<%@LANGUAGE="VBSCRIPT" CODEPAGE="1252"%> <% Dim oConn, oRs Dim qry, connectstr Dim SOL Dim db_name, db_username, db_userpassword Dim db_server db_server = "rbastudent.db.3334423.hostedresource.com" db_name = "rbastudent" db_username = "rbastudent" db_userpassword = "RBMaster1" tablename = "StudentLottery" connectstr = "Driver={SQL Server};SERVER=" & db_server & ";DATABASE=" & db_name & ";UID=" & db_username & ";PWD=" & db_userpassword Set oConn = Server.CreateObject("ADODB.Connection") oConn.Open connectstr 'qry = "SELECT * FROM " & tablename 'Set oRS = oConn.Execute(qry) SQL = "SELECT * FROM students_apply" Set oRS = oConn.Execute(SQL) if Request.Form("Add") = "Add" Then if Request.Form("FirstName") = "" Then Response.Redirect("error2.asp?Error=First Name can't be blank") End if if Request.Form("PostalCode") = "" Then Response.Redirect("error2.asp?Error=Zip Code can't be blank, enter a valid zip code") End if if Request.Form("LastName") = "" Then Response.Redirect("error2.asp?Error=Last Name can't be blank") End if if Request.Form("LastName") = "same" Then Response.Redirect("error2.asp?Error=Last Name can't be same, must be last name") End if if Request.Form("DOB") = "" Then Response.Redirect("error2.asp?Error=Date Of Birth can't be blank") End if if Request.Form("Gender") = "" Then Response.Redirect("error2.asp?Error=Gender can't be blank") End if if Request.Form("Address") = "" Then Response.Redirect("error2.asp?Error=Address Name can't be blank") End if if Request.Form("Grade") = "" Then Response.Redirect("error2.asp?Error=Grade can't be blank") End if if Request.Form("FatherFirst") = "" Then Response.Redirect("error2.asp?Error=Father's First Name can't be blank") End if if Request.Form("MotherFirst") = "" Then Response.Redirect("error2.asp?Error=Mother's First Name can't be blank") End if if Request.Form("MotherLast") = "same" Then Response.Redirect("error2.asp?Error=Mother's First Name, must be the actual name") End if if Request.Form("FatherLast") = "same" Then Response.Redirect("error2.asp?Error=Mother's First Name, must be the actual name") End if if Request.Form("County") = "" Then Response.Redirect("error2.asp?Error=County field for student can't be blank") End if if Request.Form("County") = "same" Then Response.Redirect("error2.asp?Error=County field must contain name of county") End if if Request.Form("EmailName") = "" Then Response.Redirect("error2.asp?Error=you must enter your email address to process form") End if if Request.Form("ChildLivesWith") = "" Then Response.Redirect("error2.asp?Error=you must enter child lives with to process form") End if FirstName = Request.Form("FirstName") MiddleName = Request.Form("MiddleName") LastName = Request.Form("LastName") Gender = Request.Form("Gender") Address = Request.Form("Address") Address = Replace(Address, "'", " ") MotherAddress = Replace(MotherAddress, "'", " ") FatherAddress = Replace(FatherAddress, "'", " ") City = Request.Form("City") StateOrProvince = Request.Form("StateOrProvince") PostalCode = Request.Form("PostalCode") PhoneNumber = Request.Form("PhoneNumber") DOB = Request.Form("DOB") Age = Request.Form("Age") Grade = Request.Form("Grade") Race = Request.Form("Race") Ethnicity = Request.Form("Ethnicity") EmailName = Request.Form("EmailName") FatherFirst = Request.Form("FatherFirst") FatherLast = Request.Form("FatherLast") FatherOccupation = Request.Form("FatherOccupation") FatherPhone = Request.Form("FatherPhone") FatherAddress = Request.Form("FatherAddress") FatherCity = Request.Form("FatherCity") FatherState = Request.Form("FatherState") FatherCounty = Request.Form("FatherCounty") FatherZip = Request.Form("FatherZip") FatherEmail = Request.Form("FatherEmail") MotherFirst = Request.Form("MotherFirst") MotherLast = Request.Form("MotherLast") MotherAddress = Request.Form("MotherAddress") MotherCity = Request.Form("MotherCity") MotherState = Request.Form("MotherState") MotherZip = Request.Form("MotherZip") MotherCounty = Request.Form("MotherCounty") MotherOccupation = Request.Form("MotherOccupation") MotherEmail = Request.Form("MotherEmail") MotherPhone = Request.Form("MotherPhone") FormerSchool = Request.Form("FormerSchool") FormerSchoolAddress = Request.Form("FormerSchoolAddress") FormerSchoolPhone = Request.Form("FormerSchoolPhone") Sibling = Request.Form("Sibling") Notes = Request.Form("Notes") Notes = Replace(Notes, "'", " ") MobilePhone = Request.Form("MobilePhone") ChildLivesWith = Request.Form("ChildLivesWith") SchoolApplied = "Charter Day School" DateSubmitted = Now SQLAdd = "INSERT INTO students_apply(FirstName,MiddleName,LastName,Gender,Address,City,State,ZipCode,County,PhoneNumber,DOB,Age,Grade,Race,Ethnicity,Email,FatherFirst,FatherLast,FatherOccupation,FatherPhone,FatherAddress,FatherCity,FatherState,FatherCounty,FatherEmail,FatherZipCode,MotherFirst,MotherLast,MotherAddress,MotherCity,MotherState,MotherZipCode,MotherCounty,MotherOccupation,MotherEmail,MotherPhone,FormerSchool,Notes,FormerSchoolAddress,FormerSchoolPhone,Sibling,MobilePhone,ChildLivesWith,SchoolApplied,DateSubmitted)Values('" SQLAdd = SQLAdd &FirstName&"','"&MiddleName&"','"&LastName&"','"&Gender&"','"&Address&"','"&City&"','"&StateOrProvince&"','"&PostalCode&"','"&County&"','"&PhoneNumber&"','"&DOB&"','"&Age&"','"&Grade&"','"&Race&"','"&Ethnicity&"','"&EmailName&"','"&FatherFirst&"','"&FatherLast&"','"&FatherOccupation&"','"&FatherPhone&"','"&FatherAddress&"','"&FatherCity&"','"&FatherState&"','"&FatherCounty&"','"&FatherEmail&"','"&FatherZip&"','"&MotherFirst&"','"&MotherLast&"','"&MotherAddress&"','"&MotherCity&"','"&MotherState&"','"&MotherZip&"','"&MotherCounty&"','"&MotherOccupation&"','"&MotherEmail&"','"&MotherPhone&"','"&FormerSchool&"','"&Notes&"','"&FormerSchoolAddress&"','"&FormerSchoolPhone&"','"&Sibling&"','"&MobilePhone&"','"&ChildLivesWith&"','"&SchoolApplied&"','"&DateSubmitted&"')" oConn.Execute SQLAdd oConn.Close Set oConn = nothing Response.Redirect("studentapplicationdone.asp") Else %>
 

