashes($_POST["belongsto"]))."', '".addslashes(stripslashes($_POST["cesamemnum"]))."', '".addslashes(stripslashes($_POST["WebUsername"]))."', '".addslashes(stripslashes($_POST["WebPassword"]))."', '".addslashes(stripslashes($_POST["MentorID"]))."', '".addslashes(stripslashes($_POST["EmployerID"]))."', '".str_replace($uploaddir, '', $uploadfileID)."', '".str_replace($uploaddir, '', $uploadfileCV)."', '".str_replace($uploaddir, '', $uploadfilequal1)."', '".str_replace($uploaddir, '', $uploadfilequal2)."', '".str_replace($uploaddir, '', $uploadfilequal3)."', '".str_replace($uploaddir, '', $uploadfilementor)."', '".str_replace($uploaddir, '', $uploadfilecandu)."', '".str_replace($uploaddir, '', $uploadfilepolicy)."', '".str_replace($uploaddir, '', $uploadfiledisability)."', '".str_replace($uploaddir, '', $uploadfilepayslip)."', '".str_replace($uploaddir, '', $uploadfilebank)."', '".str_replace($uploaddir, '', $uploadfilephoto)."')"; //echo $sql; mysql_query($sql); $sForm = ' <table width="643" border="1" cellpadding="5" cellspacing="0"> <tbody> <tr> <td valign="top">Organisation:</td> <td>'.$_REQUEST["Organisation"].'</td> </tr> <tr> <td>Title:</td> <td>'.$_REQUEST["Title"].' </td> </tr> <tr> <td width="298"><p>First Name:</p></td> <td width="319">'.$_REQUEST["FirstName"].'</td> </tr> <tr> <td><p>Surname:</p></td> <td>'.$_REQUEST["Surname"].'</td> </tr> <tr> <td><p>Preferred Name (Known As):</p></td> <td>'.$_REQUEST["KnownAs"].'</td> </tr> <tr> <td>Job Title:</td> <td>'.$_REQUEST["JobTitle"].'</td> </tr> <tr> <td>Department:</td> <td>'.$_REQUEST["Department"].'</td> </tr> <tr> <td>South African ID Number (Only):</td> <td>'.$_REQUEST["IDNumber"].'</td> </tr> <tr> <td>Date of Birth:</td> <td>'.$_REQUEST["DateofBirth"].'</td> </tr> <tr> <td>Place of Birth:</td> <td>'.$_REQUEST["PlaceofBirth"].'</td> </tr> <tr> <td>Country of Birth:</td> <td>'.$_REQUEST["CountryofBirth"].'</td> </tr> <tr> <td>Male / Female:</td> <td>'.$_REQUEST["MaleorFemale"].'</td> </tr> <tr> <td>Race Group:</td> <td>'.$_REQUEST["RaceGroup"].'</td> </tr> <tr> <td>Do you have a disability?</td> <td>'.$_REQUEST["Disability"].'</td> </tr> <tr> <td>If so, indicate the nature:</td> <td>'.$_REQUEST["DisabilityNature"].'</td> </tr> <tr> <td>With which professional council are you registered?</td> <td>'.$_REQUEST["ProfessionalCouncil"].'</td> </tr> <tr> <td>Category of registration:</td> <td>'.$_REQUEST["CategoryReg"].'</td> </tr> <tr> <td>Council registration number (if applicable):</td> <td>'.$_REQUEST["CouncilRegNumber"].'</td> </tr> <tr> <td>How long have you been registered as a candidate?</td> <td>'.$_REQUEST["LengthCandidateReg"].'</td> </tr> <tr> <td>How many years left to professional registration?</td> <td>'.$_REQUEST["YearsToProfReg"].'</td> </tr> <tr> <td>Start date of first job post qualification:</td> <td>'.$_REQUEST["FirstJobStart"].'</td> </tr> <tr> <td>Membership of voluntary associations:</td> <td>'.$_REQUEST["VolAssociations"].'</td> </tr> <tr> <td>Belongs to:</td> <td>'.$_REQUEST["belongsto"].'</td> </tr> <tr> <td>CESA / SABTACO membership number:</td> <td>'.$_REQUEST["cesamemnum"].'</td> </tr> <tr> <td>Area of Discipline:</td> <td>'.$_REQUEST["AreaDiscipline"].'</td> </tr> <tr> <td>Area of Sub-discipline:</td> <td>'.$_REQUEST["AreaSubDiscipline"].'</td> </tr> <tr> <td><p>Telephone No:</p></td> <td>'.$_REQUEST["Telephone"].'</td> </p></td> </tr> <tr> <td><p>Cell No. :</p></td> <td>'.$_REQUEST["Cellphone"].'</td> </tr> <tr> <td><p>E-mail Address:</p></td> <td>'.$_REQUEST["EmailAddress"].'</td> </tr> <tr> <td valign="top">Work Physical Address:</td> <td>'.stripslashes($_REQUEST["WorkAddress"]).'</td> </tr> <tr> <td valign="top">Province:</td> <td>'.$_REQUEST["Province"].'</td> </tr> <tr> <td valign="top">Postal Address:</td> <td>'.stripslashes($_REQUEST["PostalAddress"]).'</td> </tr> <tr> <td valign="top">VAT No:</td> <td>'.$_REQUEST["VATNo"].'</td> </tr> <tr> <td valign="top">Salary (Basic):</td> <td>'.$_REQUEST["Salary"].'</td> </tr> <tr> <td valign="top">Bank account details:</td> <td align="right">Name: '.$_REQUEST["BankAccountName"].'<br />Bank: '.$_REQUEST["BankAccountBank"].'<br /> Branch: '.$_REQUEST["BankAccountBranch"].'<br /> Number: '.$_REQUEST["BankAccountNo"].'</td> </tr> <tr> <td valign="top">Do you have funding from any other skills development programme/project funded by a public institution? (Describe)</td> <td>'.$_REQUEST["Funding"].'</td> </tr> <tr> <td valign="top">Does your company have a structured Candidate Workplace Development/ Training Plan?</td> <td>'.