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    <title>
        Richesta di adesione - Associazione Portico delle Parole
    </title>

    <?php include_once $_SERVER['DOCUMENT_ROOT']."/google-analytics.php" ?>
</head>

<body>
<?php include $_SERVER['DOCUMENT_ROOT']."/header.php" ?>

<div class="main-container shadow">
  <h1>Richesta di adesione</h1>
	<form method="POST" action="<?php $_PHP_SELF ?>">

	<p>Nome, Cognome
		<br/>
		<input type="text" name="name" style="width:100%" value="<?php if (isset($_POST['name'])) { echo $_POST['name']; }?>">
	</p>

	<p>Data di nascita
		<br/>
		<input type="text" name="birthday" size="15em" value="<?php if (isset($_POST['name'])) { echo $_POST['birthday']; }?>">
	</p>

	<p>Indirizzo e-mail
		<br/>
		<input type="text" name="email" style="width:100%" value="<?php if (isset($_POST['email'])) { echo $_POST['email']; }?>">
	</p>

	<p>Numero di telefono<br/>
		<input type="text" name="phone" size="15em" value="<?php if (isset($_POST['phone'])) { echo $_POST['phone']; }?>">
	</p>

	<p>
		<label>
			<input type="checkbox" name="gdpr_autorized" value="yes" required <?php if (isset($_POST['gdpr_autorizzato'])) { echo 'checked'; }?>>
			Autorizzo il trattamento dei dati personali in base all’art. 13 del D. Lgs. 196/2003 e all’art. 13 GDPR 679/16.<br>
		</label>
	</p>

  <p>
    <input type="submit" value="Invia">
  </p>

  </form>

</div>

<?php include $_SERVER['DOCUMENT_ROOT']."/contacts-bottom.php" ?>
</body>
</html>

Add the membership request page
Add the membership request page
