<?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
        if (isset($context["client"])) { $_client_ = $context["client"]; } else { $_client_ = null; }
        echo twig_escape_filter($this->env, $this->env->getExtension('routing')->getPath("DorcasTabithaBundle_print_pledgeShow", 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 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
        if (isset($context["pledge"])) { $_pledge_ = $context["pledge"]; } else { $_pledge_ = null; }
        echo twig_escape_filter($this->env, $this->getAttribute($_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
        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 36
        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<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
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_desc"), array("attr" => array("size" => "15", "tabindex" => "2")));
        echo "
\t\t\t\t\t\t<br />
\t\t\t\t\t\t";
        // line 53
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "other_desc2"), array("attr" => array("size" => "15", "tabindex" => "4")));
        echo "
\t\t\t\t\t\t<br />
\t\t\t\t\t\t<br />&nbsp;
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: right; line-height:150%;\">
\t\t\t\t\t\t";
        // line 58
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_dorcas"), array("attr" => array("size" => "15", "tabindex" => "1", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t\t<br />
\t\t\t\t\t\t";
        // line 60
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_other"), array("attr" => array("size" => "15", "tabindex" => "3", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t\t<br />
\t\t\t\t\t\t ";
        // line 62
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "pledge_other2"), array("attr" => array("size" => "15", "tabindex" => "5", "onchange" => "isNumber(this)")));
        echo "
\t\t\t\t\t</div>
\t\t\t\t</div>\t\t\t\t
\t\t\t\t<br />
\t\t\t<div style=\"padding: 20px; line-height: 180%; height:180px; \">
\t\t\t\t<div style=\" float: left; padding-right: 10px;\">
\t\t\t\t\t<strong>Type of Assistance (Rent, Water, Oasis, Gas, etc.):</strong> 
\t\t\t\t</div>
\t\t\t\t<div style=\"padding-left:20px; float: right;\">
\t\t\t\t\t ";
        // line 71
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "check_purpose"), array("attr" => array("style" => "width: 160px;")));
        echo "
\t\t\t\t</div>
\t\t\t\t
\t\t\t\t<div style=\"float: left;\">\t
\t\t\t\t\t<div style=\"float: left;\">
\t\t\t\t\t\t<strong>";
        // line 76
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "account_number"));
        echo "</strong>
\t\t\t\t\t</div>
\t\t\t\t
\t\t\t\t\t<div style=\"padding-left: 10px; float: left;\">
\t\t\t\t\t\t";
        // line 80
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "account_number"), array("attr" => array("size" => "15")));
        echo " 
\t\t\t\t\t</div>
\t\t\t\t
\t\t\t\t
\t\t\t\t\t<div style=\"padding-left: 45px; padding-right: 10px; float: left;\">
\t\t\t\t\t\t <strong>Name on Bill: </strong>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"padding-left: 8px;\">
\t\t\t\t\t\t ";
        // line 88
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "name_on_bill"), array("attr" => array("size" => "24")));
        echo "
\t\t\t\t\t</div>
\t\t\t\t</div>
\t\t\t\t<br />
\t\t\t\t<div style=\"float: left; \">
\t\t\t\t\t<strong>Vendor Name:</strong>
\t\t\t\t\t<br />
\t\t\t\t\t<strong>";
        // line 95
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderLabel($this->getAttribute($_form_, "vendor_address"));
        echo "</strong>
\t\t\t\t</div>
\t\t\t\t<div style=\"float:right;\">
\t\t\t\t\t";
        // line 98
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_name"), array("attr" => array("size" => "50")));
        echo "
\t\t\t\t\t<br />
\t\t\t\t\t";
        // line 100
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_address"), array("attr" => array("size" => "50")));
        echo " 
\t\t\t\t</div>
\t\t\t\t\t
\t\t\t\t
\t\t\t\t<br />&nbsp;<br /><br />&nbsp;