$_REQUEST["CWDTP"].'</td> </tr> <tr> <td valign="top"><strong>Mentor:</strong></td> <td>'.$_REQUEST["MentorName"].'</td> </tr> <tr> <td valign="top">Designation:</td> <td>'.$_REQUEST["MentorDesig"].'</td> </tr> <tr> <td valign="top">Professional Registration No:</td> <td>'.$_REQUEST["MentorProfRegNo"].'</td> </tr> <tr> <td valign="top">Mentor\'s Registration No:</td> <td>'.$_REQUEST["MentorRegNo"].'</td> </tr> <tr> <td valign="top">Tel No:</td> <td>'.$_REQUEST["MentorTel"].'</td> </tr> <tr> <td valign="top">Cell No:</td> <td>'.$_REQUEST["MentorCell"].'</td> </tr> <tr> <td valign="top">Email Address:</td> <td>'.$_REQUEST["MentorEmail"].'</td> </tr> <tr> <td valign="top"><strong>Supervisor:</strong></td> <td>'.$_REQUEST["SupervisorName"].'</td> </tr> <tr> <td valign="top">Designation:</td> <td>'.$_REQUEST["SupervisorDesig"].'</td> </tr> <tr> <td valign="top">Professional Registration No: (if applicable)</td> <td>'.$_REQUEST["SupervisorProfRegNo"].'</td> </tr> <tr> <td valign="top">Tel No:</td> <td>'.$_REQUEST["SupervisorTelNo"].'</td> </tr> <tr> <td valign="top">Cell No:</td> <td>'.$_REQUEST["SupervisorCellNo"].'</td> </tr> <tr> <td valign="top">Email Address:</td> <td>'.$_REQUEST["SupervisorEmail"].'</td> </tr> <tr> <td valign="top"><strong>HR Manager:</strong></td> <td>'.$_REQUEST["HRManagerName"].'</td> </tr> <tr> <td valign="top">Designation:</td> <td>'.$_REQUEST["HRManagerDesignation"].'</td> </tr> <tr> <td valign="top">Tel No:</td> <td>'.$_REQUEST["HRManagerTelNo"].'</td> </tr> <tr> <td valign="top">Cell No:</td> <td>'.$_REQUEST["HRManagerCellNo"].'</td> </tr> <tr> <td valign="top">Email Address:</td> <td>'.$_REQUEST["HRManagerEmail"].'</td> </tr> <tr> <td valign="top"><strong>Application Loaded By:</strong></td> <td>'.$_REQUEST["BookedByName"].'</td> </tr> <tr> <td valign="top">Designation:</td> <td>'.$_REQUEST["BookedByDesignation"].'</td> </tr> <tr> <td valign="top">Tel No:</td> <td>'.$_REQUEST["BookedByTelNo"].'</td> </tr> <tr> <td valign="top">Fax No:</td> <td>'.$_REQUEST["BookedByFaxNo"].'</td> </tr> <tr> <td valign="top">Cell No:</td> <td>'.$_REQUEST["BookedByCellNo"].'</td> </tr> <tr> <td valign="top">Email Address:</td> <td>'.$_REQUEST["BookedByEmail"].'</td> </tr> <tr> <td valign="top"><strong>South African - Highest Examinations Passed:</strong></td> <td> </td> </tr> <tr> <td valign="top">Educational Institution:</td> <td>'.$_REQUEST["EducationalInst"].'<br/>'.$_REQUEST["EducationInstOther"].'</td> </tr> <tr> <td valign="top">Qualifications Attained:</td> <td>'.$_REQUEST["Qualifications"].'</td> </tr> <tr> <td valign="top">Date of Final Examination:</td> <td>'.$_REQUEST["DateFinalExam"].'</td> </tr> <tr> <td valign="top"><strong>Documents:</strong></td> <td> </td> </tr> <tr> <td valign="top">Certified copy of ID or passport:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfileID).'">'.str_replace($uploaddir, '', $uploadfileID).'</a></td> </tr> <tr> <td valign="top">Curriculum Vitae (CV):</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfileCV).'">'.str_replace($uploaddir, '', $uploadfileCV).'</a></td> </tr> <tr> <td valign="top">Certified copies of qualification/s:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilequal1).'">'.str_replace($uploaddir, '', $uploadfilequal1).'</a><br> <a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilequal2).'">'.str_replace($uploaddir, '', $uploadfilequal2).'</a><br /> <a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilequal3).'">'.str_replace($uploaddir, '', $uploadfilequal3).'</a></td> </tr> <tr> <td valign="top">Undertaking from Mentor:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilementor).'">'.str_replace($uploaddir, '', $uploadfilementor).'</a></td> </tr> <tr> <td valign="top">Undertaking of C&U (ECSA):</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilecandu).'">'.str_replace($uploaddir, '', $uploadfilecandu).'</a></td> </tr> <tr> <td valign="top">Employment contract:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilepolicy).'">'.str_replace($uploaddir, '', $uploadfilepolicy).'</a></td> </tr> <tr> <td valign="top">Cerificate of disability (if applicable):</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfiledisability).'">'.str_replace($uploaddir, '', $uploadfiledisability).'</a></td> </tr> <tr> <td valign="top">Payslip:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilepayslip).'">'.str_replace($uploaddir, '', $uploadfilepayslip).'</a></td> </tr> <tr> <td valign="top">Proof of bank account (candidate, not company):</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilebank).'">'.str_replace($uploaddir, '', $uploadfilebank).'