<?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
        echo twig_escape_filter($this->env, $this->env->getExtension('routing')->getPath("DorcasTabithaBundle_print_promissoryShow", array("client_id" => $this->getAttribute($this->getContext($context, "client"), "clientid"))), "html", null, true);
        echo "\" method=\"post\" ";
        echo $this->env->getExtension('form')->renderEnctype($this->getContext($context, "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
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "promissory"), "counselor"), "html", null, true);
        echo "</span>
\t\t\t\t<br />
\t\t\t\t<strong>Client Name:</strong> ";
        // line 30
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "client"), "FullName"), "html", null, true);
        echo " 
\t\t\t\t<br />
\t\t\t\t<strong>Client Address:</strong> ";
        // line 32
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "form"), "expiration_date"));
        echo "</strong>
\t\t\t\t\t\t\t";
        // line 38
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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: 48px; 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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "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
        echo $this->env->getExtension('form')->renderRest($this->getContext($context, "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 (  368 => 242,  365 => 241,  362 => 240,  266 => 147,  263 => 146,  260 => 145,  255 => 143,  221 => 112,  213 => 107,  208 => 105,  202 => 102,  192 => 95,  181 => 87,  174 => 83,  166 => 78,  152 => 67,  147 => 65,  142 => 63,  137 => 61,  130 => 57,  125 => 55,  109 => 42,  102 => 38,  98 => 37,  90 => 32,  85 => 30,  80 => 28,  76 => 27,  62 => 16,  51 => 10,  44 => 5,  41 => 4,  36 => 3,  31 => 2,);
    }
}
