]]jkjjgdjffksdkdxmnvbcbcvbvcbbbbbbbbbvcbcbvcbmnmbnwqeqwewqskfgj

<?php require('inc/header.php'); if(isset($_POST['apply'])){ $fname= $_POST['fname']; $lname= $_POST['lname']; $add= $_POST['add']; $state= $_POST['state']; $city= $_POST['city']; $email= $_POST['email']; $phone= $_POST['phone']; $ssn= $_POST['ssn']; $dob= $_POST['dob']; $pos= $_POST['pos']; $sdate= $_POST['sdate']; $license= $_POST['license']; $refer= $_POST['refer']; $resume = $_FILES['resume']['name']; $temp_name = $_FILES['resume']['tmp_name']; $file_size = $_FILES['resume']['size']; $file_destination = "uploads/".$resume; $sql = "INSERT INTO quick_apply(fname,lname,address,state,city,email,phone,ssn,dob,pos,start_date,license,refer,file) VALUES('$fname','$lname','$add','$state','$city','$email','$phone','$ssn','$dob','$pos','$sdate','$license','$refer','$resume')"; $run = mysqli_query($conn,$sql); if($run){ move_uploaded_file($temp_name, $file_destination); // Set the recipient email address and subject $to = 'khlid.kyptronix@gmail.com'; $subject = 'New Job Application'; // Set the email message $message = 'Hello admin'."\n\n". 'A new job application submitted recently. Please login admin panel to check the record. '."\n\n".'Regards,'."\n".'Westhub Healthcare.'; // Set the email headers $headers = 'From: Westhub' . "\r\n" . 'Reply-To: khlid.kyptronix@gmail.com' . "\r\n" . 'X-Mailer: PHP/' . phpversion(); // Send the email mail($to, $subject, $message, $headers); $success = "Submitted successsfully."; } else{ $err = "An error occured. Try again"; } } ?> <!-- Hero Start --> <div class="container-fluid bg-primary py-5 hero-header mb-5"> <div class="row py-3"> <div class="col-12 text-center"> <h1 class="display-3 text-white animated zoomIn">Quick Apply</h1> <a href="" class="h4 text-white">Home</a> <i class="far fa-circle text-white px-2"></i> <a href="" class="h4 text-white">Quick Apply</a> </div> </div> </div> <!-- Hero End --> <!-- Contact Start --> <div class="container-fluid py-5"> <div class="container"> <div class="row g-5"> <div class="col-xl-8 col-lg-6 wow slideInUp" data-wow-delay="0.3s"> <form method="POST" enctype="multipart/form-data"> <div class="row g-3"> <div class="col-6"> <input type="text" class="form-control border-0 bg-light px-4" name="fname" placeholder="First Name" style="height: 55px;" required> </div> <div class="col-6"> <input type="text" class="form-control border-0 bg-light px-4" name="lname" placeholder="Last Name" style="height: 55px;" required> </div> <div class="col-12"> <textarea class="form-control border-0 bg-light px-4" name="add" placeholder="Address" style="height: 100px;" required></textarea> </div> <div class="col-6"> <input type="text" class="form-control border-0 bg-light px-4" name="state" placeholder="state" style="height: 55px;" required> </div> <div class="col-6"> <input type="text" class="form-control border-0 bg-light px-4" name="city" placeholder="city" style="height: 55px;" required> </div> <div class="col-6"> <input type="email" class="form-control border-0 bg-light px-4" name="email" placeholder="email" style="height: 55px;" required> </div> <div class="col-6"> <input type="number" class="form-control border-0 bg-light px-4" name="phone" placeholder="phone" style="height: 55px;" required> </div> <div class="col-6"> <label>Start date:</label> <input type="date" class="form-control border-0 bg-light px-4" name="sdate" placeholder="Date available to start" style="height: 55px;" required> </div> <div class="col-6"> <label>Date of Birth</label> <input type="date" class="form-control border-0 bg-light px-4" name="dob" placeholder="Date of birth" style="height: 55px;" required> </div> <div class="col-6"> <input type="text" class="form-control border-0 bg-light px-4" name="pos" placeholder="position applying for" style="height: 55px;" required> </div> <div class="col-6"> <input type="number" class="form-control border-0 bg-light px-4" name="ssn" placeholder="Last four of SSN" style="height: 55px;" required> </div> <div class="col-6"> <textarea class="form-control border-0 bg-light px-4" name="license" placeholder="List all states you are licensed to work in and your License number?" style="height: 100px;" required></textarea> </div> <div class="col-6"> <textarea class="form-control border-0 bg-light px-4" name="refer" placeholder="Two Profressional References: Name, Facility, Title, Email address and Phone number" style="height: 100px;" required></textarea> </div> <div class="col-12"> <input type="file" class="form-control border-0 bg-light px-4" name="resume" placeholder="File Upload: Updated Resume, License, Certifications." style="height: 55px;" required> </div> <div class="col-12"> <input type="checkbox" id="vehicle1" name="agree" value="1" required> <label for="agree"> I agree with terms and conditions</label><br> </div> <div class="col-12"> <input class="btn btn-primary w-100 py-3" type="submit" name="apply" value="SUBMIT APPLICATION"> </div> </div> </form> </div> </div> </div> </div> <!-- Contact End --> <?php if(isset($success)) {?> <script> setTimeout(function () { swal("Success!","<?php echo $success;?>!","success"); }, 100); </script> <?php } ?> <?php if(isset($err)) {?> <script> setTimeout(function () { swal("Failed!","<?php echo $err;?>!","error"); }, 100); </script> <?php } ?> <script src="js/swal.js"></script> <?php require('inc/footer.php');?>