</a></td> </tr> <tr> <td valign="top">Photograph:</td> <td><a href="http://www.cesa.co.za/ccmadmin/uploads/'.str_replace($uploaddir, '', $uploadfilephoto).'">'.str_replace($uploaddir, '', $uploadfilephoto).'</a></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 .= 'BCC: julia@xe.co.za' . "\r\n"; // $headers .= 'CC: athromethm@cesa.co.za' . "\r\n"; $sSendFormTo = "mentanet@cesa.co.za"; // $sSendFormTo = "julia@xe.co.za"; mail($sSendFormTo, "UPDATE OF INFORMATION FOR SABTACO/CESA Candidacy Programme", $sForm, $headers); ?> <p><strong>Thank you for updating the information for the SABTACO/CESA Candidacy Programme.</strong></p> <p>Only completed application forms, with all supporting documentation, except for the Graduate/ Candidate’s training plan, if not available at time of submitting, will be considered.</p> <p><strong>DISCLAIMER:</strong></p> <ul> <li>This request to submit an EOI is not an agreement and is not an offer or invitation to enter into an agreement of any kind with any party.</li> <li>All information contained in this Expression of Interest (EOI) or subsequently provided is done so in good faith.</li> <li>CESA and SABTACO reserve the right to accept/reject any Expression of Interest (EOI) from parties without assigning any reasons whatsoever.</li> </ul> <p>Please email <a href="mailto:mentanet@cesa.co.za">mentanet@cesa.co.za</a> if you have any questions. A copy of your form appears below.</p> <p><strong><a href="register_step2.php">Click here to update another candidate</a></strong></p> <hr /> <?php echo $sForm; ?> <?php } } } if ($bShowForm) { ?> <form action="/mentanet/register_step2.php" method="post" enctype="multipart/form-data" name="form1" id="form1"> <h3>INFORMATION UPLOAD FORM: CETA Candidacy Programmes to Culminate in the Registration of Candidates in Designated Professions</h3> <?php if (!empty($sMsg)) echo "<p style='color:red'><b>Error:<br /><ul style='color:red'>".$sMsg."</ul></b></p>"; ?> <?php if (!isset($_REQUEST["IDNumber"]) || $bWrongID) { ?> <input type="hidden" name="go" value="1" /> <p><strong>Please enter the registered candidate's ID number to continue:</strong></p> <table width="643" border="1" cellpadding="5" cellspacing="0"> <tr> <td>South African ID Number:</td> <td><input name="IDNumber" type="text" id="IDNumber" size="30" value="" /></td> </tr> </table> <?php } else { $sql="SELECT * FROM CCMStudents WHERE IDNumber='".$_REQUEST["IDNumber"]."' ORDER BY CCMStudentID DESC"; $rec=mysql_query($sql); if ($row=mysql_fetch_assoc($rec)) { ?> <input type="hidden" name="go" value="2" /> <input type="hidden" name="IDNumber" value="<?php echo $row["IDNumber"]; ?>" /> <input type="hidden" name="CCMStudentID" value="<?php echo $row["CCMStudentID"]; ?>" /> <input type="hidden" name="WebUsername" value="<?php echo $row["WebUsername"]; ?>" /> <input type="hidden" name="WebPassword" value="<?php echo $row["WebPassword"]; ?>" /> <input type="hidden" name="MentorID" value="<?php echo $row["MentorID"]; ?>" /> <input type="hidden" name="EmployerID" value="<?php echo $row["EmployerID"]; ?>" /> <p><strong>Please complete the information below.</strong></p> <table width="643" border="1" cellpadding="5" cellspacing="0"> <tbody> <tr> <td valign="top">Organisation:</td> <td><?php echo $row["Organisation"]; ?><input type="hidden" name="Organisation" value="<?php echo addslashes($row["Organisation"]); ?>"></td> </tr> <tr> <td>Title:</td> <td> <?php echo $row["Title"]; ?> <input type="hidden" name="Title" value="<?php echo addslashes($row["Title"]); ?>"> </td> </tr> <tr> <td width="298"><p>First Name:</p></td> <td width="319"><p> <?php echo $row["FirstName"]; ?> <input type="hidden" name="FirstName" value="<?php echo addslashes($row["FirstName"]); ?>"> </p></td> </tr> <tr> <td><p>Surname:</p></td> <td><?php echo $row["Surname"]; ?><input type="hidden" name="Surname" value="<?php echo addslashes($row["Surname"]); ?>"></td> </tr> <tr> <td><p>Preferred Name (Known As):</p></td> <td><p> <?php echo $row["KnownAs"]; ?> <input type="hidden" name="KnownAs" value="<?php echo addslashes($row["KnownAs"]); ?>"> </p></td> </tr> <tr> <td>Job Title:</td> <td><?php echo $row["JobTitle"]; ?><input type="hidden" name="JobTitle" value="<?php echo addslashes($row["JobTitle"]); ?>"></td> </tr> <tr> <td>Department:</td> <td><?php echo $row["Department"]; ?><input type="hidden" name="Department" value="<?php echo addslashes($row["Department"]); ?