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* The template for displaying all pages.
* This is the template that displays all pages by default.
* Please note that this is the WordPress construct of pages
* and that other 'pages' on your WordPress site will use a
* different template.
* Template Name: Corporate
* @package WordPress
* @subpackage Twenty_Ten
* @since Twenty Ten 1.0
if(isset($_POST[company_id]) && $_POST[company_id]!="")
$passkey = mysql_real_escape_string($_POST['company_id']);
$query = "SELECT * FROM `corporate_promo` WHERE passkey = '$passkey' LIMIT 1";
// Insert a row of information into the "category" table
$result = mysql_query($query) or die(mysql_error());
$promoCompany = mysql_fetch_assoc($result);
//header('Location: index.php?error=true');
$msg="<font color='#f00'>Invalid ID</font>";
<div id="main-leftCol">
<div id="content-leftCol">
<div id="service1">
<div class="sec1">
<!--<h1 class="entry-title">Corporate Wellness Partnership BETA</h1>-->
<h1>Corporate Wellness Partnership</h1>
<div class="serv-img-right"><img src="images/services/service-partnership.png" width="274" height="337" alt="Corporate Wellness Partnership" /></div><br />
<form id="form1" name="form1" method="post" action="personal-info">
Already have an ID? Login here:
<input name="company_id" id="company_id" type="text" size="8" />
<input type="submit" name="button" id="button" value="Go" />
<?php print $msg?>
if( $url[1] =="error")
<font color="#f00">Sorry, that ID is not recognized. Please try again.</font>
<p>2nd Wind's Corporate Wellness Partnership is a free health benefits program, open to any corporation, business, or government organization with a minimum of 50 full-time employees.</p>
<p>The CWP offers a variety of benefits, including discounts on equipment and accessories, as well as free set-up and delivery.</p>
<p>For more information and instructions about this program, please <a href="/wp-content/uploads/2011/03/cwp_info.pdf" target="_blank">click here</a>.</p>
<h1>Apply For Enrollment</h1>
<p>If your company meets the requirements in the above link and you would like to apply to this FREE program, please fill out the form below and you will be contacted<br />very soon:</p>
<form action="" method="get" class="cwp-form">
<label for="textfield">Company Name:</label>
<input type="text" name="textfield3" id="textfield" />
<br />
<label for="label">Company Address:</label>
<input type="text" name="textfield4" id="label" />
<br />
<label for="label2">Your First Name:</label>
<input type="text" name="textfield5" id="label2" />
<br />
<label for="label3">Your Last Name:</label>
<input type="text" name="textfield6" id="label3" />
<br />
<label for="label4">Your Email Address:</label>
<input type="text" name="textfield7" id="label4" />
<br />
<label for="label5">Your Phone Number:</label>
<input type="text" name="textfield8" id="label5" />
<br />
<br />
Are you authorized to make HR/Benefits decisions for your company?
<input name="radiobutton" type="radio" value="radiobutton" id="radiobutton" />Yes
<input name="radiobutton" type="radio" value="radiobutton" id="radio" />No
<br />
<br />
<label for="Submit"></label>
<input type="submit" name="Submit" value="Submit" id="Submit" />
</form> <span class="edit-link"><a class="post-edit-link" href=";action=edit" title="Edit Page">Edit</a></span>
<div><script type="text/javascript" src=""></script><noscript><a href="" title="Online Form">Online Form - Corporate Wellness Partnership</a></noscript></div>
<!-------------- Right Column Started -------------->
<div id="main-rightCol">
<div id="sidebar">
<? dynamic_sidebar("blog-sidebar-widget") ?>
<!-------------- Right Column end -------------->
<?php get_footer(); ?>