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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
<script type='text/javascript' src='https://ajax.googleapis.com/ajax/libs/jquery/1.11.0/jquery.min.js?ver=1.11.0'></script>
</head>
<body>
<script>
var ajax_path = 'http://dev.mitzvahmarket.com/wp-content/plugins/lcs-family-spotlights/ajax.php';
validateForm = function()
{
var err = false;
$('.lcs_required:visible').each(function() {
if ($(this).attr('type') == 'radio')
{
if (typeof($("input[name='" + $(this).attr('name') + "']:checked").val()) === 'undefined')
{
alert('Please fill in all required fields!');
err = true;
return false;
}
}
else
{
if ($(this).val() <= ' ')
{
alert('Please fill in all required fields!');
err = true;
return false;
}
if ($(this).hasClass('lcs_captcha'))
{
$.ajax({
url: ajax_path + "?func=verify_captcha&captcha=" + encodeURI($(this).val()),
cache: false,
dataType: "json",
async : false,
success: function(json) {
//alert('CAPTCHA verification callback');
if (json.captcha_check == false)
{
alert('Verification code invalid!');
err = true;
return false;
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,error: function (request, status, error) {
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alert('Unable to validate verification code!');
err = true;
return false;
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}
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});
return !err;
}
validateFormSubmit = function()
{
if (!validateForm())
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return false;
}
else
{
//$('#progress_bar_outer').show();
//window.setTimeout(update_progress,1000);
return true;
}
}
</script>
<form name="family-spotlight-form" action="/formtest.php" method="post" id="family-spotlight-form" enctype="multipart/form-data" onsubmit="return validateFormSubmit();" />
<input type="hidden" name="PHP_SESSION_UPLOAD_PROGRESS" value="lcs_form_progress" />
<input name="submitted" type="hidden" value="1" />
<input name="mitzvah_date" id="mitzvah_date" type="text" maxlength="25" class="input-field-small2 date-pick dp-applied " value="" /><br />
Mitzvah Child First Name / Last Name / Birthdate *<br />
<input name="child_first_name" id="child_first_name" type="text" maxlength="25" class="input-field-small2 " value="" />
<input name="child_last_name" id="child_last_name" type="text" maxlength="25" class="input-field-small2 " value="" />
<input name="child_birthdate" id="child_birthdate" type="text" maxlength="25" class="input-field-small2 date-pick dp-applied " value="" /><br />
Parent 1 First Name / Last Name<br />
<input name="parent1_first_name" id="parent1_first_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="parent1_last_name" id="parent1_last_name" type="text" maxlength="25" class="input-field-small2" value="" /><br />
Parent 2 First Name / Last Name<br />
<input name="parent2_first_name" id="parent2_first_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="parent2_last_name" id="parent2_last_name" type="text" maxlength="25" class="input-field-small2" value="" /><br />
Sibling 1 First Name / Last Name / Birthdate<br />
<input name="sibling1_first_name" id="sibling1_first_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling1_last_name" id="sibling1_last_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling1_birthdate" id="sibling1_birthdate" type="text" maxlength="25" class="input-field-small2 date-pick dp-applied" value="" /><br />
Sibling 2 First Name / Last Name / Birthdate<br />
<input name="sibling2_first_name" id="sibling2_first_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling2_last_name" id="sibling2_last_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling2_birthdate" id="sibling2_birthdate" type="text" maxlength="25" class="input-field-small2 date-pick dp-applied" value="" /><br />
Sibling 3 First Name / Last Name / Birthdate<br />
<input name="sibling3_first_name" id="sibling3_first_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling3_last_name" id="sibling3_last_name" type="text" maxlength="25" class="input-field-small2" value="" />
<input name="sibling3_birthdate" id="sibling3_birthdate" type="text" maxlength="25" class="input-field-small2 date-pick dp-applied" value="" /><br />
City / State / Zip *<br />
<input name="city" id="city" type="text" maxlength="50" class="input-field-small2 " value="" />
<select name="state" id="state" class="input-field-small2 " onchange="set_country('state', 'country');" >
<option value="">State/Province...</option>
