<?php

/* DorcasTabithaBundle:Print:pledgeform.html.twig */
class __TwigTemplate_c9c47ba2d7b6292cf8f4d06bbcd02897 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 action=\"";
        // line 12
        echo twig_escape_filter($this->env, $this->env->getExtension('routing')->getPath("DorcasTabithaBundle_print_pledgeShow", 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 18
        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<h2>Pledge Confirmation</h2></center>
\t\t\t

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

\t\t\t\t<strong>Date:</strong> ";
        // line 30
        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 31
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "pledge"), "counselor"), "html", null, true);
        echo "</span>
\t\t\t\t<br />
\t\t\t\t<br />
\t\t\t\t<strong>Client Name:</strong> ";
        // line 34
        echo twig_escape_filter($this->env, $this->getAttribute($this->getContext($context, "client"), "FullName"), "html", null, true);
        echo " 
\t\t\t\t<br />
\t\t\t\t<strong>Client Address:</strong> ";
        // line 36
        echo twig_escape_filter($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<div style=\"border:1px solid;background-color:#cdf1f1; padding:20px; height:80px;\">
\t\t\t\t\t
\t\t\t\t\t<div style=\"float: left; line-height: 150%;\">
\t\t\t\t\t\t<strong>Assistance Offered by Dorcas: </strong> 
\t\t\t\t\t\t<br />
\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t<br />
\t\t\t\t\t\t<strong>Amount Offered by Other Agency: </strong>
\t\t\t\t\t\t<br />
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: left;line-height: 150%;padding-left: 20px;\">
\t\t\t\t\t\t<br />
\t\t\t\t\t\t";
        // line 51
        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<br />
\t\t\t\t\t\t";
        // line 53
        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<br />
\t\t\t\t\t\t<br />&nbsp;
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: right; line-height:150%;\">
\t\t\t\t\t\t";
        // line 58
        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<br />
\t\t\t\t\t\t";
        // line 60
        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<br />
\t\t\t\t\t\t ";
        // line 62
        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</div>
\t\t\t\t</div>\t\t\t\t
\t\t\t\t<br />
\t\t\t<div style=\"padding: 20px; line-height: 180%; height:180px; \">
\t\t\t\t<div style=\" float: left; padding-right: 10px;\">
\t\t\t\t\t<strong>Type of Assistance (Rent, Water, Oasis, Gas, etc.):</strong> 
\t\t\t\t</div>
\t\t\t\t<div style=\"padding-left:20px; float: right;\">
\t\t\t\t\t ";
        // line 71
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "check_purpose"), array("attr" => array("style" => "width: 160px;")));
        echo "
\t\t\t\t</div>
\t\t\t\t
\t\t\t\t<div style=\"float: left;\">\t
\t\t\t\t\t<div style=\"float: left;\">
\t\t\t\t\t\t<strong>";
        // line 76
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "form"), "account_number"));
        echo "</strong>
\t\t\t\t\t</div>
\t\t\t\t
\t\t\t\t\t<div style=\"padding-left: 10px; float: left;\">
\t\t\t\t\t\t";
        // line 80
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "account_number"), array("attr" => array("size" => "15")));
        echo " 
\t\t\t\t\t</div>
\t\t\t\t
\t\t\t\t
\t\t\t\t\t<div style=\"padding-left: 55px; padding-right: 10px; float: left;\">
\t\t\t\t\t\t <strong>Name on Bill: </strong>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"padding-left: 8px;\">
\t\t\t\t\t\t ";
        // line 88
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "name_on_bill"), array("attr" => array("size" => "24")));
        echo "
\t\t\t\t\t</div>
\t\t\t\t</div>
\t\t\t\t<br />
\t\t\t\t<div style=\"float: left; \">
\t\t\t\t\t<strong>Vendor Name:</strong>
\t\t\t\t\t<br />
\t\t\t\t\t<strong>";
        // line 95
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($this->getContext($context, "form"), "vendor_address"));
        echo "</strong>
\t\t\t\t</div>
\t\t\t\t<div style=\"float:right;\">
\t\t\t\t\t";
        // line 98
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "vendor_name"), array("attr" => array("size" => "50")));
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t";
        // line 100
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "vendor_address"), array("attr" => array("size" => "50")));
        echo " 
\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t
\t\t\t\t<br />&nbsp;<br /><br />&nbsp;
\t\t\t\t
\t\t\t\t<div style=\"height:60px;\">
\t\t\t\t\t<div style=\"float: left;\">
\t\t\t\t\t\t<strong>Pledge Made By:</strong>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: left; padding-left:14px;\">
\t\t\t\t\t\t<div id=\"phone\">
\t\t\t\t\t\t\t<strong>Phone: </strong>";
        // line 112
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "vendor_phone"), array("attr" => array("size" => "10")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t\t
\t\t\t\t\t\t<div id=\"online \">
\t\t\t\t\t\t\t<strong>On-line: </strong>";
        // line 116
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "on_line"), array("attr" => array("size" => "10")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\" padding-left: 5px; float:right;\">
\t\t\t\t\t\t<div id=\"vendor\">
\t\t\t\t\t\t\t<strong>Vendor Contact: </strong>";
        // line 121
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "vendor_contact"), array("attr" => array("size" => "30")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t\t
\t\t\t\t\t\t<div id=\"confnum\">
\t\t\t\t\t\t\t<strong>Confirmation Number: </strong>";
        // line 125
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($this->getContext($context, "form"), "confirm_num"), array("attr" => array("size" => "24")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t</div>
\t\t\t\t</div>
\t\t\t</div>
\t\t\t\t
\t\t\t\t

