The Organic Farm

Veggie Co-op

Sign Up

date("Y-m-d h:i:s")); $n_maxlen_key = 0; $n_maxlen_val = 0; $a_required = array('Name', 'Email_Address'); // Data for Admin Email foreach($_POST as $key => $val) { if ($key == 'Submit') { continue; } if (in_array($key, $a_required)) { if (strlen($val) == 0) { signup_form("Please make sure the \"$key\" field is filled in."); exit; } } if ($key == 'Email_Address' && data_validate_email($val) == false) { $key = str_replace('_', ' ', $key); signup_form("Please make sure the \"$key\" is correct."); exit; } $key = str_replace('_', ' ', $key); $val = str_replace('_', ' ', $val); // Get Max Length of Column Names $n_maxlen_key = strlen($key) > $n_maxlen_key ? strlen($key) : $n_maxlen_key; // Get Max Length of Column Values $n_maxlen_val = strlen($val) > $n_maxlen_val ? strlen($val) : $n_maxlen_val; //$email_output .= $key.'...'.$val."\n"; // Put this data in the list $a_email_output[$key] = $val; } // Add 1 to Max Lengths $n_maxlen_key+=1; $n_maxlen_val+=1; //echo '
'.$n_maxlen_key.'
'; foreach($a_email_output as $key => $val) { //echo '
'.strlen($key).' - '.($n_maxlen_key-strlen($key)).'
'; $str_left = str_pad($key.' ', ($n_maxlen_key), '.', STR_PAD_RIGHT); $str_right = str_pad(' '.$val, ($n_maxlen_val), '.', STR_PAD_LEFT); $email_output .= $str_left.$str_right."\n"; } /** * ======================== * Email to Farm. * ======================== $admin_to = ''; */ $admin_to = 'organicfarm@nl.rogers.com'; $admin_subject = 'Veggie Co-op Application - Returning Member'; $admin_message = 'A Co-op Membership Form has been submitted:'."\n\n".$email_output; $admin_headers = ''; $admin_headers .= "From: The Organic Farm \n"; $admin_headers .= "Reply-to: coopsignups@theorganicfarm.net\n"; #$admin_headers .= "Cc: louis@highermind.org\n"; // To send HTML mail, you can set the Content-type header. //$headers = "MIME-Version: 1.0\n"; //$headers .= "Content-type: text/html; charset=iso-8859-1\n"; //-- This handles bounces; //$headers .= "Return-Path: louis@highermind.org\n"; if (getenv('HTTP_HOST') != '127.0.0.1') { mail ($admin_to, $admin_subject, $admin_message, $admin_headers); } else { echo '
'.$email_output.'
'; } /** * ======================== * Email to Potential Customer. * ======================== */ $cust_to = $_POST['Email_Address']; $cust_subject = 'The Organic Farm - Veggie Co-op Membership Application'; $cust_headers = ''; $cust_headers .= "From: The Organic Farm \n"; $cust_headers .= "Reply-to: organicfarm@nl.rogers.com\n"; #$cust_headers .= "Bcc: louis@highermind.org\n"; $cust_message = ' Dear '.$_POST['Name'].' Thank you for your interest in joining the Veggie Coop. '.$email_output.' '; if (getenv('HTTP_HOST') != '127.0.0.1') { mail ($cust_to, $cust_subject, $cust_message, $cust_headers); } else { echo '
'.$email_output.'
'; } ?>

Veggie Coop Membership Application
2008 Season

Thank You for Your Membership Application!

We will be in touch with you shortly.

Return to the Organic Farm Home Page

















0) { $error_message_display = '
'.$error_message.'
'; } ?>

Veggie Coop Returning Member Application
2008 Season

*Required Items
Contact Information:
Name*:
E-Mail*:
Address:
Work Phone:
Home Phone:
Cell Phone:


Membership Types and Payment Rates:
Small Bag (Mondays): />
Large Bag (Wednesdays): />


Payment Options:
Checks are the preferred form of payment.

If this is not feasible, please Contact Us to make a plan.


Dated Payable June 15th
 />
Dated June 15th and August 15th
 />
Dated June 15, July 15th, August 15th, and Sept 15th
 />

Please make checks payable to: Organic Farm

Arrangements for pick-up:
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Additional Information:
We would like to know how many people are benefitting from the Veggie Coop.

For our information and statistics, please describe the names of other families who may be sharing a bag and their vital statistics, for both grown-ups and children.

Number of Families:
Number of Adults:
Ages of Adults:
Number of Children:
Ages of Children:
Sharing with:
E-Mail:
Phone:


Holidays:
If you are planning holidays, please remember to let us know in writing.








* @version v 1.0 2000/12/03 23:59:59 * @param string email * @return bool true if email valid, false if not */ function data_validate_email($email) { if (!ereg('^[-!#$%&\'*+\\./0-9=?A-Z^_`a-z{|}~]+'. '@'. '[-!#$%&\'*+\\/0-9=?A-Z^_`a-z{|}~]+\.' . '[-!#$%&\'*+\\./0-9=?A-Z^_`a-z{|}~]+$', $email)) { return false; } return true; } ?>