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Parse error: syntax error, .....eval()'d code on line 12

fa
farb 07 Jul, 2011
I am getting the following error:

Parse error: syntax error, unexpected '/', expecting ',' or ';' in /home/content/04/6331804/html/components/com_chronocontact/chronocontact.php(53) : eval()'d code on line 12



Here is the link to the form

I cant figure it out.

Thanks

Here is the form code:
<img src="images/SubPageImagery/ManorAdmissionsHeader.jpg" align="top" border="0" />
   
<div class="form_item">
  <div class="form_element cf_text" style="width: 425px;"> <span class="cf_text"><h4>With an excellent reputation and commitment to caring, The Manor at St. Mary’s is a great place to live. Our doors are open! Feel free to complete the admission application below for immediate consideration.</h4></span> </div>
  
<br>

<div class="form_item">
  <div class="form_element cf_text">
<span class="cf_text"><strong>Personal Information</strong></span></div>
  </div>
  <div class="cfclear"> </div>
  </div>



<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_9" name="Name" type="text" />

  </div>
  <div class="cfclear"> </div>
</div>


<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Birthdate</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_4" name="Birthdate" type="text" />
 

  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_8" name="StreetAddress" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_7" name="City/State/Zip" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_6" name="Telephone#" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Social Security #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_5" name="SocialSecurity#" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Medicare</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_3" name="Medicare" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textarea">
    <label class="cf_label" style="width: 150px;">Other</label>
    <textarea class="cf_inputbox" rows="3" id="text_10" title="" cols="22" name="Other"></textarea>
    
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Emergency Contact Information</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_15" name="Name2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_18" name="Telephone#2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_20" name="StreetAddress2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_23" name="City/State/Zip2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Doctor's Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_21" name="DoctorsName3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_27" name="Telephone#3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_22" name="StreetAddress3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_26" name="City/State/Zip3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Dentist's Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_25" name="DentistsName4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_19" name="Telephone#4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_24" name="StreetAddress4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_13" name="City/State/Zip4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Legal Guardian Information (if applicable)</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_32" name="Name5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_33" name="Telephone#5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_31" name="StreetAddress5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_34" name="City/State/Zip5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Financial Information</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Social Security Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_37" name="MonthlySocialSecurityIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Pension Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_38" name="MonthlyPensionIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_39" name="MonthlyIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Other Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_36" name="OtherIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Total Monthly Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_41" name="TotalMonthlyIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Financial Institution Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_42" name="FinancialInstitutionName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Checking Account #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_43" name="CheckingAccount#" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Savings Account #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_46" name="SavingsAccount#" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Stocks</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_44" name="Stocks" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Bonds</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_45" name="Bonds" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Other Assets</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_47" name="OtherAssets" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Real Estate</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_40" name="RealEstate" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>This application will be reviewed based on the fact that <p>I will abide by the terms of our admission contract.</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Resident Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_49" name="ResidentName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Guardian Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_50" name="GuardianName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_button">
    <input value="Submit" name="button_52" type="submit" />
  </div>
  <div class="cfclear"> </div>
</div>
Gr
GreyHead 08 Jul, 2011
Hi farb,

The problem is here
<input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_7" name="City/State/Zip" type="text" />
You aren't allowed to have / in an HTML input neme. Only [a-zA-Z0-9] and underscore, no spaces, dashes or other special characters; and the name must start with a letter.

Bob

PS I didn't check all the inputs so there may be more like this.
fa
farb 08 Jul, 2011
Greyhead,

FIrst of all thanks for the quick reply. I removed all special characters from the input names but I am still getting the error. Here is the current code. Please help.


Thanks

<img src="images/SubPageImagery/ManorAdmissionsHeader.jpg" align="top" border="0" />
   
<div class="form_item">
  <div class="form_element cf_text" style="width: 425px;"> <span class="cf_text"><h4>With an excellent reputation and commitment to caring, The Manor at St. Mary’s is a great place to live. Our doors are open! Feel free to complete the admission application below for immediate consideration.</h4></span> </div>
  
<br>

<div class="form_item">
  <div class="form_element cf_text">
<span class="cf_text"><strong>Personal Information</strong></span></div>
  </div>
  <div class="cfclear"> </div>
  </div>



<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_9" name="Name" type="text" />

  </div>
  <div class="cfclear"> </div>
</div>


<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Birthdate</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_4" name="Birthdate" type="text" />
 

  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_8" name="StreetAddress" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_7" name="CityStateZip" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_6" name="Telephone" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Social Security #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_5" name="SocialSecurity" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Medicare</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_3" name="Medicare" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textarea">
    <label class="cf_label" style="width: 150px;">Other</label>
    <textarea class="cf_inputbox" rows="3" id="text_10" title="" cols="22" name="Other"></textarea>
    
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Emergency Contact Information</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_15" name="Name2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_18" name="Telephone2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_20" name="StreetAddress2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_23" name="CityStateZip2" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Doctor's Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_21" name="DoctorsName3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_27" name="Telephone3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_22" name="StreetAddress3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_26" name="CityStateZip3" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Dentist's Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_25" name="DentistsName4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_19" name="Telephone4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_24" name="StreetAddress4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_13" name="CityStateZip4" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Legal Guardian Information (if applicable)</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_32" name="Name5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Telephone #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_33" name="Telephone5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Street Address</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_31" name="StreetAddress5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">City/State/Zip</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_34" name="CityStateZip5" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>Financial Information</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Social Security Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_37" name="MonthlySocialSecurityIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Pension Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_38" name="MonthlyPensionIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Monthly Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_39" name="MonthlyIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Other Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_36" name="OtherIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Total Monthly Income</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_41" name="TotalMonthlyIncome" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Financial Institution Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_42" name="FinancialInstitutionName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Checking Account #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_43" name="CheckingAccount" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Savings Account #</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_46" name="SavingsAccount" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Stocks</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_44" name="Stocks" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Bonds</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_45" name="Bonds" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Other Assets</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_47" name="OtherAssets" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Real Estate</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_40" name="RealEstate" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>
<br>
<div class="form_item">
  <div class="form_element cf_text"> <span class="cf_text"><strong>This application will be reviewed based on the fact that <p>I will abide by the terms of our admission contract.</strong></span> </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Resident Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_49" name="ResidentName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Guardian Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_50" name="GuardianName" type="text" />
  
  </div>
  <div class="cfclear"> </div>
</div>

<div class="form_item">
  <div class="form_element cf_button">
    <input value="Submit" name="button_52" type="submit" />
  </div>
  <div class="cfclear"> </div>
</div>
Gr
GreyHead 08 Jul, 2011
Hi farb,

Did you change the database column names to match the new form names?

You need to refresh the DB Connection after any changes to database column names. In the Form Editor click the DB Connection tab and set the Connection to 'No'. Click the 'Apply icon in the toolbar to save the form, open the DB Connection tab, set the Connection back to 'Yes' and re-save the form. This will refresh the copy of the table information that ChronoForms uses.

Bob
fa
farb 08 Jul, 2011
Greyhead,

As always YOU ROCK.

Probelm soled.

Thanks
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