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request-account.php
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<?php
session_start();
?>
<html lang="en">
<head>
<meta charset="utf-8">
<script src="https://www.google.com/recaptcha/api.js" async defer></script>
<title>Request Account</title>
<!--<link rel="stylesheet" type="text/css" href="https://ajax.googleapis.com/ajax/libs/jqueryui/1.7/themes/smoothness/jquery-ui.css">
<script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.11.0/jquery.min.js"></script>
<script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jqueryui/1.10.3/jquery-ui.min.js"></script>-->
<link rel="stylesheet" href="//code.jquery.com/ui/1.12.1/themes/base/jquery-ui.css">
<link rel="stylesheet" href="//cdnjs.cloudflare.com/ajax/libs/timepicker/1.3.5/jquery.timepicker.min.css">
<script src="https://code.jquery.com/jquery-1.12.4.js"></script>
<script src="https://code.jquery.com/ui/1.12.1/jquery-ui.js"></script>
<script src="//cdnjs.cloudflare.com/ajax/libs/timepicker/1.3.5/jquery.timepicker.min.js"></script>
<link rel="stylesheet" type="text/css" media="all" href="https://ajax.googleapis.com/ajax/libs/jqueryui/1.7.2/themes/dark-hive/jquery-ui.css">
<!--jquery.timepicker.min.css-->
<link href="https://fonts.googleapis.com/css?family=Maven+Pro:400,700,900" rel="stylesheet" type="text/css">
<link rel="stylesheet" type="text/css" href="style.css">
</head>
<body>
<div id="title" class="contain">
<span class="textcenter" id="titleText">
<h1>Request Account</h1>
</span>
</div>
<div class="contain">
<img src="images/UCSLogos.png" alt="University Campus Store">
</div>
<div class="contain">
<form name="postForm" id="postForm" enctype="multipart/form-data" action="send-account-request.php" method="post">
<div style="margin: 0 auto; padding-top: 10px; width: 50%;">
<label><strong>First Name:</strong>
<input type="text" size="25" id="firstname" name="firstname" tabindex="2" required>
</label>
</div><br>
<div style="margin: 0 auto; padding-top: 10px; width: 50%;">
<label><strong>Last Name:</strong>
<input type="text" size="25" id="lastname" name="lastname" tabindex="2" required>
</label>
</div><br>
<div style="margin: 0 auto; padding-top: 10px; width: 40%;">
<label><strong>UnID:</strong>
<input type="text" size="25" id="uid" name="unid" tabindex="2" required>
</label>
</div><br>
<div style="margin: 0 auto; padding-top: 10px; width: 50%;">
<?php include 'classes/departmentSelector.html'; ?>
</div><br>
<div style="margin: 0 auto; padding-top: 10px; width: 50%;">
<span><strong>Account type:</strong>
<select id="clearance" name="clearance" required>
<option value="Please select" selected="true" disabled="disabled">Please select</option>
<option value="0 - User">User</option>
<option value="1 - Manager">Manager</option>
</select>
</span>
</div>
<div class="subForm">
<span>
<input class="button textcenter" type="submit" id="submit" value="Submit" tabindex="13"/>
</span>
</div>
</form>
</div>
<footer>
<hr>
<h4 class="textcenter">© University of Utah 2016<script>new Date().getFullYear()>2015&&document.write(" - "+new Date().getFullYear());</script></h4>
</footer>
</body>
</html>