\t\t\t\t
\t\t\t\t<div style=\"height:60px;\">
\t\t\t\t\t<div style=\"float: left;\">
\t\t\t\t\t\t<strong>Pledge Made By:</strong>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\"float: left; padding-left:14px;\">
\t\t\t\t\t\t<div id=\"phone\">
\t\t\t\t\t\t\t<strong>Phone: </strong>";
        // line 112
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_phone"), array("attr" => array("size" => "10")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t\t
\t\t\t\t\t\t<div id=\"online \">
\t\t\t\t\t\t\t<strong>On-line: </strong>";
        // line 116
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "on_line"), array("attr" => array("size" => "10")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t</div>
\t\t\t\t\t<div style=\" padding-left: 5px; float:right;\">
\t\t\t\t\t\t<div id=\"vendor\">
\t\t\t\t\t\t\t<strong>Vendor Contact: </strong>";
        // line 121
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_form_, "vendor_contact"), array("attr" => array("size" => "30")));
        echo "
\t\t\t\t\t\t</div>
\t\t\t\t\t\t
\t\t\t\t\t\t<div id=\"confnum\">
\t\t\t\t\t\t\t<strong>Confirmation Number: </strong>";
        // line 125
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderWidget($this->getAttribute($_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
        if (isset($context["form"])) { $_form_ = $context["form"]; } else { $_form_ = null; }
        echo $this->env->getExtension('form')->renderRest($_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 (  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 => 34,  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 => 131,  385 => 175,  372 => 125,  367 => 124,  360 => 121,  343 => 157,  325 => 110,  320 => 109,  303 => 164,  298 => 103,  290 => 99,  285 => 98,  280 => 130,  273 => 127,  263 => 133,  256 => 89,  251 => 125,  246 => 87,  234 => 116,  229 => 82,  221 => 78,  168 => 78,  151 => 56,  97 => 24,  75 => 14,  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 => 179,  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 => 105,  237 => 104,  233 => 103,  220 => 99,  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 => 96,  247 => 106,  240 => 91,  223 => 100,  218 => 85,  213 => 84,  205 => 80,  195 => 93,  188 => 75,  183 => 74,  171 => 81,  149 => 71,  137 => 63,  72 => 35,  40 => 5,  21 => 3,  252 => 107,  248 => 110,  244 => 73,  236 => 106,  230 => 102,  225 => 63,  222 => 62,  212 => 98,  204 => 98,  200 => 94,  197 => 95,  177 => 65,  160 => 54,  157 => 71,  126 => 18,  106 => 52,  98 => 36,  184 => 60,  181 => 59,  173 => 38,  163 => 60,  155 => 63,  139 => 66,  135 => 58,  133 => 58,  114 => 48,  110 => 32,  105 => 30,  93 => 46,  76 => 22,  69 => 20,  209 => 74,  206 => 51,  201 => 76,  194 => 64,  191 => 70,  186 => 88,  180 => 65,  176 => 61,  166 => 76,  158 => 59,  153 => 62,  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 => 57,  95 => 29,  82 => 25,  73 => 22,  67 => 12,  52 => 14,  109 => 23,  104 => 34,  96 => 32,  84 => 19,  80 => 34,  26 => 7,  34 => 3,  112 => 34,  102 => 40,  89 => 47,  63 => 28,  56 => 12,  43 => 8,  92 => 34,  79 => 18,  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 => 14,  30 => 4,  25 => 3,  249 => 96,  239 => 84,  235 => 90,  228 => 84,  224 => 102,  219 => 101,  217 => 58,  214 => 75,  211 => 75,  208 => 74,  202 => 71,  199 => 93,  193 => 44,  182 => 84,  178 => 84,  175 => 81,  172 => 59,  165 => 55,  161 => 75,  156 => 51,  154 => 72,  150 => 50,  147 => 49,  132 => 58,  127 => 62,  117 => 51,  113 => 33,  86 => 32,  83 => 17,  78 => 37,  68 => 30,  64 => 34,  61 => 21,  48 => 4,  39 => 3,  32 => 5,  24 => 3,  22 => 2,  23 => 3,  20 => 2,  17 => 1,  144 => 62,  138 => 60,  130 => 60,  124 => 38,  121 => 36,  115 => 45,  111 => 64,  108 => 31,  99 => 43,  94 => 20,  91 => 32,  88 => 28,  85 => 31,  77 => 58,  74 => 23,  71 => 13,  65 => 12,  62 => 9,  58 => 15,  54 => 17,  51 => 9,  42 => 9,  38 => 11,  35 => 6,  31 => 2,  28 => 3,);
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}
