
<!DOCTYPE html>
<html lang="en" dir="ltr">
  <head>
     <link rel="stylesheet" href="table.css">
    <link rel="stylesheet" href="newMemberApplicationForm.css">
    <link rel="stylesheet" href="includes/form.css">

    <meta charset="utf-8">
    <title>New Member Intake Form</title>
    

    <link rel="stylesheet" href="includes/time.css">
    <link rel="stylesheet" href="includes/main12.css">

    <script type="text/javascript">

function SetDate()
{
var date = new Date();

var day = date.getDate();
var month = date.getMonth() + 1;
var year = date.getFullYear();

if (month < 10) month = "0" + month;
if (day < 10) day = "0" + day;

var today = year + "-" + month + "-" + day;


document.getElementById('theDate').value = today;
}
</script>



  </head>
  <body onload= SetDate()>


  <?php include 'header.php' ?>
<section>
    <form action="newMemberApplicationProcess.php" method="post">
  <div class="field">
    <h2>To request to become a member, Please fill out this Form</h2>
  </div>

  <div class="formmain">
    <form  method="post">
      <div class="field12">
       <p><label for="GuestFirstName">Enter First Name :</label></p>
      <p><input type="text" name="NewMemberFirstName" id="NewMemberFirstName"></p>
      </div>

      <div class="field12">
        <p><label for="NewMemberLastName">Enter Last Name :</label></p>
      <p><input type="text" name="NewMemberLastName" id="NewMemberLastName"></p>
      </div>

      <div class="field12">
        <p><label for="NewMemberEmail">Enter Email:</label></p>
      <p><input type="text" name="NewMemberEmail" id="NewMemberEmail"></p>
      </div>

      <div class="field12">
        <p><label for="NewMemberPhoneNumber">Enter Phone Number :</label></p>
      <p><input type="text" name="NewMemberPhoneNumber" id="NewMemberPhoneNumber"></p>
      </div>
      
      <div class="field12">
        <p><label for="NewMemberMaritalStatus">Your Current Marital Status :</label></p>
      <p><input type="radio" name="NewMemberMaritalStatus" id="NewMemberMaritalStatus" placeholder="Married"> Married</p>
      <p><input type="radio" name="NewMemberMaritalStatus" id="NewMemberMaritalStatus" placeholder="Single"> Single</p>
      <p><input type="radio" name="NewMemberMaritalStatus" id="NewMemberMaritalStatus" placeholder="Other"> Other</p>
      </div>

      <div class="field12">
        <p><label for="NewMemberLastChurch">Last previous Church where you were Member too :</label></p>
      <p><input type="text" name="NewMemberLastChurch" id="NewMemberLastChurch" ></p>
      </div>
      
      <div class="field12">
          <p><label for="NewMemberBirthDay"> Enter your Birthday</label>
          <p><input type="date" name="NewMemberBirthDay" id="NewMemberBirthDay" </p></p>
      </div>
      
      <div class="field12">
          <p><label for="NewMemberFormPastor"> Enter your Previous Pastor Name (if any)</label>
          <p><input type="text" name="NewMemberFormPastor" id="NewMemberFormPastor" </p></p>
      </div>
      
      
      <div class="field12">

        <p><button class="button"> Submit </button></P>
        </div>

    </form>
  </div>

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</section>


</body>
</html>
