<?php

/* DorcasTabithaBundle:Print:promissoryform.html.twig */
class __TwigTemplate_3b9b03bf858362438055d8c90ca653c9 extends Twig_Template
{
    public function __construct(Twig_Environment $env)
    {
        parent::__construct($env);

        $this->parent = $this->env->loadTemplate("::base.html.twig");

        $this->blocks = array(
            'image' => array($this, 'block_image'),
            'clientname' => array($this, 'block_clientname'),
            'body' => array($this, 'block_body'),
            'logout' => array($this, 'block_logout'),
            'javascripts' => array($this, 'block_javascripts'),
            'stylesheets' => array($this, 'block_stylesheets'),
        );
    }

    protected function doGetParent(array $context)
    {
        return "::base.html.twig";
    }

    protected function doDisplay(array $context, array $blocks = array())
    {
        $this->parent->display($context, array_merge($this->blocks, $blocks));
    }

    // line 2
    public function block_image($context, array $blocks = array())
    {
    }

    // line 3
    public function block_clientname($context, array $blocks = array())
    {
    }

    // line 4
    public function block_body($context, array $blocks = array())
    {
        // line 5
        echo "
<div id=\"user_edit\" style=\"zoom: 90%;padding-left:40px;\" >

<div id=\"override_javascript_alert\"></div>

    <form id=\"clientform\" action=\"";
        // line 10
        if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
        echo twig_escape_filter($this->env, $this->env->getExtension('routing')->getPath("DorcasTabithaBundle_print_promissoryShow", array("client_id" => $this->getAttribute($_client_, "clientid"))), "html", null, true);
        echo "\" method=\"post\" ";
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderEnctype($_form_);
        echo " class=\"dorcas\" style=\" font-size:14px;\">


\t\t<body style=\"padding: 60px; padding-top:20px; background-color: #cdf1f1; \"> 


\t\t\t<center><img src=\"";
        // line 16
        echo twig_escape_filter($this->env, $this->env->getExtension('assets')->getAssetUrl("bundles/dorcastabitha/images/dorcasLogoVertical.png"), "html", null, true);
        echo "\" alt=\"Dorcas\">
\t\t\t<h4>
\t\t\t187 High House Road<br />
\t\t\tCary, NC 27511<br />
\t\t\t</h4>

