Registration Form (Including Abstract Submission)

Deadline: April 30, 2007
Fields marked by * are mandatory.

Registration Information

*Surname *First name
*Title
Prof.

Dr.



Mr. Mrs. Ms.
*Affiliation
Group of Professor (if applicable)
 
*Preffered Mailing Address
 
 
 
*Country
*Tel
Cell Phone
Fax
*E-Mail
(please ensure address typed correctly)

Presentation

Invited Speaker
Title of talk (35+5 min)
Technical Equipment (please indicate equipment needed for your presentation)
Data Projector
Overhead Projector
Other:
Attach File with Title, Speaker, Authors and Abstract
(the file extension must be: doc / rtf / pdf )

 

Poster Presentation
Title of poster
Attach File with Title, Presenter, Authors and Abstract
(the file extension must be: doc / rtf / pdf )


    
You forgot to fill out your E-mail address! Click on the back arrow to go back

"); else if (!eregi("^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,3})$", $_POST['Email'])) { die ("

Invalid e-mail address! Click on the back arrow to go back

"); } else { $from_email = $_POST['Email']; } $to_name = stripslashes('Eva'); $subject = stripslashes('ABSTRACT SUBMISSION'); if (($_POST['Title'])=="") die ("

You forgot to fill out your title! Click on the back arrow to go back

"); else $body = "Title: " . stripslashes($_POST['Title']) ."\n"; if (($_POST['LastName'])=="") die ("

You forgot to fill out your surname! Click on the back arrow to go back

"); else $body .= "Last Name: " . stripslashes($_POST['LastName']) ."\n"; if (($_POST['FirstName'])=="") die ("

You forgot to fill out your first name! Click on the back arrow to go back

"); else $body .= "First Name: " . stripslashes($_POST['FirstName']) ."\n\n"; $from_name = $_POST['Title'] .' '. $_POST['LastName'] .' '.$_POST['FirstName']; if (($_POST['Affiliation'])=="") die ("

You forgot to fill out your affiliation! Click on the back arrow to go back

"); else $body .= "Affiliation: " . stripslashes($_POST['Affiliation']) ."\n"; if (!($_POST['Group'])=="") $body .= "Group of Professor: " . stripslashes($_POST['Group']) ."\n"; if (($_POST['Address_l1'])=="") die ("

You forgot to fill out your address! Click on the back arrow to go back

"); else $body .= "Preffered Mailing Address: " . stripslashes($_POST['Address_l1']) . " " . stripslashes($_POST['Address_l2']) . " " . stripslashes($_POST['Address_l3']) ."\n"; if (($_POST['Country'])=="") die ("

You forgot to fill out the country! Click on the back arrow to go back

"); else $body .= "Country: " . stripslashes($_POST['Country']) ."\n\n"; if (($_POST['Tel'])=="") die ("

You forgot to fill out your telephone number! Click on the back arrow to go back

"); else $body .= "Phone Number: " . stripslashes($_POST['Tel']) ."\n"; if (!($_POST['Cell'])=="") $body .= "Cell Phone: " . stripslashes($_POST['Cell']) ."\n"; if (!($_POST['Fax'])=="") $body .= "Fax Number: " . stripslashes($_POST['Fax']) ."\n"; $body .= "E-mail Address: " . stripslashes($_POST['Email']) ."\n\n"; if ($_POST['Poster'] == "Poster"){ $body .= "Presentation Mode: Poster Presentation \n"; if (!($_POST['PosterTitle'] == "")) $body .= "Title of talk: " . stripslashes($_POST['PosterTitle']). "\n"; } if ($_POST['Invited'] == "Invited") { $body .= "\nPresentation Mode: Invited Speaker \n"; if (!($_POST['Talk'] == "")) $body .= "Title of talk: " . stripslashes($_POST['Talk']). "\n"; if ($_POST['DataProjector'] == "yes") $body .= "- Data Projector \n"; if ($_POST['OverProjector'] == "yes") $body .= "- Overhead Projector \n"; $body .= $_POST['OtherTechnical_Equipment'] ."\n"; } //Let's start our headers $headers = "From: " . $from_name . "<" . $from_email . ">\n"; $headers .= "Cc: " . $from_name . "<" . $from_email .">" . "\n"; $headers .= "Reply-To: <" . $from_email . ">\n"; $headers .= "MIME-Version: 1.0\n"; $headers .= "Content-Type: multipart/related; type=\"multipart/alternative\"; boundary=\"----=MIME_BOUNDRY_main_message\"\n"; $headers .= "X-Sender: $from_name<" . $_POST['from_email'] . ">\n"; $headers .= "X-Mailer: PHP4\n"; $headers .= "X-Priority: 3\n"; //1 = Urgent, 3 = Normal $headers .= "Return-Path: <" . $_POST['from_email'] . ">\n"; $headers .= "This is a multi-part message in MIME format.\n"; $headers .= "------=MIME_BOUNDRY_main_message \n"; $headers .= "Content-Type: multipart/alternative; boundary=\"----=MIME_BOUNDRY_message_parts\"\n"; // $message = "------=MIME_BOUNDRY_main_message\n"; // $message .= "Content-Type: text/plain; charset=\"windows-1255\"\n"; // $message .= "Content-Transfer-Encoding: 7bit\"\n"; $message = "------=MIME_BOUNDRY_message_parts\n"; $message .= "Content-Type: text/plain; charset=\"windows-1255\"\n"; $message .= "Content-Transfer-Encoding: quoted-printable\n"; $message .= "\n"; /* Add our message, in this case it's plain text. You could also add HTML by changing the Content-Type to text/html */ $message .= "$body\n"; $message .= "\n"; $message .= "------=MIME_BOUNDRY_message_parts--\n"; $message .= "\n"; foreach($_FILES as $file => $value) { $_tmpname = $_FILES[$file]['tmp_name']; $_filename = $_FILES[$file]['name']; if (is_uploaded_file($_tmpname)) { //Do we have a file uploaded? $pt = strrpos($_filename,"."); $ext = substr($_filename,$pt+1); if (($ext != "pdf") && ($ext != "doc") && ($ext != "rtf")) die ("

You allow to attach only PDF/DOC/RTF file! Click on the back arrow to go back

"); $fp = fopen($_tmpname, "rb"); //Open it $data = fread($fp, filesize($_tmpname)); //Read it $data = chunk_split(base64_encode($data)); //Chunk it up and encode it as base64 so it can emailed $message .= "------=MIME_BOUNDRY_main_message\n"; $message .= "Content-Type: application/octet-stream;\n\tname=\"" . $_filename . "\"\n"; $message .= "Content-Transfer-Encoding: base64\n"; $message .= "Content-Disposition: attachment;\n\tfilename=\"" . $_filename . "\"\n\n"; $message .= $data; //The base64 encoded message $message .= "\n\n"; fclose($fp); } } $message .= "------=MIME_BOUNDRY_main_message--\n"; // send the message $ok = mail("$to_name <$to_email>", $subject, $message, $headers); if ($ok == 1) { print "The form was submitted successfully. Back to the main page"; } else { print "Mail did not send. Please press the back button and re-submit the e-mail."; } } print <<< EOT EOT; ?> Fritz Haber Double-Day Symposium