source: WAeUP_SRP/trunk/skins/waeup_student/contact_student.pt @ 886

Last change on this file since 886 was 869, checked in by Henrik Bettermann, 18 years ago

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File size: 2.2 KB
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1<metal:html tal:define="info context/getStudentInfo;
2                is_manager info/is_manager|nothing;
3                is_student info/is_student|nothing">
4  <metal:body use-macro="here/main_template/macros/master">
5    <metal:main fill-slot="main">
6      <h3>Support Form</h3>
7      <br />If you are having problems using the system please fill the form below with your correct details.<br /> <br />
8      <form id="form1" name="form1" method="post" action="mail2admin">
9      <input type="hidden" name="regno" type="text" id="regno"
10             tal:attributes="value info/id"/>
11      <table width="100%" border="0" cellspacing="5" cellpadding="0">
12        <tr>
13          <td width="150px">
14             <strong>Full Name: </strong>
15          </td>
16          <td>
17             <input name="fullname" type="text" id="fullname"
18                    tal:attributes="value info/student/Title"/>
19          </td>
20        </tr>
21        <tr>
22          <td>
23             <strong>Email: </strong>
24          </td>
25          <td>
26             <input name="email" type="text" id="email"
27                    tal:attributes="value info/app_doc/app_email"/>
28          </td>
29        </tr>
30        <tr>
31          <td>
32             <strong>Problem Type: </strong>
33          </td>
34          <td>
35              <select name="probtype" class="boxgreen" id="probtype">
36                <option>Payment</option>
37                <option>Application</option>
38                <option>Admission</option>
39                <option>Clearance</option>
40                <option>Course Registration</option>
41                <option>Hostal Reservation</option>                               
42                <option>Other</option>
43              </select>       
44          </td>
45        </tr>
46        <tr>
47          <td valign="top">
48             <strong>Description: </strong>
49          </td>
50          <td>
51             <textarea name="descr" rows="10" cols="60" id="descr"></textarea>
52          </td>
53        </tr>
54     
55        <tr>
56          <td>&nbsp;</td>
57          <td><input name="Submit" type="submit" class="standalone" value="Submit" /><br /><br /></td>
58        </tr>
59      </table>
60      </form>
61    </metal:main>
62  </metal:body>
63</metal:html>
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