\t\t\t<h1>Promissory Note</h1></center>
\t\t\t

\t\t\t<p style=\"line-height:180%; padding-left: 20px;\">

\t\t\t\t<strong>Date:</strong> ";
        // line 27
        echo twig_escape_filter($this->env, twig_date_format_filter($this->env, "now", "m/d/Y"), "html", null, true);
        echo "
\t\t\t\t<span style=\"padding-left:250px;\"><strong>Counselor:</strong> ";
        // line 28
        if (isset($context["promissory"])) { $_promissory_ = $context["promissory"]; } else { $_promissory_ = null; }
        echo twig_escape_filter($this->env, $this->getAttribute($_promissory_, "counselor"), "html", null, true);
        echo "</span>
\t\t\t\t<br />
\t\t\t\t<strong>Client Name:</strong> ";
        // line 30
        if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
        echo twig_escape_filter($this->env, $this->getAttribute($_client_, "FullName"), "html", null, true);
        echo " 
\t\t\t\t<br />
\t\t\t\t<strong>Client Address:</strong> ";
        // line 32
        if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
        echo twig_escape_filter($this->env, $this->getAttribute($_client_, "fulladdress"), "html", null, true);
        echo "
\t\t\t\t<br />
\t\t\t\t\t
\t\t\t\t<div style=\"border:1px solid;background-color:#cdf1f1; padding:20px; height:120px;\">
\t\t\t\t
\t\t\t\t\t\t<strong>";
        // line 37
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "expiration_date"));
        echo "</strong>
\t\t\t\t\t\t\t";
        // line 38
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "expiration_date"), array("attr" => array("size" => "11", "class" => "datepicker")));
        echo " 
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t
\t\t\t\t\t\t<div style=\"float: left; line-height: 150%;\">
\t\t\t\t\t\t\t<span class = \"underline\"><strong>";
        // line 42
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "balance_client"));
        echo "</strong></span>
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t<strong>Assistance Offered by Dorcas: </strong> 
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t</div>
\t\t\t\t\t\t<div style=\"float: left;line-height: 150%;padding-left: 20px;\">
\t\t\t\t\t\t\t
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t";
        // line 55
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_desc"), array("attr" => array("size" => "15", "tabindex" => "2")));
        echo "
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t";
        // line 57
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_desc2"), array("attr" => array("size" => "15", "tabindex" => "4")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t\t<div style=\"float: right; line-height:150%;\">
\t\t\t\t\t\t\t
\t\t\t\t\t\t\t";
        // line 61
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "balance_client"), array("attr" => array("size" => "15", "tabindex" => "1", "onchange" => "isNumber(this)")));
        echo " 
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t";
        // line 63
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_dorcas"), array("attr" => array("size" => "15", "tabindex" => "1", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t";
        // line 65
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_other"), array("attr" => array("size" => "15", "tabindex" => "3", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t\t\t<br />
\t\t\t\t\t\t\t ";
        // line 67
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_other2"), array("attr" => array("size" => "15", "tabindex" => "5", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t</div>\t\t\t\t
\t\t\t\t
\t\t\t\t
\t\t\t\t<div style=\"padding: 20px; line-height: 180%; height:120px; \">
\t\t\t\t\t<div style=\" float: left; padding-right: 10px;\">
\t\t\t\t\t\t<strong>Type of Assistance (Rent, Water, Oasis, Gas, etc.):</strong> 
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"padding-left:20px; float: right;\">
\t\t\t\t\t\t
\t\t\t\t\t\t ";
        // line 78
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "check_purpose"), array("attr" => array("style" => "width: 160px;", "tabindex" => "7")));
        echo "
\t\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t\t<div style=\"float: left;\">\t
\t\t\t\t\t\t<div style=\"float: left;\">
\t\t\t\t\t\t\t<strong>";
        // line 83
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "account_number"));
        echo "</strong>
\t\t\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t\t\t<div style=\"padding-left: 10px; float: left;\">
\t\t\t\t\t\t\t";
        // line 87
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "account_number"), array("attr" => array("size" => "15", "tabindex" => "8")));
        echo " 
\t\t\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t\t
\t\t\t\t\t\t<div style=\"padding-left: 38px; padding-right: 10px; float: left;\">
\t\t\t\t\t\t\t <strong>Name on Bill: </strong>
\t\t\t\t\t\t</div>
\t\t\t\t\t\t<div style=\"padding-left: 8px; float: right;\">
\t\t\t\t\t\t\t ";
        // line 95
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "name_on_bill"), array("attr" => array("size" => "24", "tabindex" => "9")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t</div>
\t\t\t\t\t<br />
\t\t\t\t\t<div style=\"float: left; \">
\t\t\t\t\t\t<strong>Vendor Name:</strong>
\t\t\t\t\t\t<br />
\t\t\t\t\t\t<strong>";
        // line 102
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "vendor_address"));
        echo "</strong>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float:right;\">
\t\t\t\t\t\t";
        // line 105
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_name"), array("attr" => array("size" => "50", "tabindex" => "10")));
        echo "
\t\t\t\t\t\t<br />
\t\t\t\t\t\t";
        // line 107
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_address"), array("attr" => array("size" => "50", "tabindex" => "11")));
        echo " 
\t\t\t\t\t</div>
\t\t\t\t</div>\t\t
\t\t\t\t\t
\t\t\t\t\t
\t\t\t\t";
        // line 112
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderRest($_form_);
        echo "
\t\t\t\t
\t\t\t</p>    
\t\t   
\t\t   
\t\t\t<div style=\"border:2px solid; padding: 14px;  font-size:12px;\">
\t\t\t\t<strong>ATTENTION: This is NOT a pledge.</strong>  The client must pay the remaining balance 
\t\t\t\tby the <em>expiration date above</em> or this note will expire without further notice.
\t\t\t\t<br />
\t\t\t\t<strong>LANDLORD or BUSINESS</strong> <em>must call</em> the Crisis Ministry Office by the expiration date to 
\t\t\t\tconfirm that the above balance has been paid.
\t\t\t\t<br />
\t\t\t\t<strong>FOR PROGRESS ENERGY AND OTHER UTILITIES:</strong> The CLIENT <em>must call</em> Dorcas Ministries with their 
\t\t\t\treceipt number after making a payment.  For Progress Energy, pay: on-line, by phone, or in 
\t\t\t\tperson at an authorized payment center, such as the High House Food Mart (corner of Old Apex/High House Roads).
\t\t\t\t<br /><center>CALL: 919-459-9861, ext 201</center>
\t\t\t\t<br />
\t\t\t\t<strong>NO CHECK WILL BE RELEASED WITHOUT CONFORMATION that the client paid their balance.</strong>
\t\t\t\tDorcas must also have verification that another agency has offered assistance.
\t\t\t\t
\t\t\t\t<div style=\"position:absolute; top:10px; left:10px;\">
                                                <input type=\"button\" value=\"Create Printable Promissory Note\" onclick=\"save(false)\" >
\t\t\t\t</div>
\t\t\t</div>
\t\t\t<br />
\t\t</body>
\t</form>
</div>

