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University Residence Association at SVSU

GLACURH 2006 Application

If you have questions or comments about this application, please email Reggie Blockett (rablocke@svsu.edu) or call him at extension 6309.

You are required to answer all questions.

Aplication Form
Personal Info

Application Questions


EOT; if(isset($_POST['submit'])) { $message = "Name: " . $nominee . "\r\n"; $message .= "Email: " . $nemail . "\r\n\r\n"; $message .= "Room: " . $room . "\r\n\r\n"; $message .= "Phone: " . $phone . "\r\n\r\n"; $message .= "Nominator: " . $nominator . "\r\n\r\n"; $message .= "Title: " . $title . "\r\n\r\n"; $message .= $comments; $message = wordwrap($message, '70'); $headers = "From: " . $nominator . "<" . $email . ">\r\n"; $headers .= "Date: " . $date . "\r\n"; $isError = 0; $errorMessage = '
"); echo($form); } else { if (mail("rswalker@svsu.edu", "GLACURH 2006 Application", $message, $headers)) { echo('

Thanks for your application!

'); } else { echo('

We\'re sorry but there was an error sending your application. Please try again later.

'); echo($form); } } } else { echo $form; } ?>