\t\t\t\t";
        // line 133
        echo $this->env->getExtension('form')->renderRest($this->getContext($context, "form"));
        echo "



\t\t\t</p>    
\t\t\t
\t\t\t
\t\t\t<div style=\"border:2px solid; padding: 14px; font-size:12px;\">
\t\t\t\t<strong>ATTENTION:</strong> This is to confirm that Dorcas Ministries has pledged the above 
\t\t\t\tstated amount toward the payment of the above named clients's bill.  A check in
\t\t\t\t this amount will be requested from our bookkeeper.
\t\t\t\t <br /><br />
\t\t\t\t If you have any questions, you may contact Dorcas Ministries at:
\t\t\t\t <center><strong>919-469-9861, ext. 201</strong></center>
\t\t\t\t <br />
\t\t\t </div>
\t\t\t
\t\t\t<div style=\"position:absolute; top:10px; left:10px;\">
\t\t\t\t<input type=\"submit\" value=\"Create Printable Pledge Confirmation\" >
\t\t\t</div>
\t\t\t<br />&nbsp;<br />
\t\t\t
\t\t</body>
    </form>
</div>

";
    }

    // line 161
    public function block_logout($context, array $blocks = array())
    {
    }

    // line 163
    public function block_javascripts($context, array $blocks = array())
    {
        // line 164
        echo "
";
        // line 165
        $this->displayParentBlock("javascripts", $context, $blocks);
        echo "

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


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});
};

function closeandreload(){ 
  opener.location.reload(); // or opener.location.href = opener.location.href; 
  window.close(); // or self.close(); 
}

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

</script>
   
";
    }

    // line 200
    public function block_stylesheets($context, array $blocks = array())
    {
        // line 201
        echo "
";
        // line 202
        $this->displayParentBlock("stylesheets", $context, $blocks);
        echo "

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

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

    public function isTraitable()
    {
        return false;
    }

    public function getDebugInfo()
    {
        return array (  328 => 202,  325 => 201,  322 => 200,  284 => 165,  281 => 164,  278 => 163,  273 => 161,  242 => 133,  231 => 125,  224 => 121,  216 => 116,  209 => 112,  194 => 100,  189 => 98,  183 => 95,  173 => 88,  162 => 80,  155 => 76,  147 => 71,  135 => 62,  130 => 60,  125 => 58,  117 => 53,  112 => 51,  94 => 36,  89 => 34,  83 => 31,  79 => 30,  64 => 18,  53 => 12,  44 => 5,  41 => 4,  36 => 3,  31 => 2,);
    }
}
