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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: " . $name . "\r\n\r\n"; $message .= "Class Standing: " . $class . "\r\n"; $message .= "Room: " . $room . "\r\n"; $message .= "Room Phone: " . $phone . "\r\n"; $message .= "Alternate Phone: " . $cell . "\r\n"; $message .= "Email: " . $email . "\r\n"; $message .= "AIM: " . $aim . "\r\n"; $message .= "Shirt Size: " . $shirt . "\r\n"; $message .= "Res Life Staff: " . $staff . "\r\n"; $message .= "How Long On Campus: " . $campus . "\r\n\r\n"; $message .= "Question 1: " . $conference . "\r\n\r\n"; $message .= "Question 2: " . $involvement . "\r\n\r\n"; $message .= "Question 3: " . $why . "\r\n\r\n"; $message .= "Question 4: " . $how . "\r\n\r\n"; $message .= "Question 5: " . $schedule . "\r\n\r\n"; $message .= "Question 6: " . $weekly . "\r\n\r\n"; $message .= "Question 7: " . $spirit . "\r\n\r\n"; $message .= "Question 8: " . $money . "\r\n\r\n"; $message = wordwrap($message, '70'); $headers = "From: " . $name . "<" . $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; } ?>