>"></td> </tr> <tr> <td>South African ID Number (Only):</td> <td><?php echo $row["IDNumber"]; ?></td> </tr> <tr> <td>Date of Birth:</td> <td><?php echo $row["DateofBirth"]; ?><input type="hidden" name="DateofBirth" value="<?php echo addslashes($row["DateofBirth"]); ?>"></td> </tr> <tr> <td>Place of Birth:</td> <td><?php echo $row["PlaceofBirth"]; ?><input type="hidden" name="PlaceofBirth" value="<?php echo addslashes($row["PlaceofBirth"]); ?>"></td> </tr> <tr> <td>Country of Birth:</td> <td><?php echo $row["CountryofBirth"]; ?><input type="hidden" name="CountryofBirth" value="<?php echo addslashes($row["CountryofBirth"]); ?>"></td> </tr> <tr> <td>Male / Female:</td> <td><input name="MaleorFemale" type="radio" id="MaleorFemale" value="M" /> <label for="MaleorFemale">Male<br /> <input type="radio" name="MaleorFemale" id="MaleorFemale2" value="F" /> Female </label></td> </tr> <tr> <td>Race Group:</td> <td><input name="RaceGroup" type="radio" id="MaleorFemale3" value="Asian" /> Asian<br /> <input name="RaceGroup" type="radio" id="MaleorFemale4" value="African" /> African<br /> <input name="RaceGroup" type="radio" id="MaleorFemale5" value="Coloured" /> Coloured<br /> <input name="RaceGroup" type="radio" id="MaleorFemale6" value="White" /> White </td> </tr> <tr> <td>Do you have a disability?</td> <td><input name="Disability" type="radio" id="MaleorFemale7" value="Y" /> Yes<br /> <input name="Disability" type="radio" id="MaleorFemale8" value="N" /> No </td> </tr> <tr> <td>If so, indicate the nature:</td> <td>Nature: <input name="DisabilityNature" type="text" id="DisabilityNature" size="40" value="<?php echo $row["DisabilityNature"]; ?>" /></td> </tr> <tr> <td>Related professional council</td> <td><select name="ProfessionalCouncil" id="ProfessionalCouncil"> <option>None</option> <option>The South African Council for the Architectural Profession (SACAP)</option> <option>The South African Council of Planners (SACPLAN)</option> <option>Engineering Council of South Africa (ECSA)</option> <option>The South African Council for the Quantity Surveying Profession (SACQSP)</option> </select></td> </tr> <tr> <td>Belongs to:</td> <td><input type="radio" name="belongsto" id="belongsto" value="CESA" /> <label for="belongsto">CESA<br /> <input type="radio" name="belongsto" id="belongsto2" value="SABTACO" /> SABTACO<br /> <input type="radio" name="belongsto" id="belongsto3" value="CESA/SABTACO" /> CESA/SABTACO<br /> <!--<input type="radio" name="belongsto" id="belongsto4" value="Neither" /> Neither--> </label></td> </tr> <tr> <td>CESA / SABTACO membership number:</td> <td><label for="cesamemnum"></label> <input type="text" name="cesamemnum" id="cesamemnum" /></td> </tr> <tr> <td>Category of registration:</td> <td><select name="CategoryReg" id="CategoryReg"> <optgroup label="Architects"> <option>Candidate Architect</option> <option>Candidate Senior Architectural Technologist</option> <option>Candidate Architectural Technologist</option> <option>Candidate Architectural Draughtsperson</option> </optgroup> <optgroup label="Town Planners"> <option>Professional Planner</option> <option>Technical Planner</option> </optgroup> <optgroup label="Engineers"> <option>Candidate Engineer</option> <option>Engineer</option> <option>Engineering Technologist</option> <option>Engineering Technician</option> </optgroup> <optgroup label="Quantity Surveyors"> <option>ND Building</option> <option>BTech QS</option> <option>BSc QS</option> <option>BSc Hon QS</option> </optgroup> </select></td> </tr> <tr> <td>Council registration number (if applicable):</td> <td><input name="CouncilRegNumber" type="text" id="CouncilRegNumber" size="30" value="<?php echo $row["CouncilRegNumber"]; ?>" /></td> </tr> <tr> <td>How long have you been registered as a candidate?</td> <td><input name="LengthCandidateReg" type="text" id="LengthCandidateReg" size="50" value="<?php echo $row["LengthCandidateReg"]; ?>" /></td> </tr> <tr> <td>How many years left to professional registration?</td> <td><input name="YearsToProfReg" type="text" id="YearsToProfReg" size="50" value="<?php echo $row["YearsToProfReg"]; ?>" /></td> </tr> <tr> <td>Start date of first job post qualification:</td> <td><input name="FirstJobStart" type="text" id="FirstJobStart" size="50" value="<?php echo $row["FirstJobStart"]; ?