#! /usr/local/bin/perl -w

use strict;
use CGI ();
use Mail::Internet ();

  use vars qw($q);
  use lib qw(.); 
  use HTML qw($q); # HTML.pm is in the same dir as script.pl
  $q = CGI->new;

# avoid mailx etc.
$ENV{'PERL_MAILERS'} = "mail:/donotuse:sendmail:/usr/sbin/sendmail";
$ENV{'MAILADDRESS'} = 'webmaster@mail.lns.cornell.edu';

my $to = "chris237\@gmail.com";

my $query = new CGI;

my @fields = ( 'Name', 'Email', 'Phone', 'InstName', 'InstStreet', 'InstCity', 'InstState', 'InstZip', 'Lodging', 'ContactName', 'ContactPhone' );

print $query->header();

HTML::printmyheader();

if (!$query->param('Name')) {
    print "<h1>Missing a name.</h1>\nPress the back button and please provide your name.\n";
} else {
    my @body;

    for my $field (@fields) {
	push @body, sprintf("%-15s %s\n", $field.":", $query->param($field))
	    if $query->param($field);
    }

    push @body, sprintf("\nsubmitted from: %s (%s)\n", 
			$ENV{'REMOTE_ADDR'},
			$ENV{'REMOTE_HOST'} || "no reverse DNS"
		       );

    my $submitted_name = $query->param('Name');
    my $submitted_email = $query->param('Email');
    my $submitted_phone1 = $query->param('Phone');
    my $submitted_inst = $query->param('InstName');
    my $submitted_street = $query->param('InstStreet');
    my $submitted_city = $query->param('InstCity');
    my $submitted_state = $query->param('InstState');
    my $submitted_zip = $query->param('InstZip');
    my $submitted_lodging = $query->param('Lodging');
    my $submitted_contact = $query->param('ContactName');
    my $submitted_phone2 = $query->param('ContactPhone');
    my $subLodgeOnCampus = "";
    my $subLodgeOther = "";
    my $subLodgeNone = "";

    
    if ($submitted_lodging eq "OnCampus"){
       $subLodgeOnCampus = "checked";
    }elsif ($submitted_lodging eq "Other"){
       $subLodgeOther = "checked";
    }elsif ($submitted_lodging eq "None"){    
       $subLodgeNone = "checked";
    }
    
print qq(<big><b>Please review the information you have entered. Press Submit to send your registration.</b></big><br><br>);

print << "newpage";
<form action="http://www.lepp.cornell.edu/restricted/rbin/outreach/register" method="post"><input type="hidden" name="page" value="WorkshopRegistration">
  <input type="hidden" name="Subject" value="Workshop Registration (PFPT)">
  <input type="reset" value="Erase fields and start over"><br>
  <ol>
    <li><label for="name"><b>What is your name?</b></label>
      <input name="Name" size="60" value="$submitted_name" id="name"><br>
      <p>
      </p>
    </li>
    <li><label for="addr"><b>What is your email address?</b></label>
      <br>
      <input name="Email" size="60" value="$submitted_email" id="addr"><br>
      <p>
      </p>
    </li>
    <li><label for="phone"><b>What is your telephone number(s)?</b></label>
      <br>
      <input name="Phone" size="60" value="$submitted_phone1" id="phone"><br>
      <p>
      </p>
    </li>
    <li><label for="instname"><b>With which institution are you affiliated?</b></label>
      <br>
      <input name="InstName" size="60" value="$submitted_inst" id="instname"><br>
      <p>
    <li><b>What is the address of this institution?</b>
    </li>
      <ul>
        <li><label for="inststreet"><b>Street</b></label>
          <input name="InstStreet" size="55" value="$submitted_street" id="inststreet">
          <p>
          </p>
        </li>
        <li><label for="instcity"><b>City</b></label>
          <input name="InstCity" size="30" value="$submitted_city" id="instcity">
          <label for="inststate"><b>State</b></label>
          <input name="InstState" size="2" value="$submitted_state" id="inststate">
          <label for="instzip"><b>Zip</b></label>
          <input name="InstZip" size="5" value="$submitted_zip" id="instzip">
          <p>
          </p>
        </li>
      </ul>
    <li><label for="lodging"><b>What is your lodging preference?</b></label>
      <br>
      <input name="Lodging" type="radio" value="OnCampus" $subLodgeOnCampus> I would like on-campus lodging for $55 per night.
      <br>
      <input name="Lodging" type="radio" value="Other" $subLodgeOther> I will make other arrangements.
      <br>
      <input name="Lodging" type="radio" value="None" $subLodgeNone> I will not be staying over night.
      <p>
      </p>
    <li><b>Please provide emergency contact information</b>
    </li>
      <ul>
        <li><label for="contactname"><b>Name</b></label>
          <input name="ContactName" size="60" value="$submitted_contact" id="contactname">
          <p>
          </p>
        </li>
        <li><label for="contactphone"><b>Phone Number</b></label>
          <input name="ContactPhone" size="52" value="$submitted_phone2" id="contactphone">
          <p>
          </p>
        </li>
    </ul>
<label for="mailit"><input type="submit" value="   Send   " id="mailit"><input type="hidden" name="EndPage" value="--eom--">
    </li>
  </ol>
</form>
newpage

}

HTML::printmytrailer();