<option value="">- - - - - - United States of America - - - - - -</option><option attr_country="United States of America" value="AL" >Alabama</option><option attr_country="United States of America" value="AK" >Alaska</option><option attr_country="United States of America" value="AZ" >Arizona</option><option attr_country="United States of America" value="AR" >Arkansas</option><option attr_country="United States of America" value="CA" >California</option><option attr_country="United States of America" value="CO" >Colorado</option><option attr_country="United States of America" value="CT" >Connecticut</option><option attr_country="United States of America" value="DE" >Delaware</option><option attr_country="United States of America" value="DC" >District of Columbia</option><option attr_country="United States of America" value="FL" >Florida</option><option attr_country="United States of America" value="GA" >Georgia</option><option attr_country="United States of America" value="HI" >Hawaii</option><option attr_country="United States of America" value="ID" >Idaho</option><option attr_country="United States of America" value="IL" >Illinois</option><option attr_country="United States of America" value="IN" >Indiana</option><option attr_country="United States of America" value="IA" >Iowa</option><option attr_country="United States of America" value="KS" >Kansas</option><option attr_country="United States of America" value="KY" >Kentucky</option><option attr_country="United States of America" value="LA" >Louisiana</option><option attr_country="United States of America" value="ME" >Maine</option><option attr_country="United States of America" value="MD" >Maryland</option><option attr_country="United States of America" value="MA" >Massachusetts</option><option attr_country="United States of America" value="MI" >Michigan</option><option attr_country="United States of America" value="MN" >Minnesota</option><option attr_country="United States of America" value="MS" >Mississippi</option><option attr_country="United States of America" value="MO" >Missouri</option><option attr_country="United States of America" value="MT" >Montana</option><option attr_country="United States of America" value="NE" >Nebraska</option><option attr_country="United States of America" value="NV" >Nevada</option><option attr_country="United States of America" value="NH" >New Hampshire</option><option attr_country="United States of America" value="NJ" >New Jersey</option><option attr_country="United States of America" value="NM" >New Mexico</option><option attr_country="United States of America" value="NY" >New York</option><option attr_country="United States of America" value="NC" >North Carolina</option><option attr_country="United States of America" value="ND" >North Dakota</option><option attr_country="United States of America" value="OH" >Ohio</option><option attr_country="United States of America" value="OK" >Oklahoma</option><option attr_country="United States of America" value="OR" >Oregon</option><option attr_country="United States of America" value="PA" >Pennsylvania</option><option attr_country="United States of America" value="RI" >Rhode Island</option><option attr_country="United States of America" value="SC" >South Carolina</option><option attr_country="United States of America" value="SD" >South Dakota</option><option attr_country="United States of America" value="TN" >Tennessee</option><option attr_country="United States of America" value="TX" >Texas</option><option attr_country="United States of America" value="UT" >Utah</option><option attr_country="United States of America" value="VT" >Vermont</option><option attr_country="United States of America" value="VA" >Virginia</option><option attr_country="United States of America" value="WA" >Washington</option><option attr_country="United States of America" value="WV" >West Virginia</option><option attr_country="United States of America" value="WI" >Wisconsin</option><option attr_country="United States of America" value="WY" >Wyoming</option><option value="">- - - - - - Canada - - - - - -</option><option attr_country="Canada" value="AB" >Alberta</option><option attr_country="Canada" value="BC" >British Columbia</option><option attr_country="Canada" value="MB" >Manitoba</option><option attr_country="Canada" value="NB" >New Brunswick</option><option attr_country="Canada" value="NL" >Newfoundland and Labrador</option><option attr_country="Canada" value="NT" >Northwest Territories</option><option attr_country="Canada" value="NS" >Nova Scotia</option><option attr_country="Canada" value="NU" >Nunavut</option><option attr_country="Canada" value="ON" >Ontario</option><option attr_country="Canada" value="PE" >Prince Edward Island</option><option attr_country="Canada" value="QC" >Quebec</option><option attr_country="Canada" value="SK" >Saskatchewan</option><option attr_country="Canada" value="YT" >Yukon</option> </select>
<input name="zip" id="zip" type="text" maxlength="15" class="input-field-small2 " value="" /><br />
Country<br />
<input name="country" id="country" type="text" maxlength="50" class="input-field" value="" /><br />
Email *<br />
<input name="email" id="email" type="text" maxlength="50" class="input-field " value="" /><br />
Phone *<br />
<input name="phone" id="phone" type="text" maxlength="25" class="input-field " value="" /><br />
Party Type *<br />
<input type="radio" name="party_type_bbb" class="" value="bar" /> Bar
<input type="radio" name="party_type_bbb" class="" value="bat" /> Bat
<input type="radio" name="party_type_bbb" class="" value="bnai" /> B'nai<br />
