Ext.onReady(function(){
Ext.QuickTips.init();
var fs = new Ext.FormPanel({
frame: true
,title:'Installer Qualification Questionnaire'
,labelAlign: 'right'
,labelWidth: 115
,width:840
,waitMsgTarget: true
,items:[{
layout:'column'
,frame: true
,items:[{
layout: 'form'
,id:'left_col'
,title:'General Company Information - Red Label Denotes Required Field'
,labelPad: 5
,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'left_col_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'Name', id: 'name', allowBlank: false, tabIndex: 1, itemCls:'fontRed'}
,{xtype: 'textfield', fieldLabel: 'Address', id: 'address1', allowBlank: false, tabIndex: 2, itemCls:'fontRed'}
,{xtype: 'textfield', fieldLabel: 'Address Cont', id: 'address2', tabIndex: 3}
,{xtype: 'textfield', fieldLabel: 'City', id: 'city', allowBlank: false, tabIndex: 4, itemCls:'fontRed'}
,{xtype: 'textfield', fieldLabel: 'State', id: 'state', allowBlank: false, tabIndex: 5, itemCls:'fontRed'}
,{xtype: 'textfield', fieldLabel: 'Zip', id: 'zip', allowBlank: false, tabIndex: 6, itemCls:'fontRed'}
,{xtype: 'textfield', fieldLabel: 'Emergency Contact', id: 'emergency_contact', tabIndex: 6}
,{xtype: 'textfield', fieldLabel: 'Emergency Phone', id: 'emergency_phone', tabIndex: 7}
]
},{
columnWidth:.34
,layout: 'form'
,id:'left_col_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'Phone#', id: 'phone1', allowBlank: false, tabIndex: 8 , itemCls:'fontRed'}
,{xtype: 'numberfield', fieldLabel: 'Extention', id: 'ext1',allowDecimals: false, allowNegative: false, tabIndex: 9}
,{xtype: 'textfield', fieldLabel: 'Fax', id: 'fax', tabIndex: 10}
,{xtype: 'textfield', fieldLabel: 'Website', id: 'www', tabIndex: 11} //vtype: 'url',
,{xtype: 'numberfield', fieldLabel: 'Open Time (AM)', id: 'open',allowDecimals: false, allowNegative: false, tabIndex: 12}
,{xtype: 'numberfield', fieldLabel: 'Close Time (PM)', id: 'close',allowDecimals: false, allowNegative: false, tabIndex: 13}
,{xtype: 'textfield', fieldLabel: 'Time Zone', id: 'time_zone', tabIndex: 14}
,{xtype: 'checkbox', fieldLabel: 'Minority Owner; (check for Yes)', id: 'minority_owner', tabIndex: 15}
]
},{
columnWidth:.33
,layout: 'form'
,id:'left_col_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'numberfield', fieldLabel: 'Years In Business', id: 'years',allowDecimals: false, allowNegative: false, tabIndex: 16}
,{xtype: 'numberfield', fieldLabel: 'Employees', id: 'employees',allowDecimals: false, allowNegative: false, tabIndex: 17}
,{xtype: 'numberfield', fieldLabel: 'crews', id: 'crews',allowDecimals: false, allowNegative: false, tabIndex: 18}
,{xtype: 'textfield', fieldLabel: 'Warehouse Size', id: 'whouse_area', tabIndex: 19}
,{xtype: 'checkbox', fieldLabel: 'Union
(check for Yes)', id: 'union', tabIndex: 20}
,{xtype: 'textfield', fieldLabel: 'If Union, please list', id: 'listed_union', tabIndex: 21}
,{xtype: 'checkbox', fieldLabel: 'Subcontract
(check for Yes)', id: 'subcontract', tabIndex: 22}
]
}
]}
]},
{
layout: 'form'
,id:'under_col'
,title:'Contact Information - Red Label Denotes Required Field'
,labelPad: 5
,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'under_col_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'Owner Name' ,id: 'name_a', allowBlank: false, tabIndex: 23, itemCls:'fontRed'}
,{xtype: 'numberfield', fieldLabel: 'Phone Ext' ,id: 'phone_a',allowDecimals: false, allowNegative: false, tabIndex: 24}
,{xtype: 'textfield', fieldLabel: 'Cell#' ,id: 'cell_a', tabIndex: 25}
,{xtype: 'textfield', fieldLabel: 'Email' ,id: 'email_a', vtype: 'email', tabIndex: 26, itemCls:'fontRed'}
]
},{
columnWidth:.34
,layout: 'form'
,id:'under_col_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'Primary Name' ,id: 'name_b', allowBlank: false, tabIndex: 27, itemCls:'fontRed'}