>" /></td> </tr> <tr> <td>Voluntary association to which candidate / firm belongs:</td> <td><select name="VolAssociations" id="VolAssociations"> <optgroup label="Architects"> <option>South African Institute of Architects (SAIA)</option> <option>South African Insitute of Architectural Technologists (SAIAT)</option> <option>South African Institute of Interior Design Professions (IID)</option> <option>South African Institute of Building Designers (SAIBD)</option> <option>South African Institute of Draughting (SAID)</option> <option>Border-Kei Institute of Architects (BKIA)</option> <option>Cape Institute for Architecture (CIfA)</option> <option>Eastern Cape Institute of Architects (ECIA)</option> <option>Free State Institute of Architects (FSIA)</option> <option>Gauteng Institute for Architecture (GIfA)</option> <option>KwaZulu-Natal Institute for Architecture (KZNIA)</option> <option>Pretoria Institute of Architects (PIA)</option> </optgroup> <optgroup label="Town Planners"> <option>South African Planning institute (SAPI)</option> <option>South African Association of Consulting Professional Planners - North Region (SAACPP)</option> <option>South African Association of Consulting Professional Planners - South Region (SAACPP)</option> </optgroup> <optgroup label="Engineers"> <option>Aeronautical Society of South Africa (AeSSA) </option> <option>Association of Mine Managers of South Africa (AMMSA) </option> <option>Association of Mine Resident Engineers (AMRE) </option> <option>Association of Municipal Electricity Undertakings (AMEU) </option> <option>Built Environment Professions Export Council (BEPEC) </option> <option>Clinical Engineering Association Of South Africa (CEASA) </option> <option>Concrete Society of Southern Africa (CSSA) </option> <option>Consulting Engineers South Africa (CESA ) </option> <option>Illumination Engineering Society of South Africa (IESSA) </option> <option>Institute of Electrical and Electronic Engineers South African Section (IEEE) </option> <option>Institute of Professional Engineering Technologists (IPET) </option> <option>Institute of Quarrying Southern Africa (IQSA) </option> <option>Institute of Timber Construction (ITC) </option> <option>Institution of Certificated Mechanical and Electrical Engineering (ICMEESA ) </option> <option>Institution of Municipal Engineering of Southern Africa (IMESA) </option> <option>International Council on Systems Engineering (SA Chapter) (INCOSE SA) </option> <option>Lift Inspectors Association of South Africa (LIASA) </option> <option>National Society of Black Engineers (NSBE) </option> <option>Society For Asphalt Technology (SAT) </option> <option>Society of Telkom Engineers (STE) </option> <option>South African Colliery Engineers’ Association (SACEA) </option> <option>South African Colliery Managers Association (SACMA) </option> <option>South African Federation of Civil Engineering Contractors (SAFCEC) </option> <option>South African Federation of Hospital Engineers (SAFHE) </option> <option>South African Flameproof Association (SAFA) </option> <option>South African Fluid Power Association (SAFPA) </option> <option>South African Institute of Agricultural Engineers (SAIAE) </option> <option>South African Institute of Draughting (SAID) </option> <option>South African Institute of Electrical Engineers (SAIEE) </option> <option>South African Institute of Marine Engineers and Naval Architects (SAIMENA) </option> <option>South African Institute of Measurement and Control (SAIMC) </option> <option>South African Institute of Refrigeration and Air-Conditioning (SAIRAC) </option> <option>South African Institute of Steel Construction (SAISC) </option> <option>South African Institute of Welding (SAIW) </option> <option>South African Institution of Chemical Engineers (SAIChE) </option> <option>South African Institution of Civil Engineering (SAICE) </option> <option>South African Road Federation (SARF) </option> <option>Southern African Asset Management Association (SAAMA) </option> <option>Southern African Institute for Industrial Engineers (SAIIE) </option> <option>Southern African Institute of Mining And Metallurgy (SAIMM) </option> <option>Southern African Society For Trenchless Technology (SASTT) </option> <option>The Chamber of Engineering Technology (COET) </option> <option>The South African Institution of Mechanical Engineering (SAIMechE) </option> <option>Water Institute of Southern Africa (WISA) </option> </optgroup> <optgroup label="Quantity Surveyors"> <option>The Association of South African Quantity Surveyors (ASAQS)</option> <option>South African Property Owners Association (SAPOA)</option> <option>Chartered Institute of Building (CIOB)</option> </optgroup> </select></td> </tr> <tr> <td>Area of Discipline:</td> <td><!