2010-2011 Charter Day School
ONLINE APPLICATION FOR OPEN STUDENT ENROLLMENT
We are currently accepting applications. Please Disable all Pop-Up Blockers.

  
 

Student Information

please do not enter any apostrophes, quotation marks or parenthess into the form fields;
 doing so will produce errors and your application will not be received.

*First Name :
*Email :
*Middle Name :
*Address :
*Last Name :
*City :
*Date Of Birth (mm/dd/yyyy):
*State :
*Age :
*Zip :
*Gender :
*County :
*Race :

Black
American Indian
White
Asian
Hawaiian/Pacific

*Grade Applying For :
If child has sibling currently enrolled, please provide name of student :
*Ethnicity :

Non-Hispanic
Hispanic

 

Family Information

  
 
Father First Name :
Mother First Name :
Father Last Name :
Mother Last Name :
Father's Phone :
Mother's Phone :
Father's Address :
Mother's Address :
Father's City :
Mother's City :
Father's State :
Mother's State :
Father's Zip :
Mother's Zip :
Father's County :
Mother's County :
Father's Occupation :
Mother's Occupation :
 
 
With whom does child reside?

If other please explain below

Mobile Phone :

Academic Background

     
Former School :
    
Former School Address :
   
Former School Phone :
   
Reason For Leaving/OtherNotes:
  

* Required Fields
Double Check Spelling & Accuracy Before Submitting errors in entry may cause errors.
Errors may delay processing and possibly eliminate application from the lottery.

 
 
     
<% End if%>