284 lines
14 KiB
HTML
284 lines
14 KiB
HTML
{{ $formClasses := "bg-neutral-500 text-neutral-50 placeholder-neutral-300 focus:ring-2 focus:ring-primary-500 focus:ring-offset-2 focus:ring-offset-transparent m-2 p-3 rounded-lg hover:bg-neutral-500 checked:text-neutral-500" }}
|
|
|
|
<script>
|
|
function process() {
|
|
var studentAgree = document.getElementById("student-agree").checked;
|
|
console.log(studentAgree);
|
|
var parentAgree = document.getElementById("adult-agree").checked;
|
|
console.log(parentAgree);
|
|
if (studentAgree && parentAgree) {
|
|
document.getElementById('mt-form').hidden = false
|
|
console.log("WOOHOO");
|
|
}
|
|
else {
|
|
document.getElementById('form').hidden = true
|
|
document.getElementById('mt-form').hidden = true
|
|
console.log("NEGATORY");
|
|
}
|
|
}
|
|
document.addEventListener('DOMContentLoaded', process);
|
|
</script>
|
|
|
|
<div class="m-4">
|
|
<div class="p-2">
|
|
<input type="checkbox" name="student-agree" id="student-agree"
|
|
onclick="process()" class="form-checkbox {{ $formClasses }}" />
|
|
<label for="student-agree">I agree to the above</label>
|
|
</div>
|
|
<div class="p-2">
|
|
<input type="checkbox" name="adult-agree" id="adult-agree"
|
|
onclick="process()" class="form-checkbox {{ $formClasses }}" />
|
|
<label for="adult-agree">Parent agrees to the above</label>
|
|
</div>
|
|
</div>
|
|
|
|
<div id="mt-form" class="form text-lg w-full">
|
|
<form action="" autocomplete="on" method="post" target="_parent" class="w-full items-center flex flex-wrap">
|
|
<h3 class="basis-full">Mission Trip Application</h3>
|
|
<div class="basis-full flex flex-wrap my-4">
|
|
<label for="firstname" class="basis-full">What is your first and last name?</label>
|
|
<br/>
|
|
<input type="text" id="firstname" name="firstname"
|
|
placeholder="First Name" class="flex-1 form-input {{ $formClasses }}">
|
|
<input type="text" id="lastname" name="lastname"
|
|
placeholder="Last Name" class="flex-1 form-input {{ $formClasses }}">
|
|
</div>
|
|
<div class="basis-full flex flex-wrap my-4">
|
|
<label for="parentfirstname" class="basis-full">What is your parent's first and last name?</label>
|
|
<input type="text" id="parentfirstname" name="parentfirstname"
|
|
class="flex-1 form-input {{ $formClasses }}"
|
|
placeholder="First Name">
|
|
<input type="text" id="parentlastname" name="parentlastname"
|
|
class="flex-1 form-input {{ $formClasses }}"
|
|
placeholder="Last Name">
|
|
</div>
|
|
<label for="parentemail" class="basis-full">What is your parent's email address?</label>
|
|
<input type="email" id="parentemail" name="parentemail"
|
|
pattern="^[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*@[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*$"
|
|
class="basis-full form-input {{ $formClasses }}">
|
|
<div class="basis-full my-8">
|
|
<div class="">
|
|
<label for="birthday" class="">When were you born?</label>
|
|
<input type="date" id="birthday" name="birthday"
|
|
class="form-date {{ $formClasses }}">
|
|
</div>
|
|
<div class="">
|
|
<label for="gender" class="">Gender</label>
|
|
<select id="gender" name="gender" class="form-select {{ $formClasses }}">
|
|
<option value="male">Male</option>
|
|
<option value="female">Female</option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="basis-full flex flex-wrap my-4">
|
|
<label for="street" class="basis-full">What is your address?</label>
|
|
<input type="text" id="street" name="street"
|
|
class="basis-full form-input {{ $formClasses }}"
|
|
placeholder="Street Address">
|
|
<input type="text" id="city" name="city"
|
|
class="flex-auto form-input {{ $formClasses }}"
|
|
placeholder="City">
|
|
<input type="text" id="state" name="state"
|
|
class="flex-auto form-input {{ $formClasses }}"
|
|
placeholder="State">
|
|
<input type="text" id="zip" name="zip"
|
|
class="flex-auto form-input {{ $formClasses }}"
|
|
placeholder="Zip Code">
|
|
</div>
|
|
<div class="basis-full flex flex-wrap items-center my-8">
|
|
<div class="flex-auto flex flex-wrap items-center">
|
|
<label for="cellphone" class="mr-4">Cell phone</label>
|
|
<input type="tel" id="cellphone" name="cellphone"
|
|
pattern="[0-9]{3}-[0-9]{3}-[0-9]{4}"
|
|
class="flex-auto form-input {{ $formClasses }}">
