RubyGems - akamai_bookmarklet - Versions diffs - 0.1.0 - Mend

akamai_bookmarklet 0.1.0

Files changed (556) hide show

data/vendor/gems/ruby/1.8/gems/nokogiri-1.3.3/test/hpricot/files/pace_application.html ADDED Viewed

@@ -0,0 +1,1320 @@
+<html>
+<head>
+<meta name="GENERATOR" content="Microsoft Visual Studio 6.0">
+<script language="javascript1.2">
+function DateCheck(frmMo, frmDy, frmYr)
+{
+  var returnCode;
+  var cdtStr, fdtStr;
+  var cdt = new Date();
+  //cdtStr = cdt.getYear().toString() + ZeroPad(cdt.getMonth() + 1, 2).toString() + ZeroPad(cdt.getDate(), 2).toString()
+  cdtStr = 20070205
+  fdtStr = frmYr + ZeroPad(frmMo, 2) + ZeroPad(frmDy, 2);
+  var frmDate = ZeroPad(frmMo, 2) + '/' + ZeroPad(frmDy, 2) + '/' + frmYr;
+  compareDate = new Date(frmDate);
+  var newDate = ZeroPad(compareDate.getMonth() + 1, 2) + '/' + ZeroPad(compareDate.getDate(), 2) + '/' + frmYr;
+  if (frmDate != newDate)
+  {
+    alert(frmDate + ' is not a valid date!');
+    returnCode = false;
+  }
+  else
+  {
+    if (fdtStr > cdtStr)
+    {
+      alert(frmDate + ' is an invalid BirthDate (greater than current date).\n\nYou have entered: ' + frmDate + ' as a birthdate.\n' + cdtStr + ' is the current date.\n');
+      returnCode = false;
+    }
+    else
+      returnCode = true;
+  }
+  return (returnCode);
+}
+function AutoTabCheck(obj, frmObj)
+{
+  if (obj.value.length == obj.maxLength)
+  {
+    start = obj.id.length - 2;
+    incre = parseInt(obj.id.substr(start, 2));
+    NewIDnum = ZeroPad(incre + 1, 2);
+    NewID = obj.id.substr(0, start) + NewIDnum;
+    newObj = eval(frmObj.id + "." + NewID);
+    newObj.focus();
+  }
+}
+function CancelOutWizard()
+{
+  var leaving = confirm("Clicking [OK] will exit the wizard without submitting, all data will be lost.\nClick [Cancel] to remain here.");
+  if (leaving)
+    window.location.replace('http://pacecares.fhsc.com/default.asp');
+}
+function allMoney(num)
+{
+  numSet = "0123456789.";
+  for (x=0;x<=num.length;x++)
+  {
+    charX = num.substr(x, 1);
+    if (numSet.indexOf(charX) == -1)
+    {
+      leftS = num.substring(0, x);
+      rightS = num.substr(x+1);
+      num = leftS + rightS;
+      x--;
+    }
+  }
+  return(num);
+}
+function allNum(num)
+{
+  numSet = "0123456789";
+  for (x=0;x<=num.length;x++)
+  {
+    charX = num.substr(x, 1);
+    if (numSet.indexOf(charX) == -1)
+    {
+      leftS = num.substring(0, x);
+      rightS = num.substr(x+1);
+      num = leftS + rightS;
+      x--;
+    }
+  }
+  return(num);
+}
+function isAlphaNum(str)
+{
+  alphaSet = "ABCDEFGHIJKLMNOPQRSTUVWXYZ0123456789";
+  newstr = str.toUpperCase();
+  for (x=0; x<newstr.length; x++)
+  {
+    if (alphaSet.indexOf(newstr.substr(x, 1)) == -1)
+    {
+      x = newstr.length;
+      return false;
+    }
+  }
+  return true;
+}
+function ZeroPad(str, pre)
+{
+  var x;
+  var workstr;
+  for (x=1; x<pre; x++)
+  {
+    workstr = "0".concat("0");
+  }
+  return (workstr.concat(str).substr(workstr.concat(str).length-pre));
+}
+function Right(str, retlen)
+{
+  if (retlen >= str.length)
+    return (str);
+  else
+    return (str.substr(str.length - retlen));
+}
+function HighlightField(FldStyle)
+{
+  FldStyle.borderColor = "blue";
+  FldStyle.backgroundColor = "LightSteelBlue";
+}
+function UnHighlightField(FldStyle)
+{
+  FldStyle.borderColor = "";
+  FldStyle.backgroundColor = "";
+}
+function AddTotalsthenSubmit(j)
+{
+  xx = 0, yrvalue = 0, spvalue = 0;
+  while (xx<7)
+  {
+    xx++;
+    tot = eval("document.frmPace.Tot_Income" + xx);
+    sp = eval("document.frmPace.Sp_Income" + xx);
+    yr = eval("document.frmPace.Yr_Income" + xx);
+    tvalue = parseFloat(yr.value) + parseFloat(sp.value);
+    yrvalue = yrvalue + parseFloat(yr.value);
+    spvalue = spvalue + parseFloat(sp.value);
+    tot.value = Math.round(tvalue * Math.pow(10, 2)) / Math.pow(10, 2);
+    if (xx == 6)
+    {
+      document.frmPace.Yr_Income7.value = Math.round(yrvalue * Math.pow(10, 2)) / Math.pow(10, 2);
+      document.frmPace.Sp_Income7.value = Math.round(spvalue * Math.pow(10, 2)) / Math.pow(10, 2);
+    }
+  }
+}
+function IndividualEdits(Indv, obj, NoFocus)
+{
+  var Status = true;
+  frm6Obj = document.frmSect06;
+  switch(Indv)
+  {
+    case "ssn":
+      val = obj.value;
