$F->tbNotVal("PhoneDetails"); ?> <?php $F->tbContactNotes(); ?> </div> <div style="float:left; width:260px; padding:15px"> <?php $F->tbNotVal("Address"); ?> <?php $F->tbNotVal("City"); ?> <?php $F->ddlStates(); ?> <?php $F->tbNotVal("ZipCode"); ?> <?php $F->ddlGeneric("County", "County"); ?> <?php $F->ddlCountries(); ?> <?php $F->submitButton("Create Customer"); ?> </div>
$F->tbVal("FirstName", "First Name", "", "float: left;", $user["FirstName"]); $F->tbVal("LastName", "Last Name", "", "float: left;", $user["LastName"]); $F->tbNotVal("License", "Driver's License", "", "clear: both; float: left;", $user["License"]); $F->tbNotVal("Social", "Social Security Number", "", "float: left", $user["Social"]); $F->tbNotVal("BirthDate", "Birth Date", "", "clear: both;", $user["BirthDate"]); ?> <div style="clear: both"></div> <h1>Contact Info:</h1> <?php $firephp->log($AgencyParams); $F->tbVal("Address1", "Address 1", "", "float: left;", $user["Address"]); $F->tbNotVal("Address2", "Address 2", "", "float: left;", $user["Address2"]); $F->ddlHomeType("float:left;", $user["HomeType"]); $F->tbVal("City", "City", "", "clear: both; float: left", $user["City"]); $F->ddlStates($user["State"], "State", "State", "float:left;"); $F->tbVal("ZipCode", "Zip Code", "", "float: left", $user["ZipCode"]); $F->tbVal("Phone", "Phone", "", "clear: both; float: left", $user["Phone"]); $F->tbVal("Cell", "Cell", "", "float: left", $user["Cell"]); ?> <div style="clear: both"></div> <h1>Emergency Contact:</h1> <?php $F->tbNotVal("ContactFirstName", "Contact First Name", "", "float: left;", $user["ContactFirstName"]); $F->tbNotVal("ContactLastName", "Contact Last Name", "", "float: left;", $user["ContactLastName"]); $F->tbNotVal("ContactAddress1", "Contact Address 1", "", "clear: both; float: left;", $user["ContactAddress"]); $F->tbNotVal("ContactAddress2", "Contact Address 2", "", "float: left;", $user["ContactAddress2"]); $F->tbNotVal("ContactCity", "Contact City", "", "clear: both; float: left", $user["ContactCity"]); $F->ddlStates($user["ContactState"], "ContactState", "Contact State", "float:left;"); $F->tbNotVal("ContactZipCode", "Contact Zip", "", "float: left", $user["ContactZipCode"]);
<?php $F->tbNotVal("Email", "Email", "", "float:left; clear:both;"); ?> <?php $F->tbNotVal("Phone", "Phone", "", "float:left; padding-left:0"); ?> <?php $F->tbNotVal("PhoneDetails", "Phone Details", "", "float:left; padding-left:0"); ?> <?php $F->tbNotVal("license", "Driver's License", "", "float:left; clear:both;"); ?> <?php $F->ddlStates("AL", "licenseState", "Driver's License Issuing State", "float:left; padding-left:0"); ?> </ul> <div style="clear:both"></div> <h1 style="clear:both; background-color:silver; color:#365181; font-size:1.1em;margin:2em 0 0.5em 1.25em; padding:2px 0 2px 5px; width:350px;">Address</h1> <ul class="form" > <?php $F->ddlHomeType("float:left;"); ?> <?php $F->ddlHomeStatus("float: left; padding-left:0;"); ?>
" /> <input type="hidden" id="tbAddress_val" value="waiting"> <div id="tbAddress_msg"></div> </li> <li class="validated" id="tbCity_li"> <label for="r_tbCity">City:</label> <div id="tbCity_img"></div> <input class="validated" name="City" id="tbCity" type="text" maxlength="100" value="<?php echo $City; ?> " /> <input type="hidden" id="tbCity_val" value="waiting"> <div id="tbCity_msg"></div> </li> <?php $F->ddlStates($State); ?> <li class="validated" id="tbZipCode_li"> <label for="r_tbZipCode">Zip Code:</label> <div id="tbZipCode_img"></div> <input class="validated" name="ZipCode" id="tbZipCode" type="text" maxlength="10" value="<?php echo $ZipCode; ?> " /> <input type="hidden" id="tbZipCode_val" value="waiting"> <div id="tbZipCode_msg"></div> </li> </div><div style="float:left"> <li class="validated" id="tbContactName_li"> <label for="r_tbContactName">Contact Name:</label> <div id="tbContactName_img"></div>