|
|
</div>
|
|
<div class="flex-auto flex flex-wrap items-center">
|
|
<label for="homephone" class="mr-4">Home phone</label>
|
|
<input type="tel" id="homephone" name="homephone"
|
|
pattern="[0-9]{3}-[0-9]{3}-[0-9]{4}"
|
|
class="flex-auto form-input {{ $formClasses }}">
|
|
</div>
|
|
<div class="flex-auto flex flex-wrap items-center">
|
|
<label for="email" class="mr-4">Email</label>
|
|
<input type="email" id="email" name="email"
|
|
pattern="^[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*@[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*$"
|
|
class="flex-auto form-input {{ $formClasses }}">
|
|
</div>
|
|
</div>
|
|
<label for="school" class="basis-full my-4">What school do you go to?</label>
|
|
<input type="text" id="school" name="school" class="basis-full form-input {{ $formClasses }}">
|
|
|
|
<div class="basis-full my-4">
|
|
<label for="grade" class="">Grade</label>
|
|
<br/>
|
|
<input type="radio" id="grade" name="grade" value="8" class="form-input {{ $formClasses }}">
|
|
<label for="grade" class="">8th</label>
|
|
<br/>
|
|
<input type="radio" id="grade" name="grade" value="freshman"
|
|
class="form-input {{ $formClasses }}">
|
|
<label for="grade" class="">Freshman</label>
|
|
<br/>
|
|
<input type="radio" id="grade" name="grade" value="sophomore"
|
|
class="form-input {{ $formClasses }}">
|
|
<label for="grade" class="">Sophomore</label>
|
|
<br/>
|
|
<input type="radio" id="grade" name="grade" value="junior"
|
|
class="form-input {{ $formClasses }}">
|
|
<label for="grade" class="">Junior</label>
|
|
<br/>
|
|
<input type="radio" id="grade" name="grade" value="senior"
|
|
class="form-input {{ $formClasses }}">
|
|
<label for="grade" class="">Senior</label>
|
|
</div>
|
|
<div class="basis-full flex flex-wrap my-4">
|
|
<label for="pastorfirstname" class="basis-full">What is your pastor's first and last name?</label>
|
|
<input type="text" id="pastorfirstname" name="pastorfirstname"
|
|
class="flex-auto form-input {{ $formClasses }}"
|
|
placeholder="First Name">
|
|
<input type="text" id="pastorlastname" name="pastorlastname"
|
|
class="flex-auto form-input {{ $formClasses }}"
|
|
placeholder="Last Name">
|
|
</div>
|
|
<div class="basis-full my-4">
|
|
<label for="churchattendance" class="">Do you attend church regularly?</label>
|
|
<br/>
|
|
<input type="radio" id="churchattendance" name="churchattendance"
|
|
value="yes" class="form-input {{ $formClasses }}">
|
|
<label for="churchattendance" class="">Yes</label>
|
|
<br/>
|
|
<input type="radio" id="churchattendance" name="churchattendance"
|
|
value="no" class="form-input {{ $formClasses }}">
|
|
<label for="churchattendance" class="">No</label>
|
|
<br/>
|
|
<input type="radio" id="churchattendance" name="churchattendance"
|
|
value="other" class="form-input {{ $formClasses }}">
|
|
<label for="churchattendance" class="">Other</label>
|
|
</div>
|
|
<div class="basis-full flex flex-wrap my-4">
|
|
<div class="basis-1/2 flex flex-wrap items-center">
|
|
<label for="tfcgroup" class="flex-initial">TFC Group</label>
|
|
<select id="tfcgroup" name="tfcgroup" class="flex-auto form-select {{ $formClasses }}">
|
|
<option value="phillipsburg">Phillipsburg</option>
|
|
<option value="atwood">Atwood</option>
|
|
<option value="northern-valley">Northern Valley</option>
|
|
<option value="southern-valley">Southern Valley</option>
|
|
<option value="thunder-ridge">Thunder Ridge</option>
|
|
<option value="logan">Logan</option>
|
|
<option value="codell">Codell</option>
|
|
<option value="colby">Colby</option>
|
|
</select>
|
|
</div>
|
|
<div class="basis-1/2 flex flex-wrap items-center">
|
|
<label for="shirt" class="flex-initial">T-Shirt Size</label>
|
|
<select id="shirt" name="shirt" class="flex-auto form-select {{ $formClasses }}">
|
|
<option value="small">Small</option>
|
|
<option value="medium">Medium</option>
|
|
<option value="large">Large</option>
|
|
<option value="xl">XL</option>
|
|
<option value="xxl">2XL</option>
|
|
<option value="xxxl">3XL</option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="basis-full my-4 mb-8 flex flex-wrap">
|
|
<label for="image" class="basis-full">
|
|
Please give us a picture you'd like to use on prayer cards.