";
    }

    // line 143
    public function block_logout($context, array $blocks = array())
    {
    }

    // line 145
    public function block_javascripts($context, array $blocks = array())
    {
        // line 146
        echo "
";
        // line 147
        $this->displayParentBlock("javascripts", $context, $blocks);
        echo "

<script type=\"text/javascript\">

function isNumber(field)
{
     if( isNaN(field.value)){
        alert(\"&#8227 Please enter whole number only, no <br />&nbsp;  dollar sign.\");
        field.value = 0;
        field.focus();
         }
}

\$(function() {
//    \$( \".datepicker\" ).datepicker({ showAnim: \"slideDown\" });
    \$( \".datepicker\" ).datepicker({ changeMonth: true, changeYear: true, yearRange:\"-0:+10\"
        });
        });


window.alert = function(message) {
\t\$('#override_javascript_alert').html(message).dialog({
\t\tmodal:true,
\t\ttitle:'Tabitha Validation Message',
\t\tbuttons: {
\t\t\t'OK':function(){
\t\t\t\t\$(this).dialog('close');
\t\t\t}
\t\t}
\t});
};


/**--------------------------
//* Validate Date Field script- By JavaScriptKit.com
//* For this script and 100s more, visit http://www.javascriptkit.com
//* This notice must stay intact for usage
---------------------------**/

function checkdate(input){
    var validformat=/^\\d{2}\\/\\d{2}\\/\\d{4}\$/ //Basic check for format validity
    var returnval=false
    if (!validformat.test(input))
    {
//        alert(\"Invalid Date Format. Please correct and submit again.\")
    }
    else{ //Detailed check for valid date ranges
        var monthfield=input.split(\"/\")[0]
        var dayfield=input.split(\"/\")[1]
        var yearfield=input.split(\"/\")[2]
        var dayobj = new Date(yearfield, monthfield-1, dayfield)
        if ((dayobj.getMonth()+1!=monthfield)||(dayobj.getDate()!=dayfield)||(dayobj.getFullYear()!=yearfield))
        {
//            alert(\"Invalid Day, Month, or Year range detected. Please correct and submit again.\")
        }
        else
            returnval=true
    }
//    if (returnval==false) input.select()
    return returnval
}

function save(nav)
{ 
    // Read all values

    var eDate = document.getElementById('promissoryform_expiration_date').value;

    okaytosubmit = true;
    alertMessage = \"\";