,{xtype: 'numberfield', fieldLabel: 'Phone Ext' ,id: 'phone_b',allowDecimals: false, allowNegative: false, tabIndex: 28}
,{xtype: 'textfield', fieldLabel: 'Cell#' ,id: 'cell_b', tabIndex: 29}
,{xtype: 'textfield', fieldLabel: 'Email' ,id: 'email_b', vtype: 'email', tabIndex: 30, itemCls:'fontRed'}
]
},{
columnWidth:.33
,layout: 'form'
,id:'under_col_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'Installation Name' ,id: 'name_c', tabIndex: 31}
,{xtype: 'numberfield', fieldLabel: 'Phone Ext' ,id: 'phone_c',allowDecimals: false, allowNegative: false, tabIndex: 32}
,{xtype: 'textfield', fieldLabel: 'Cell#' ,id: 'cell_c', tabIndex: 33}
,{xtype: 'textfield', fieldLabel: 'Email' ,id: 'email_c', tabIndex: 34}
]
}
]}
]},
{
layout: 'form'
,id:'under_col2'
,title:'References'
,labelPad: 5
,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'under_col2_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'Company Name' ,id: 'refname_a', tabIndex: 35}
,{xtype: 'textfield', fieldLabel: 'Contact' ,id: 'refcon_a', tabIndex: 36}
,{xtype: 'textfield', fieldLabel: 'Phone#' ,id: 'refphone_a', tabIndex: 37}
]
},{
columnWidth:.34
,layout: 'form'
,id:'under_col2_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'Company Name' ,id: 'refname_b', tabIndex: 38}
,{xtype: 'textfield', fieldLabel: 'Contact' ,id: 'refcon_b', tabIndex: 39}
,{xtype: 'textfield', fieldLabel: 'Phone#' ,id: 'refphone_b', tabIndex: 40}
]
},{
columnWidth:.33
,layout: 'form'
,id:'under_col2_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'Company Name' ,id: 'refname_c', tabIndex: 41}
,{xtype: 'textfield', fieldLabel: 'Contact' ,id: 'refcon_c', tabIndex: 42}
,{xtype: 'textfield', fieldLabel: 'Phone#' ,id: 'refphone_c', tabIndex: 43}
]
}
]}
]},
{
layout: 'form'
,id:'under_col3'
,title:'Territory Coverage'
,labelWidth: 30
,labelPad: 5
,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.33
,labelWidth: 30
,layout: 'form'
,id:'under_col3_a'
,labelPad: 5
,items: [
{
layout: 'form'
,id:'under_colx'
,title:'Area'
,labelPad: 5
//,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.60
,layout: 'form'
,id:'under_colx_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_a', tabIndex: 44}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_b', tabIndex: 46}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_c', tabIndex: 48}
]
},
{
columnWidth:.40
,layout: 'form'
,id:'under_colx_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_a', tabIndex: 45, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_b', tabIndex: 47, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_c', tabIndex: 49, width: 50}
]
}
]}
]}]},
{
columnWidth:.33
,layout: 'form'
,id:'under_col3_b'
,labelPad: 5
,items: [
{
layout: 'form'
,id:'under_coly'
,title:'Area'
,labelPad: 5
//,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.60
,layout: 'form'
,id:'under_colx_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_d', tabIndex: 50}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_e', tabIndex: 52}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_f', tabIndex: 54}
]
},{
columnWidth:.40
,layout: 'form'
,id:'under_colx_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_d', tabIndex: 51, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_e', tabIndex: 53, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_f', tabIndex: 55, width: 50}
]
}
]}
]}]},{
columnWidth:.33
,layout: 'form'
,id:'under_col3_c'
,labelPad: 5
,items: [
{
layout: 'form'
,id:'under_colz'
,title:'Area'
,labelPad: 5
// ,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.60
,layout: 'form'
,id:'under_colx_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_g', tabIndex: 56}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_h', tabIndex: 58}
,{xtype: 'textfield', fieldLabel: 'City' ,id: 'city_i', tabIndex: 60}
]
},{