|
|
</label>
|
|
<input type="file" id="image" name="image"
|
|
class="file:my-4 file:ml-2 file:py-2 file:px-4 file:rounded-lg file:border-0 file:text-sm file:font-semibold file:bg-neutral-500 file:text-neutral-100 hover:file:bg-primary-300 hover:file:ring-offset-2 hover:file:ring-2 hover:file:ring-offset-transparent hover:file:text-primary-500 hover:file:ring-primary-500">
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="tripnotes" class="p-4">
|
|
Do you have any other notes for us regarding this trip?
|
|
</label>
|
|
<br/>
|
|
<textarea id="tripnotes" name="tripnotes"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder="notes..."></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="relationship-with-jesus" class="p-4">
|
|
Describe your relationship with the Lord this past year.
|
|
</label>
|
|
<br/>
|
|
<textarea id="relationship-with-jesus" name="relationship-with-jesus"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="testimony" class="p-4">
|
|
Tell us how your relationship with Jesus began. (How you became a Christian)
|
|
</label>
|
|
<br/>
|
|
<textarea id="testimony" name="testimony"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="involvement-with-group" class="p-4">
|
|
In the last year, how have you been involved in the ministry of TFC (or your church/youth group)? How do you benefit your group?
|
|
</label>
|
|
<br/>
|
|
<textarea id="involvement-with-group" name="involvement-with-group"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="reasons-for-trip-choice" class="p-4">
|
|
Why did you choose the team you applied for as your first choice? (Please indicate if you are unable to a different a trip due to previous commitments.)
|
|
</label>
|
|
<br/>
|
|
<textarea id="reasons-for-trip-choice" name="reasons-for-trip-choice"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="strengths" class="p-4">
|
|
The strengths and talents you would bring to this year's team are:
|
|
</label>
|
|
<br/>
|
|
<textarea id="strengths" name="strengths"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="weaknesses" class="p-4">
|
|
Some negative traits that might effect my attitude are:
|
|
</label>
|
|
<br/>
|
|
<textarea id="weaknesses" name="weaknesses"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full mt-10">
|
|
<label for="previous-trip-info" class="p-4">
|
|
If you were a part of a previous TFC Mission Trip team-tell us how the trip changed your life?
|
|
</label>
|
|
<br/>
|
|
<textarea id="previous-trip-info" name="previous-trip-info"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full my-10">
|
|
<label for="attitude-toward-work" class="p-4">
|
|
If we were to ask your parents/employer/or teachers about your attitudes towards work, what would they say?
|
|
</label>
|
|
<br/>
|
|
<textarea id="attitude-toward-work" name="attitude-toward-work"
|
|
class="form-input w-full h-64 {{ $formClasses }}"
|
|
placeholder=""></textarea>
|
|
</div>
|
|
<div class="basis-full">
|
|
<button class="content-right rounded-lg bg-primary-700 h-12 w-24 focus:bg-primary-900 focus:ring focus:ring-primary-700 hover:bg-primary-900 float-right">Submit</button>
|
|
</div>
|
|
</form>
|
|
</div>
|
|
|
|
<iframe
|
|
id="form"
|
|
class="mt-form w-full h-screen"
|
|
src="https://tbl.tfcconnection.org/dashboard/#/nc/form/771dc7dc-9a82-49e4-abfe-0fd7b72281f2?embed"
|
|
frameborder="0"
|
|
style="background: transparent; border: 1px solid #ddd">
|
|
</iframe>
|