--<select name="AreaDiscipline" id="AreaDiscipline"> <optgroup label="Chemical engineering"> <option>Biomolecular engineering</option> <option>Materials engineering</option> <option>Molecular engineering</option> <option>Process engineering</option> </optgroup><optgroup label="Civil engineering"> <option>Architectural engineering</option> <option>Environmental engineering</option> <option>Geotechnical engineering</option> <option>Infrastructure</option> <option>Structural engineering</option> <option>Transport engineering</option> </optgroup><optgroup label="Electrical engineering"> <option>Computer engineering</option> <option>Hardware engineering</option> <option>Electronic engineering</option> <option>Telecommunications engineering</option> <option>Power engineering</option> </optgroup><optgroup label="Mechanical engineering"> <option>Aerospace Engineering</option> <option>Acoustical engineering</option> <option>Manufacturing engineering</option> <option>Thermal engineering</option> <option>Vehicle engineering</option> </optgroup><optgroup label="Interdisciplinary and specialized fields"> <option>Agricultural engineering</option> <option>Applied engineering </option> <option>Biological engineering</option> <option>Building services engineering</option> <option>Energy engineering</option> <option>Industrial engineering</option> <option>Mechatronics</option> <option>Nano engineering</option> <option>Nuclear engineering</option> </optgroup><optgroup label="Architects"> <option>System/Product architect</option> <option>Domain Architect</option> <option>Solution Architect</option> <option>Applied Architect</option> <option>Enterprise architect</option> </optgroup><optgroup label="Town Planners"> <option>Transportation Planning </option> <option>Urban Planning </option> <option>Rural/ Regional planning </option> <option>Geographic Information System (GIS)</option> <option>Development planning</option> <option>Development economics </option> </optgroup><optgroup label="Architects"> <option>Rehabilitation </option> <option>Urban rehabilitation </option> <option>Project management </option> </optgroup> </select>--><input name="AreaDiscipline" type="text" id="AreaDiscipline" size="50" value="<?php echo $row["AreaDiscipline"]; ?>" /> </td> </tr> <tr> <td>Area of Sub-discipline:</td> <td><input name="AreaSubDiscipline" type="text" id="AreaSubDiscipline" size="50" value="<?php echo $row["AreaSubDiscipline"]; ?>" /></td> </tr> <tr> <td><p>Telephone No:</p></td> <td><p> <input name="Telephone" type="text" id="Telephone" size="30" value="<?php echo $row["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 $row["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 $row["EmailAddress"]; ?>" /> </p></td> </tr> <tr> <td valign="top">Work Physical Address:</td> <td><textarea name="WorkAddress" id="WorkAddress" cols="45" rows="5"><?php echo stripslashes($row["WorkAddress"]); ?> </textarea></td> </tr> <tr> <td valign="top">Province:</td> <td><select name="Province" id="Province"> <option>Eastern Cape</option> <option>Free State</option> <option>Gauteng</option> <option>KwaZulu-Natal</option> <option>Limpopo</option> <option>Mpumalanga</option> <option>North West</option> <option>Northern Cape</option> <option>Western Cape</option> </select></td> </tr> <tr> <td valign="top">Postal Address:</td> <td><textarea name="PostalAddress" id="PostalAddress" cols="45" rows="5"><?php echo stripslashes($row["PostalAddress"]); ?> </textarea></td> </tr> <tr> <td valign="top">VAT No:</td> <td><input name="VATNo" type="text" id="VATNo" size="30" value="<?php echo $row["VATNo"]; ?>" /></td> </tr> <tr> <td valign="top">Salary (Basic):</td> <td><input name="Salary" type="text" id="Salary" size="30" value="<?php echo $row["Salary"]; ?>" /></td> </tr> <tr> <td valign="top">Bank account details (candidate, not company):</td> <td align="right">Name: <input name="BankAccountName" type="text" id="BankAccountName" size="40" value="<?php echo $row["BankAccountName"]; ?>" /><br />Bank: <input name="BankAccountBank" type="text" id="BankAccountBank" size="40" value="<?php echo $row["BankAccountBank"]; ?>" /><br /> Branch: <input name="BankAccountBranch" type="text" id="BankAccountBranch" size="40" value="<?php echo $row["BankAccountBranch"]; ?>" /><br /> Number: <input name="BankAccountNo" type="text" id="BankAccountNo" size="40" value="<?php echo $row["BankAccountNo"]; ?>" /></td> </tr> <tr> <td valign="top">Do you have funding from any other skills development programme/project funded by a public institution? (Describe)</td> <td><textarea name="Funding" id="Funding" cols="45" rows="2"><?php echo stripslashes($row["Funding"]); ?