columnWidth:.40
,layout: 'form'
,id:'under_colx_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_g', tabIndex: 57, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_h', tabIndex: 59, width: 50}
,{xtype: 'textfield', fieldLabel: 'ST' ,id: 'state_i', tabIndex: 61, width: 50}
]
}
]}
]}]}
]
}
]},
{
layout: 'form'
,id:'under_col4'
,title:'Other Related Servides You May Offer - (check for Yes)'
,labelPad: 5
,width:840
,labelWidth: 160
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'under_col2_a'
,labelPad: 5
,items: [
{xtype: 'checkbox', fieldLabel: 'Cable Routing',
id: 'cab_rout', tabIndex: 62}
,{xtype: 'checkbox', fieldLabel: 'Software Provider',
id: 'soft_prov', tabIndex: 63}
,{xtype: 'checkbox', fieldLabel: 'Structural Elements',
id: 'stru_elem', tabIndex: 64}
,{xtype: 'checkbox', fieldLabel: 'Licensed Electrician',
id: 'Lic_elec', tabIndex: 65}
]
},{
columnWidth:.34
,layout: 'form'
,id:'under_col2_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'checkbox', fieldLabel: 'Hardware Provider',
id: 'hard_prov', tabIndex: 66}
,{xtype: 'checkbox', fieldLabel: 'Maintenance of Content',
id: 'mait_con', tabIndex: 67}
,{xtype: 'checkbox', fieldLabel: 'Maintenance of Hardware',
id: 'mait_har', tabIndex: 68}
,{xtype: 'checkbox', fieldLabel: 'Surveys',
id: 'surv', tabIndex: 69}
]
},{
columnWidth:.33
,layout: 'form'
,id:'under_col2_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'checkbox', fieldLabel: 'Permit Service',
id: 'perm_serv', tabIndex: 70}
,{xtype: 'checkbox', fieldLabel: 'General Contracting',
id: 'gen_con', tabIndex: 71}
,{xtype: 'checkbox', fieldLabel: 'Excavating/Trenching',
id: 'exav_tren', tabIndex: 72}
,{xtype: 'checkbox', fieldLabel: 'Master Licensed Electrician',
id: 'mast_elec', tabIndex: 73}
]
}
]}
]},
{
layout: 'form'
,id:'under_col5'
,title:'Installation Rates'
,labelPad: 5
,width:840
,labelWidth: 120
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'under_col2_a'
,labelWidth: 80
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_a', tabIndex: 74}
,{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_b', tabIndex: 77}
,{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_c', tabIndex: 80}
,{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_d', tabIndex: 83}
,{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_e', tabIndex: 87}
,{xtype: 'textfield', fieldLabel: 'Service Type' ,id: 'servt_f', tabIndex: 90}
]
},{
columnWidth:.34
,layout: 'form'
,id:'under_col2_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'numberfield', fieldLabel: 'One Person Rate($)' ,id: 'servt_a1',allowDecimals: true, allowNegative: false, tabIndex: 75}
,{xtype: 'numberfield', fieldLabel: 'One Person Rate' ,id: 'servt_b1',allowDecimals: true, allowNegative: false, tabIndex: 78}
,{xtype: 'numberfield', fieldLabel: 'One Person Rate' ,id: 'servt_c1',allowDecimals: true, allowNegative: false, tabIndex: 81}
,{xtype: 'numberfield', fieldLabel: 'One Person Rate' ,id: 'servt_d1',allowDecimals: true, allowNegative: false, tabIndex: 84}
,{xtype: 'numberfield', fieldLabel: 'One Person Rate' ,id: 'servt_e1',allowDecimals: true, allowNegative: false, tabIndex: 87}
,{xtype: 'numberfield', fieldLabel: 'One Person Rate' ,id: 'servt_f1',allowDecimals: true, allowNegative: false, tabIndex: 90}
]
},{
columnWidth:.33
,layout: 'form'
,id:'under_col2_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'numberfield', fieldLabel: 'Two Person Rate($)' ,id: 'servt_a2',allowDecimals: true, allowNegative: false, tabIndex: 76}
,{xtype: 'numberfield', fieldLabel: 'Two Person Rate' ,id: 'servt_b2',allowDecimals: true, allowNegative: false, tabIndex: 79}
,{xtype: 'numberfield', fieldLabel: 'Two Person Rate' ,id: 'servt_c2',allowDecimals: true, allowNegative: false, tabIndex: 82}
