<?
require_once( "../php_include/common.php" );
require_once( "../php_include/mime_mail.inc" );
require_once( "../php_include/smtp_mail.inc" );

$email = cleanPostVariable( 'email' );
$first_name = cleanPostVariable( 'first_name' );
$last_name = cleanPostVariable( 'last_name' );
$degree = cleanPostVariable( 'degree' );
$affiliation = cleanPostVariable( 'affiliation' );
$address = cleanPostVariable( 'address' );
$city = cleanPostVariable( 'city' );
$state = cleanPostVariable( 'state' );
$postal_code = cleanPostVariable( 'postal_code' );
$country = cleanPostVariable( 'country' );
$lists_1 = cleanPostVariable( 'lists_1' );
$lists_2 = cleanPostVariable( 'lists_2' );
$lists_3 = cleanPostVariable( 'lists_3' );
$referrer = cleanPostVariable( 'referrer' );
$referrer_website = cleanPostVariable( 'referrer_website' );
$referrer_other = cleanPostVariable( 'referrer_other' );
$submit = cleanPostVariable( 'submit' );
$errormessage = null;
$this_page = 1;

// ******************************************************************
$smtp_server												= "mail.doceus.com";
$default_from_name									= "Nurture Your Nature Web site";
$default_from_address								= "contact@nurtureyournature.org";
$to																	= "contact@nurtureyournature.org";
$subject														= "Health Care Provider E-mail Signup";
$set_email_from_as_contact_email		= false;
$require_email_address							= true;
// ******************************************************************

// these next lines are the error messages for all required fields. To make a field not required, remove the 2 lines associated with it below. Don't forget to remove the asterisk on the public form. 
if ( $submit != null )
	{
	if (( $require_email_address ) and ( $email == null ))
		$errormessage = "Please provide your e-mail address";
	else if (( $email != null ) and ( isValidEmail( $email ) == false ))
		$errormessage = "The e-mail address you provided appears to be invalid";
	else if ( $first_name == null )
		$errormessage = "Please provide your first name";
	else if ( $last_name == null )
		$errormessage = "Please provide your last name";
	else if ( $address == null )
		$errormessage = "Please provide your street address";
	else if ( $city == null )
		$errormessage = "Please provide your city";
	else if ( $state == null )
		$errormessage = "Please provide your state or province";
	else if ( $postal_code == null )
		$errormessage = "Please provide your postal code";
	else if (( $lists_1 == null ) and ( $lists_2 == null ) and ( $lists_3 == null ))
		$errormessage = "Please select at least one e-mail list to subscribe to";
	else if (( $referrer == "1" ) and ( $referrer_website == null ))
		$errormessage = "You selected \"Web site\" for how you heard about us. Please fill in the box under that choice to indicate which Web site.";
	else if (( $referrer != "1" ) and ( $referrer_website != null ))
		$errormessage = "Please select \"Web site\" if you wish to write in wich Web site referred you to Nurture Your Nature. Otherwise, please remove the text from this field.";
	else if (( $referrer == "6" ) and ( $referrer_other == null ))
		$errormessage = "You selected \"Other\" for how you heard about us. Please fill in the box under that choice to provide more detail.";
	else if (( $referrer != "6" ) and ( $referrer_other != null ))
		$errormessage = "Please select \"Other\" if you wish to submit your write-in answer for how you heard about us. Otherwise, please remove the text from the \"Other\" field.";

	if ( $errormessage == null )
		{
		if (( $set_email_from_as_contact_email ) and ( $email != null ) and ( isValidEmail( $email )))
			{
			$from    = cleanName( $name ) . " <$email>"; 
			$from_address = $email;
			}
		else
			{
			$from = $default_from_name . " <$default_from_address>";
			$from_address = $default_from_address;
			}

		$body = "";

		$body	 .= "IMPORTANT NOTE: This e-mail is the only action that has been taken in the subscription process. In order for this person to actually receive these e-mails, they must be manually appended to the lists for which they have subscribed\n\n";
		$body	.= "Subscription(s):";
		if ( ( $lists_1 == 1 ))
			$body	.= "\n\n               \"News Alerts: Female Sexuality in the News\"";
		else
			$body	.= "";
		if ( ( $lists_2 == 2 ))
			$body	.= "\n\n               \"News from the National Women's Health Resource Center (NWHRC)\"";
		else
			$body	.= "";
		if ( ( $lists_3 == .3 ))
			$body	.= "\n\n               \"News from the Association of Reproductive Health Professionals (ARHP)\"";
		else
			$body	.= "";
		$body	 .= "\n\n         E-mail: " . $email;
		$body	 .= "\n     First Name: " . $first_name;
		$body	 .= "\n      Last Name: " . $last_name;
		if ( $degree == null )
			$body	.= "\n         Degree: *not provided";
		else
			$body	.= "\n         Degree: " . $degree;
		if ( $affiliation == null )
			$body	.= "\n    Affiliation: *not provided";
		else
			$body	.= "\n    Affiliation: " . $affiliation;
		$body	.= "\n\n        Address: " . $address;
		$body	 .= "\n                 $city, $state $postal_code";
		$body	 .= "\n                                   $country";
		if ( $country == null )
		$body	 .= "\n                  *country not provided";
			if ( $referrer == null )
			$body	 .= "\n\nHeard about us: *not provided";
			else if ( $referrer == "1" )
			$body	 .= "\n\n Heard about us: Web Site ($referrer_website)";
			else if ( $referrer == "2" )
			$body	 .= "\n\n Heard about us: ARHP publication";
			else if ( $referrer == "3" )
			$body	 .= "\n\n Heard about us: NWHRC publication";
			else if ( $referrer == "4" )
			$body	 .= "\n\n Heard about us: Colleague";
			else if ( $referrer == "5" )
			$body	 .= "\n\n Heard about us: Conference/Continuing Medical Education Event";
			else
			$body	 .= "\n\n Heard about us: " . $referrer_other;
		$body	.= "\n\n\nThis information was submitted from:";
		$body	.= "\nhttp://www.nurtureyournature.org/prof_email_alerts.php";
		$body	.= "\n\nSubmitted from a computer with IP address: " . $REMOTE_ADDR;
		$body .= "\n\n";

