Please enter a valid and not gmail, hotmail or yahoo email."; $error = 1; } if ($firstname == "") { $firstname_failed="Please enter your first name."; $error = 1; } if ($lastname == "") { $lastname_failed="Please enter your last name."; $error = 1; } if($company == "") { $company_failed="Please enter your company name."; $error = 1; } if ($phone == "" || $area == "") { $phone_failed="Please enter area code and phone number."; $error = 1; } // if($street == "") // { // $street_failed="Please enter street."; // $error = 1; // } // if($suburb == "") // { // $suburb_failed="Please enter suburb."; // $error = 1; // } if($city == "") { $city_failed="Please enter city."; $error = 1; } if ($country == "") { $country_failed="Please enter country."; $error = 1; } // if ($position == "") // { // $position_failed="Please enter position."; // $error = 1; // } // if ($industry == "") // { // $industry_failed="Please enter a suitable industry type for your business."; // $error = 1; // } if ($employees == "") { $employees_failed="Please enter the number of employees."; $error = 1; } if($hear == "None selected" || $hear == "") { $hear_failed="Please choose one option.
"; $error = 1; } if ($newsletter == "") { $newsletter_failed="Please choose one option."; $error = 1; } // if($state == "" || $zip == "") // { // $state_failed="Please enter the state and zip code."; // $error = 1; // } if (register::is_registered($email) == "failed") { $email_failed="Sorry. This email has been registered already. Please try another one."; $error = 1; } if ($error == 1) { $error_msg = "
   Required fields input missing or error.
"; }else { //send email to admin $to = "info@centranum.com"; $subject = "A demo was requested"; $message = "A demo was requested by;
name: $firstname $lastname
email: $email
demo: ".$article->title. "
newsletter: $newsletter
review: $review
software: $software"; if (sendmail($to, $subject, $message, $headers)=="error") { $error_msg = "
   Sorry! The email failed to deliver to $email. Please try again later.
"; $maildeliver = "n"; }else { $maildeliver = "y"; } //insert a new record into the register table $register = new Register(); $register->set_firstname($firstname); $register->set_lastname($lastname); $register->set_email($email); $register->set_company($company); $register->set_areacode($area); $register->set_phone($phone); $register->set_street($street); $register->set_city($city); $register->set_position($position); $register->set_country($country); $register->set_industry($industry); $register->set_employees($employees); $register->set_hear($hear); $register->set_state($state); $register->set_zip($zip); $register->set_suburb($suburb); $register->set_special($special); $register->set_newsletter($newsletter); $register->set_maildeliver($maildeliver); $register->set_register_date($register_date); $newregister = $register->store(); if($maildeliver == "y") { //confirm message header("location: register_confirm.php"); } } } //-- news letter radio buttons if ($newsletter == 'n') { $letter_display = "Yes
"; $letter_display .= "No
"; }else { $letter_display = "Yes
"; $letter_display .= "No
"; } //-- how to find us selector $hear_opt_arr = get_hear_options(); $hear_val_arr = get_hear_values(); $hear_display = ""; ?> Centranum HRadvance - Registration for test drive




 

Request for Test Drive

Please complete all the details below. Required fields marked **.
We will be in touch with you shortly.

First Name:**
Last Name:**
Company:**
Position:
Phone:**
   
E-Mail ** (not gmail/Yahoo/Hotmail)
Street:
Suburb:
City:**
State/Zip or Postcode:   
Country:**
   
   
Industry:
Number of employees:**
Special requirements:

Please tell us how you found us:**



Receive Centranum newsletter with latest Talent & Performance management research:




Privacy Policy: The information above is requested for the purpose of providing to you information about our products and services. Confidentiality will be maintained. The information will not be provided to third parties, nor used for any other purpose.



 
image
image
 image