,{xtype: 'numberfield', fieldLabel: 'Two Person Rate' ,id: 'servt_d2',allowDecimals: true, allowNegative: false, tabIndex: 85}
,{xtype: 'numberfield', fieldLabel: 'Two Person Rate' ,id: 'servt_e2',allowDecimals: true, allowNegative: false, tabIndex: 88}
,{xtype: 'numberfield', fieldLabel: 'Two Person Rate' ,id: 'servt_f2',allowDecimals: true, allowNegative: false, tabIndex: 91}
]
}
]}
]},
{
layout: 'form'
,id:'under_col6'
,title:'Certifications / Associations'
,labelPad: 5
,labelWidth: 180
,width:840
,items:[{
layout:'column',
items:[{
columnWidth:.40
,layout: 'form'
,id:'under_col2_a'
,labelPad: 5
,items: [
{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'cert_a', tabIndex: 92}
,{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'cert_b', tabIndex: 94}
,{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'certt_c', tabIndex: 96}
,{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'cert_d', tabIndex: 98}
,{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'cert_e', tabIndex: 100}
,{xtype: 'textfield', fieldLabel: 'Cert/Assoc' ,id: 'cert_f', tabIndex: 102}
]
},{
columnWidth:.60
,layout: 'form'
,id:'under_col2_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_a1', tabIndex: 93}
,{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_b1', tabIndex: 95}
,{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_c1', tabIndex: 97}
,{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_d1', tabIndex: 99}
,{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_e1', tabIndex: 101}
,{xtype: 'textfield', fieldLabel: 'How long a member?' ,id: 'cert_f1', tabIndex: 103}
]
}
]}
]},
{
layout: 'form'
,id:'under_col7'
,title:'Digital Sign Experience - (check for Yes)'
,labelPad: 5
,width:840
,labelWidth: 160
,items:[{
layout:'column',
items:[{
columnWidth:.33
,layout: 'form'
,id:'under_col2_a'
,labelPad: 5
,items: [
{xtype: 'checkbox', fieldLabel: 'Menu Boards',
id: 'men_boar'}
,{xtype: 'checkbox', fieldLabel: 'Retail',
id: 'retail'}
,{xtype: 'checkbox', fieldLabel: 'Kiosks',
id: 'kiosks'}
,{xtype: 'checkbox', fieldLabel: 'Neon',
id: 'neon'}
,{xtype: 'textfield', fieldLabel: 'Other' ,id: 'other_d1'}
]
},{
columnWidth:.34
,layout: 'form'
,id:'under_col2_b'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'checkbox', fieldLabel: 'Corporate',
id: 'corp'}
,{xtype: 'checkbox', fieldLabel: 'Financial',
id: 'fin'}
,{xtype: 'checkbox', fieldLabel: 'Hotel',
id: 'hotel'}
,{xtype: 'checkbox', fieldLabel: 'Outdoor Menu',
id: 'out_men'}
,{xtype: 'textfield', fieldLabel: 'Other' ,id: 'other_d2'}
]
},{
columnWidth:.33
,layout: 'form'
,id:'under_col2_c'
,labelPad: 5
,defaults: {
msgTarget: 'side'
}
,items: [
{xtype: 'checkbox', fieldLabel: 'Government',
id: 'govn'}
,{xtype: 'checkbox', fieldLabel: 'Way finders',
id: 'way_fin'}
,{xtype: 'checkbox', fieldLabel: 'Airport',
id: 'airpo'}
,{xtype: 'checkbox', fieldLabel: 'Restaurant',
id: 'restraunt'}
,{xtype: 'textfield', fieldLabel: 'Other' ,id: 'other_d3'}
]//
}
]}
]}
]}
]});
var submit = fs.addButton({
text: 'Submit',
handler: function(){
//alert(document.getElementById('way_fin').checked);
fs.getForm().submit({
url: 'mailthis.php',
// params: {
// men_boarx: document.getElementById('men_boar').checked},
waitMsg: 'Please Wait ...',
failure: function () {
Ext.MessageBox.show({
title: 'Error Sending Message',
msg: 'There was an error in sending your data.',
buttons: Ext.MessageBox.OK,
icon: Ext.MessageBox.ERROR
});
},
success : function(response){
submit.disable();
submit.setVisible(false);
Ext.Msg.alert('Success', 'Your Data has been sent. Thank You.');
}
})
}
});
fs.render('form-ct');
});
Ext.form.XmlErrorReader = function(){
Ext.form.XmlErrorReader.superclass.constructor.call(this, {
record : 'field',
success: '@success'
}, [
'id', 'msg'
]
);
};
Ext.extend(Ext.form.XmlErrorReader, Ext.data.XmlReader);