<input type="radio" name="party_type_time" class="" value="day" /> Daytime
<input type="radio" name="party_type_time" class="" value="evening" /> Evening<br />
Party Description (including theme) *<br />
<textarea name="party_description" cols="45" rows="6" class="input-area " id="party_description"></textarea><br />
Mom-to-Mom Advice<br />
<textarea name="mom_advice" cols="45" rows="6" class="input-area" id="mom_advice"></textarea><br />
Mitzvah Project Description<br />
<textarea name="project_description" cols="45" rows="6" class="input-area" id="project_description"></textarea><br />
Additional Comments<br />
<textarea name="comments" cols="45" rows="6" class="input-area" id="comments"></textarea><br />
Did you find MM.com helpful when planning, please let us know<br />
<textarea name="testimonial" cols="45" rows="6" class="input-area" id="testimonial"></textarea><br />
<input name="btn_save_1" type="button" class="" id="btn_save_1" value="Save for later" onclick="show_tab_validate(4);" style="margin-left:10px;" />
<input name="btn_next_2" type="button" class="" id="btn_next_2" value="Next..." onclick="show_tab_validate(2);" /><br />
<input name="photo_count" id="photo_count" type="hidden" value="0" />
<input name="photo_delete" id="photo_delete" type="hidden" value="" />
<div class="spotlight_columns">
<div class="spotlight_left_column">
<p>
Please provide the following photos with captions explaining some of the details for:
<ol>
<li>The immediate family dressed for the party</li>
<li>The Bar or Bat Mitzvah child on bimah or family at Temple</li>
<li>The Venue</li>
<li>The Mitzvah child with or without siblings</li>
<li>The invitation and/or Save-The-Date</li>
<li>The favors (for kids and adults)</li>
<li>The DJ interacting with guests</li>
<li>The Mitzvah child entering the room</li>
<li>The candle Lighting</li>
<li>The cake</li>
<li>The decor, centerpieces, room signs etc</li>
<li>The photo booth or other child entertainment</li>
<li>Any other special touches you might have had</li>
<li>Any photos from the Mitzvah Project</li>
</ol>
</p>
</div>
<div id="photo_section">
<div id="photo_entry__0__" style="display:block;" class="photo_entry" >
<div class="photo_entry_delete">
<input class="photo_delete_button" name="btn_photo_delete__0__" type="button" id="btn_photo_delete__0__" value="Remove" onclick="delete_photo('__0__');" /><br />
</div>
<input name="__img__0__id" id="__img__0__id" type="hidden" value="" />
Image File *<br />
<!--
-->
<input name="__img__0__filename" id="__img__0__filename" vid="__0__" type="file" class="input-field" /><br />
Caption *<br />
<input name="__img__0__caption" id="__img__0__caption" type="text" maxlength="125" class="input-field " value="" /><br />
Party Idea Category<br />
<select name="__img__0__category" id="__img__0__category" class="input-field" />
<option value=""></option>
<option value="Themes" >Themes</option><option value="Cake/Food" >Cake/Food</option><option value="Candle Lighting" >Candle Lighting</option><option value="Entertainment/Resources" >Entertainment/Resources</option><option value="Decor" >Decor</option><option value="Fashion/DIY" >Fashion/DIY</option><option value="Favors/Gifts/Judaica" >Favors/Gifts/Judaica</option><option value="Invitations/Place Cards" >Invitations/Place Cards</option><option value="Sign-In" >Sign-In</option><option value="Video: Entrance/Montage" >Video: Entrance/Montage</option><option value="Other Ideas" >Other Ideas</option> </select><br />
Related Vendor<br />
<select name="__img__0__vendor" id="__img__0__vendor" class="input-field lcs_related_vendor" />
<option value=""></option>
<option value="" selected></option> </select><br />
</div>
</div>
</div>
<div style="clear:both;">
</div>
<span class="highlight">Click here to add photos ---></span>
<input name="btn_photo" type="button" class="" id="btn_photo" value="Add photo..." onclick="add_photo();" /><br />
Please refer to the list above.<br />
<input name="btn_save_3" type="button" class="" id="btn_save_3" value="Save for later" onclick="show_tab_validate(4);" style="margin-left:10px;" />
<input name="btn_next_4" type="button" class="" id="btn_next_4" value="Next..." onclick="show_tab_validate(4);" style="margin-left:10px;" />
<input name="btn_prev_2" type="button" class="" id="btn_prev_2" value="Previous..." onclick="show_tab_validate(2);" /><br />
<div style="clear:both;">
</div>
Verification Code *<br />
<input name="captcha" type="text" class="input-field-small2 lcs_required lcs_captcha" id="captcha" maxlength="6" />
<img id="family_spotlight_captcha" class="lcs_spotlight_graphic" style="vertical-align:top;" align="middle" src="http://dev.mitzvahmarket.com/wp-content/themes/mitzvah3/captcha.php" />
<img class="lcs_spotlight_graphic" style="vertical-align:middle; cursor:pointer;" align="middle" src="http://dev.mitzvahmarket.com/wp-content/themes/mitzvah3/images/reload.png" onclick="reload_captcha('family_spotlight_captcha');" />
<br />
<br />
<input name="btn_submit" type="submit" class="" id="btn_submit" value="SUBMIT" style="margin-left:10px;" />
</form>
</body>
</html>