></textarea></td> </tr> <tr> <td valign="top">Does your company have a structured Candidate Workplace Development/ Training Plan?</td> <td><input name="CWDTP" type="radio" id="MaleorFemale11" value="Y" /> Yes<br /> <input name="CWDTP" type="radio" id="MaleorFemale12" value="N" /> No </td> </tr> <tr> <td valign="top">Mentor Name:</td> <td><input name="MentorName" type="text" id="MentorName" size="50" value="<?php echo $row["MentorName"]; ?>" /></td> </tr> <tr> <td valign="top">Designation:</td> <td><input name="MentorDesig" type="text" id="MentorDesig" size="50" value="<?php echo $row["MentorDesig"]; ?>" /></td> </tr> <tr> <td valign="top">Professional Registration No:</td> <td><input name="MentorProfRegNo" type="text" id="MentorProfRegNo" size="50" value="<?php echo $row["MentorProfRegNo"]; ?>" /></td> </tr> <tr> <td valign="top">Mentor's Registration No:</td> <td><input name="MentorRegNo" type="text" id="MentorRegNo" size="50" value="<?php echo $row["MentorRegNo"]; ?>" /></td> </tr> <tr> <td valign="top">Tel No:</td> <td><input name="MentorTel" type="text" id="MentorTel" size="30" value="<?php echo $row["MentorTel"]; ?>" /></td> </tr> <tr> <td valign="top">Cell No:</td> <td><input name="MentorCell" type="text" id="MentorCell" size="30" value="<?php echo $row["MentorCell"]; ?>" /></td> </tr> <tr> <td valign="top">Email Address:</td> <td><input name="MentorEmail" type="text" id="MentorEmail" size="50" value="<?php echo $row["MentorEmail"]; ?>" /></td> </tr> <tr> <td valign="top">Supervisor Name:</td> <td><input name="SupervisorName" type="text" id="SupervisorName" size="50" value="<?php echo $row["SupervisorName"]; ?>" /></td> </tr> <tr> <td valign="top">Designation:</td> <td><input name="SupervisorDesig" type="text" id="SupervisorDesig" size="50" value="<?php echo $row["SupervisorDesig"]; ?>" /></td> </tr> <tr> <td valign="top">Professional Registration No: (if applicable)</td> <td><input name="SupervisorProfRegNo" type="text" id="SupervisorProfRegNo" size="50" value="<?php echo $row["SupervisorProfRegNo"]; ?>" /></td> </tr> <tr> <td valign="top">Tel No:</td> <td><input name="SupervisorTelNo" type="text" id="SupervisorTelNo" size="30" value="<?php echo $row["SupervisorTelNo"]; ?>" /></td> </tr> <tr> <td valign="top">Cell No:</td> <td><input name="SupervisorCellNo" type="text" id="SupervisorCellNo" size="30" value="<?php echo $row["SupervisorCellNo"]; ?>" /></td> </tr> <tr> <td valign="top">Email Address:</td> <td><input name="SupervisorEmail" type="text" id="SupervisorEmail" size="50" value="<?php echo $row["SupervisorEmail"]; ?>" /></td> </tr> <tr> <td valign="top"><strong>HR Manager:</strong></td> <td><input name="HRManagerName" type="text" id="HRManagerName" size="50" value="<?php echo $row["HRManagerName"]; ?>" /></td> </tr> <tr> <td valign="top">Designation:</td> <td><input name="HRManagerDesignation" type="text" id="HRManagerDesignation" size="50" value="<?php echo $row["HRManagerDesignation"]; ?>" /></td> </tr> <tr> <td valign="top">Tel No:</td> <td><input name="HRManagerTelNo" type="text" id="HRManagerTelNo" size="30" value="<?php echo $row["HRManagerTelNo"]; ?>" /></td> </tr> <tr> <td valign="top">Cell No:</td> <td><input name="HRManagerCellNo" type="text" id="HRManagerCellNo" size="30" value="<?php echo $row["HRManagerCellNo"]; ?>" /></td> </tr> <tr> <td valign="top">Email Address:</td> <td><input name="HRManagerEmail" type="text" id="HRManagerEmail" size="50" value="<?php echo $row["HRManagerEmail"]; ?>" /></td> </tr> <tr> <td valign="top">Application Loaded By:</td> <td><input name="BookedByName" type="text" id="BookedByName" size="50" value="<?php echo $row["BookedByName"]; ?>" /></td> </tr> <tr> <td valign="top">Designation:</td> <td><input name="BookedByDesignation" type="text" id="BookedByDesignation" size="50" value="<?php echo $row["BookedByDesignation"]; ?>" /></td> </tr> <tr> <td valign="top">Tel No:</td> <td><input name="BookedByTelNo" type="text" id="BookedByTelNo" size="30" value="<?php echo $row["BookedByTelNo"]; ?>" /></td> </tr> <tr> <td valign="top">Fax No:</td> <td><input name="BookedByFaxNo" type="text" id="BookedByFaxNo" size="30" value="<?php echo $row["BookedByFaxNo"]; ?>" /></td> </tr> <tr> <td valign="top">Cell No:</td> <td><input name="BookedByCellNo" type="text" id="BookedByCellNo" size="30" value="<?php echo $row["BookedByCellNo"]; ?>" /></td> </tr> <tr> <td valign="top">Email Address:</td> <td><input name="BookedByEmail" type="text" id="BookedByEmail" size="50" value="<?php echo $row["BookedByEmail"]; ?