		$mail = new mime_mail;

		$mail->from    = $from;
		$mail->to      = $to;
		$mail->headers = "Reply-to: $from_address";
		$mail->subject = $subject;
		$mail->body    = $body;
		$data = $mail->get_mail();
		$smtp = new smtp_mail;
		if ( $smtp->send_email( $smtp_server, $from_address, $to, $data ) == true )
			$this_page = 2;
		else
			$errormessage = "Sorry, we encountered an error while trying to submit your subscription information. This may be due to some technical issues on our end, a connection problem on your end, or someone else's problem in between. Please try again later.";
		}
	}
?><!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">

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<? if (( $errormessage != null ) or ( $this_page == 1 )) { ?>
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																		<h3>Sign up for more Health Care Provider information on healthy female sexuality!</h3>
																		<p>Sign up now to receive free e-mail news updates and newsletters for health care providers on healthy female sexuality and other topics in women's health from the co-sponsors of <a href="about.html">Nurture Your Nature</a>, the <a href="about_arhp.html">Association of Reproductive Health Professionals (ARHP)</a> and the <a href="about_nwhrc.html">National Women's Health Resource Center (NWHRC)</a>.</p>
																		<p>You may <a href="prof_email_alerts_unsubscribe.php">unsubscribe at any time</a>.</p><br>
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<? if ( $errormessage != null ) { ?>
								<p class="error"><? echoHTML( $errormessage ) ?></p>
<? } ?>
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																				<form method="post" action="prof_email_alerts.php">
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																							<td class="smcopy" align="right" colspan="3"><span class="red">&#042;</span>&#061;Required Field</td>
																							<td width="10">&nbsp;</td>
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																							<td>&nbsp;</td>
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																							<td align="right" class="copy" nowrap><b>E-mail</b></td>
																							<td width="10">&nbsp;</td>
																							<td class="copy"><input type="text" name="email" value="<? echoHTML( $email ) ?>"><span class="red">&#042;</span></td>
																							<td width="10">&nbsp;</td>
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																							<td align="right" class="copy" nowrap><b>First Name</b></td>
																							<td width="10">&nbsp;</td>
																							<td class="copy"><input type="text" name="first_name" value="<? echoHTML( $first_name ) ?>"><span class="red">&#042;</span></td>
																							<td width="10">&nbsp;</td>
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																							<td align="right" class="copy" nowrap><b>Last Name</b></td>
																							<td width="10">&nbsp;</td>
																							<td class="copy"><input type="text" name="last_name" value="<? echoHTML( $last_name ) ?>"><span class="red">&#042;</span></td>
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																							<td class="copy"><input type="text" name="degree" value="<? echoHTML( $degree ) ?>"></td>
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																							<td align="right" class="copy" valign="top" nowrap><b>Lists</b><span class="red">&#042;</span></td>
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																										<td valign="top"><input type="checkbox" name="lists_1" value="1"<? if ( $lists_1 == 1 ) echo " checked"; ?>></td>
																										<td valign="top"><p class="copy"><strong>News Alerts: Female Sexuality in the News</strong> 
																										<br>Targeted specifically to reproductive health professionals, these breaking news E-mail Updates provide the latest about female sexuality in the headlines. Stay involved through the most current breakthroughs in research and policy news. &#040;e-mailed as needed&#041;</p></td>
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																						  <td width="10">&nbsp;</td>
																						  <td><table cellpadding="0" cellspacing="0" border="0">
                                                                                              <tr>
                                                                                                <td valign="top"><input type="checkbox" name="lists_2" value="2"<? if ( $lists_2 == 2 ) echo " checked"; ?>></td>
                                                                                                <td valign="top"><p class="copy"><strong>News from the National Women&#039;s Health Resource Center &#040;NWHRC&#041;</strong> <br>
          Latest happenings at the NWHRC, including new campaigns and publications of interest to the health care professional. Professional conferences and bulk publication order opportunities included, too. &#040;mailed bi-weekly&#041; <br>
          <a href="javascript: openNewWindow('http://www.healthywomen.org/viral/viralhcp.html')">Preview this Publication</a></p></td>
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																						  <td width="10">&nbsp;</td>
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																						  <td>&nbsp;</td>
																					    </tr>
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																						  <td align="right" class="copy">&nbsp;</td>
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																						  <td><table cellpadding="0" cellspacing="0" border="0">
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