    // Check Date for valid date
    if (eDate && !checkdate(eDate))
    {
        alertMessage = alertMessage + '&#8227 Please enter a valid Expiration Date. <br/>';
        okaytosubmit = false;
    }

    if (okaytosubmit == true)
    {
        var form = document.forms[\"clientform\"];
        form.submit();
    }
    else
    {
        alert(alertMessage);
    }
}

</script>
   
";
    }

    // line 240
    public function block_stylesheets($context, array $blocks = array())
    {
        // line 241
        echo "
";
        // line 242
        $this->displayParentBlock("stylesheets", $context, $blocks);
        echo "

<style >
input
    {
        font-size:14px;
    }
</style>
";
    }

    public function getTemplateName()
    {
        return "DorcasTabithaBundle:Print:promissoryform.html.twig";
    }

    public function isTraitable()
    {
        return false;
    }

    public function getDebugInfo()
    {
        return array (  387 => 241,  288 => 147,  282 => 145,  277 => 143,  189 => 83,  103 => 37,  278 => 142,  270 => 138,  259 => 144,  227 => 105,  216 => 109,  159 => 65,  140 => 73,  120 => 61,  18 => 1,  347 => 201,  344 => 200,  306 => 165,  300 => 163,  295 => 161,  226 => 112,  53 => 12,  813 => 347,  784 => 322,  779 => 321,  772 => 318,  767 => 317,  760 => 314,  755 => 313,  748 => 310,  743 => 309,  736 => 306,  731 => 305,  724 => 302,  719 => 301,  712 => 298,  707 => 297,  700 => 294,  695 => 293,  688 => 290,  683 => 289,  676 => 286,  671 => 285,  664 => 282,  659 => 281,  652 => 278,  647 => 277,  640 => 274,  635 => 273,  625 => 267,  618 => 264,  611 => 261,  604 => 258,  597 => 255,  590 => 252,  583 => 249,  576 => 246,  569 => 243,  562 => 240,  548 => 234,  541 => 231,  529 => 223,  524 => 222,  517 => 219,  512 => 218,  505 => 215,  500 => 214,  493 => 211,  488 => 210,  481 => 207,  476 => 206,  469 => 203,  464 => 202,  452 => 198,  445 => 195,  440 => 194,  433 => 191,  428 => 190,  421 => 187,  409 => 183,  404 => 182,  397 => 179,  392 => 178,  380 => 174,  373 => 171,  368 => 170,  357 => 163,  336 => 154,  329 => 151,  266 => 124,  243 => 121,  231 => 105,  116 => 42,  588 => 205,  582 => 203,  575 => 200,  570 => 199,  555 => 237,  550 => 187,  545 => 186,  538 => 183,  533 => 182,  528 => 181,  521 => 178,  516 => 177,  511 => 176,  497 => 166,  492 => 165,  487 => 164,  480 => 161,  475 => 160,  470 => 159,  463 => 156,  458 => 155,  442 => 147,  437 => 146,  432 => 145,  425 => 142,  415 => 140,  407 => 136,  402 => 135,  395 => 132,  390 => 242,  385 => 175,  372 => 125,  367 => 124,  360 => 121,  343 => 157,  325 => 110,  320 => 109,  303 => 164,  298 => 103,  290 => 99,  285 => 146,  280 => 130,  273 => 139,  263 => 133,  256 => 89,  251 => 125,  246 => 87,  234 => 116,  229 => 82,  221 => 78,  168 => 78,  151 => 56,  97 => 24,  75 => 39,  457 => 199,  453 => 154,  449 => 203,  443 => 202,  436 => 197,  429 => 195,  426 => 194,  420 => 141,  416 => 186,  413 => 191,  410 => 190,  408 => 189,  405 => 188,  398 => 185,  391 => 182,  384 => 240,  377 => 126,  369 => 172,  365 => 170,  362 => 169,  359 => 168,  354 => 167,  352 => 166,  322 => 148,  315 => 145,  308 => 142,  301 => 139,  281 => 122,  276 => 119,  272 => 117,  268 => 93,  260 => 113,  242 => 112,  237 => 104,  233 => 107,  220 => 102,  210 => 100,  207 => 97,  192 => 69,  185 => 66,  164 => 78,  145 => 69,  142 => 64,  131 => 43,  125 => 59,  81 => 30,  70 => 13,  41 => 4,  174 => 80,  169 => 61,  128 => 50,  203 => 71,  187 => 61,  141 => 54,  129 => 63,  119 => 37,  59 => 8,  370 => 141,  355 => 120,  350 => 202,  345 => 128,  338 => 115,  333 => 114,  328 => 123,  321 => 120,  316 => 119,  311 => 118,  304 => 115,  299 => 114,  294 => 136,  287 => 133,  274 => 101,  269 => 100,  264 => 99,  257 => 138,  247 => 106,  240 => 91,  223 => 112,  218 => 85,  213 => 84,  205 => 104,  195 => 93,  188 => 75,  183 => 92,  171 => 88,  149 => 71,  137 => 63,  72 => 35,  40 => 5,  21 => 3,  252 => 107,  248 => 110,  244 => 73,  236 => 106,  230 => 115,  225 => 63,  222 => 62,  212 => 98,  204 => 98,  200 => 94,  197 => 87,  177 => 90,  160 => 54,  157 => 71,  126 => 18,  106 => 52,  98 => 36,  184 => 60,  181 => 59,  173 => 38,  163 => 60,  155 => 63,  139 => 57,  135 => 58,  133 => 55,  114 => 48,  110 => 32,  105 => 30,  93 => 46,  76 => 22,  69 => 20,  209 => 95,  206 => 51,  201 => 102,  194 => 99,  191 => 70,  186 => 88,  180 => 78,  176 => 61,  166 => 87,  158 => 59,  153 => 63,  143 => 49,  134 => 51,  123 => 53,  118 => 56,  90 => 21,  87 => 18,  66 => 18,  60 => 11,  146 => 55,  136 => 59,  122 => 53,  107 => 33,  101 => 50,  95 => 29,  82 => 28,  73 => 22,  67 => 12,  52 => 14,  109 => 23,  104 => 34,  96 => 32,  84 => 19,  80 => 34,  26 => 7,  34 => 3,  112 => 57,  102 => 40,  89 => 47,  63 => 28,  56 => 12,  43 => 8,  92 => 34,  79 => 40,  57 => 18,  46 => 6,  37 => 4,  33 => 14,  29 => 2,  19 => 1,  44 => 5,  27 => 4,  55 => 14,  45 => 8,  36 => 3,  50 => 21,  47 => 19,  30 => 4,  25 => 3,  249 => 96,  239 => 84,  235 => 90,  228 => 84,  224 => 102,  219 => 110,  217 => 58,  214 => 75,  211 => 75,  208 => 105,  202 => 71,  199 => 93,  193 => 44,  182 => 84,  178 => 84,  175 => 81,  172 => 59,  165 => 67,  161 => 75,  156 => 51,  154 => 72,  150 => 50,  147 => 61,  132 => 69,  127 => 62,  117 => 51,  113 => 33,  86 => 32,  83 => 17,  78 => 27,  68 => 30,  64 => 16,  61 => 21,  48 => 4,  39 => 3,  32 => 5,  24 => 5,  22 => 2,  23 => 3,  20 => 2,  17 => 1,  144 => 62,  138 => 60,  130 => 60,  124 => 38,  121 => 36,  115 => 45,  111 => 64,  108 => 38,  99 => 43,  94 => 32,  91 => 44,  88 => 30,  85 => 42,  77 => 58,  74 => 23,  71 => 13,  65 => 12,  62 => 29,  58 => 15,  54 => 17,  51 => 10,  42 => 17,  38 => 11,  35 => 6,  31 => 2,  28 => 6,);
    }
}
