0)
{
$errorMMM=”Username Already Exist! Please Try Another Username.”;
}
$selectAll = “SELECT * FROM tbl_client WHERE email='”.$email.”‘”;
$mysqlQAll = mysql_query($selectAll);
$mysqlRAll = mysql_num_rows($mysqlQAll);
if($mysqlRAll > 0)
{
$errorMMM=”Email Already Exist! Please Try Another Email Adddress.”;
}
if(trim($error) == “” && $errorMMM==””)
{
$Insert_Pages = “INSERT INTO tbl_client SET
username = ‘”.$username.”‘,
password = ‘”.$userpass.”‘,
affiliate_id = ‘”.$affiliate_name.”‘,
first_name = ‘”.$first_name.”‘,
last_name = ‘”.$last_name.”‘,
gender = ‘”.$gender.”‘,
mobile = ‘”.$mobile.”‘,
email = ‘”.$email.”‘,
address = ‘”.$address.”‘,
country = ‘”.$country.”‘,
state = ‘”.$state.”‘,
city = ‘”.$city.”‘,
zip = ‘”.$zip.”‘,
desc1 = ‘”.$desc1.”‘,
terms = ‘”.$terms.”‘,
user_image = ‘”.$user_image.”‘,
reg_date = NOW(),
employer_type = ‘gen’,
status = ‘”.$status.”‘,
conditions = ‘”.$psy.”‘,
medication = ‘”.$med.”‘,
danger = ‘”.$threathening.”‘”;
if($_FILES[“user_image”][“name”] != “”)
{
move_uploaded_file($tmp_name, “$uploads_dir/$user_image”);
}
$result_insert = mysql_query($Insert_Pages) or die(mysql_error());
include(“mail.php”);
Mail::sendMail($email,$username,$userpass,$first_name,’gen’);
//header(“location:thanks.php”);
header(“location:page.php?name=registration-auto-response”);
exit;
}
}
include(“includes/header_cms.php”);
include(“includes/js.php”);
?>
Client Registration Form
* Fields are mandatory
| |
-->
|
| * Username | |
| * Password | |
| * Confirm Password | |
| * First Name | |
| * Last Name | |
| * Gender | Male Female |
| * Mobile | |
| |
|
| * Street Address |
|
| State | |
| * City | |
| * Postcode | |
| Sort Description |
|
| Have you been diagnosed with any severe mental health conditions or personality disorders? : |
|
| Are you currently taking prescribed medication? : |
|
| You currently in extreme life-threathening danger? : |
|
| * Terms | I agree to all the |
| Validation code: | Can’t read the image? click here to refresh |