>" /></td> </tr> <tr> <td valign="top"><strong>South African - Highest Examinations Passed:</strong></td> <td> </td> </tr> <tr> <td valign="top">Educational Institution:</td> <td><select name="EducationalInst" id="EducationalInst"> <optgroup label="University"> <option>University of Johannesburg</option> <option>University of Cape Town</option> <option>Rhodes University</option> <option>University of KwaZulu Natal</option> <option>University of Pretoria</option> <option>Stellenbosch University</option> <option>University of the Witwatersrand</option> <option>North West University </option> <option>University of the Free State</option> <option>University of Venda</option> <option>University of the Western Cape</option> <option>University of Limpopo</option> <option>University of Fort Hare</option> <option>University of South Africa</option> <option>Walter Sisulu University</option> <option>Nelson Mandela Metropolitan University</option> </optgroup> <optgroup label="University of Technikons"> <option>Cape Peninsula University of Technology</option> <option>Durban University of Technology </option> <option>Central University of Technology </option> <option>Mangosutho University of Technology </option> <option>Tshwane University of Technology </option> <option>Vaal University of Technology</option> </optgroup> <optgroup label="Technikons"> <option>Border Technikon</option> <option>Cape Technikon</option> <option>Natal Technikon</option> <option>ML Sultan Technikon</option> <option>Eastern Cape Technikon</option> <option>Free State Technikon</option> <option>Mangosutho Technikon</option> <option>Northern Technikon</option> <option>Peninsula Technikon</option> <option>Port Elizabeth Technikon</option> <option>Pretoria Technikon</option> <option>Technikon SA</option> <option>Vaal Technikon</option> <option>Technikon Witwatersrand</option> </optgroup> <option>Other</option> </select><br/> <input type="text" name="EducationInstOther" id="EducationInstOther" value="<?php echo $row["EducationInst"]; ?>" /> </td> </tr> <tr> <td valign="top">Qualifications Attained:</td> <td><label for="Qualifications"></label> <textarea name="Qualifications" id="Qualifications" cols="45" rows="2"><?php echo $row["Qualifications"]; ?></textarea></td> </tr> <tr> <td valign="top">Date of Final Examination:</td> <td><input name="DateFinalExam" type="text" id="DateFinalExam" size="10" value="<?php echo $row["DateFinalExam"]; ?>" /></td> </tr> <tr> <td valign="top"><strong>Documents:</strong></td> <td> </td> </tr> <tr> <td valign="top">Certified copy of ID or passport:</td> <td><input type="file" name="IDFile" id="IDFile" /></td> </tr> <tr> <td valign="top">Curriculum Vitae (CV):</td> <td><label> <input type="file" name="CVFile" id="CVFile" /> </label></td> </tr> <tr> <td valign="top">Certified copies of qualification/s:</td> <td><input type="file" name="QualCertificate1" id="QualCertificate1" /> <br /> <input type="file" name="QualCertificate2" id="QualCertificate2" /> <br /> <input type="file" name="QualCertificate3" id="QualCertificate3" /></td> </tr> <tr> <td valign="top">Undertaking from Mentor (if applicable):</td> <td><input type="file" name="MentorUndertaking" id="MentorUndertaking" /></td> </tr> <tr> <td valign="top">Undertaking of C&U (ECSA):</td> <td><input type="file" name="CandUUndertaking" id="CandUUndertaking" /></td> </tr> <tr> <td valign="top">Company Candidate Policy:</td> <td><input type="file" name="CompanyCandidatePolicy" id="CompanyCandidatePolicy" /></td> </tr> <tr> <td valign="top">Cerificate of disability (if applicable):</td> <td><input type="file" name="DisabilityCertificate" id="DisabilityCertificate" /></td> </tr> <tr> <td valign="top">Payslip:</td> <td><input type="file" name="Payslip" id="Payslip" /></td> </tr> <tr> <td valign="top">Proof of bank account:</td> <td><input type="file" name="BankAccountProof" id="BankAccountProof" /></td> </tr> <tr> <td valign="top">Photograph of candidate:</td> <td><input type="file" name="Photograph" id="Photograph" /></td> </tr> </tbody> </table> <br /> <b>Please be patient, submission can take time if the documents to upload are large!</b> <?php } } ?> <p> <input type="submit" name="Submit" id="Submit" value="Submit" style="background-color:red;color:white;font-style:bold;width:150px;height:50px" /> </p> </form> <?php } ?> <br /> <p> </p> <?php } ?> </div> <?php include("inc_footer.php"); ?> <!-- end #container --></div> </body> </html>