+      if (isAlphaNum(val))
+      {
+        obj.value = val;
+        if (val.length > 1 && val.length != 9)
+        {
+          alert('SSN can contain a combination 9 numerics and/or letters.');
+          if (!NoFocus)
+            obj.focus();
+          Status = false;
+        }
+      }
+      else
+      {
+        Status = false;
+      }
+      break;
+    case "areacode":
+      val = obj.value;
+      newNum = allNum(val);
+      obj.value = newNum;
+      if (newNum.length > 1 && newNum.length != 3)
+      {
+        alert('area code must contain 3 numerics.');
+        if (!NoFocus)
+          obj.focus();
+        Status = false;
+      }
+      break;
+    case "phone":
+      val = obj.value;
+      newNum = allNum(val);
+      obj.value = newNum;
+      if (newNum.length > 1 && newNum.length != 7)
+      {
+        alert('phone trunk must contain 7 numerics.');
+        if (!NoFocus)
+          obj.focus();
+        Status = false;
+      }
+      break;
+    case "zip":
+      val = obj.value;
+      newNum = allNum(val);
+      obj.value = newNum;
+      if (newNum.length > 1 && newNum.length != 5)
+      {
+        alert('zip code must contain 5 numerics.');
+        obj.focus();
+        Status = false;
+      }
+      break;
+    case "zip4":
+      val = obj.value;
+      newNum = allNum(val);
+      obj.value = newNum;
+      if (newNum.length > 1 && newNum.length != 4)
+      {
+        alert('zip code suffix must contain 4 numerics.');
+        obj.focus();
+        Status = false;
+      }
+      break;
+    case "money":
+      val = obj.value;
+      newNum = allMoney(val);
+      obj.value = newNum;
+      if (newNum.length > 7)
+      {
+        alert('Money field can contain no more than 7 numerics including decimals.');
+        obj.focus();
+        Status = false;
+      }
+      break;
+    case "divYear":
+      val = obj.value;
+      if (frm6Obj.Yr_mstat[0].checked || frm6Obj.Yr_mstat[1].checked)
+      {
+        obj.value = '';
+      }
+      break;
+    case "marStat":
+      if (frm6Obj.Yr_mstat[0].checked || frm6Obj.Yr_mstat[1].checked)
+      {
+        frm6Obj.DSyear.value = '';
+      }
+      break;
+    default:
+  }
+  return Status;
+}
+function HelpWindows(Proof)
+{
+  switch(Proof)
+  {
+    case "Age":
+      alert("Valid Proofs of Age:\n" +
+            "(note: The following examples are acceptable documents but not limited to:)\n\n" +
+            "- Birth Certificate/foreign birth certificate\n" +
+            "- Baptismal Record\n" +
+            "- Valid Driver's License\n" +
+            "- Social Security Document\n" +
+            "- Insurance Policy (not an insurance application)\n" +
+            "- Photocopy of previous PACE/PACENET card\n" +
+            "- Passport\n" +
+            "- Military Discharge Papers");
+      break;
+    case "Addr":
+      alert("Valid Proofs of Residency:\n" +
+            "(note: The following examples are acceptable documents but not limited to:)\n\n" +
+            "- Valid Driver's License/Owner's Card\n" +
+            "- Utility reciepts\n" +
+            "- Pre-printed rent reciepts\n" +
+            "- Social Security correspondence\n" +
+            "- Nursing Home residents may submit a letter on the facility's stationery stating the admission date and signed by the director or administrator\n" +
+            "- Local, state, or federal income tax return with a pre-printed name and address label");
+      break;
+    case "Income":
+      alert("Valid Proofs of Income:\n" +
+            "(note: The following examples are acceptable documents but not limited to:)\n\n" +
+            "- PA-40 or an IRS 1040 income tax return\n" +
+            "- Income tax return schedules (B, C, D, etc.)\n" +
+            "- Social Security 1099 form (only document accepted for Social Security income\n" +
+            "- Benefit letter stating SSI payments\n" +
+            "- RRB-1099 and RRB-1099R forms (Railroad)\n" +
+            "- Pension/Annuities/IRA 1099 forms\n" +
+            "- W-2 forms (wages)\n" +
+            "- Bank statement (last month of previous year)\n" +
+            "- Court Order");
+      break;
+    default:
+  }
+}
+function FieldFriendlyDisc(field)
+{
+  switch(field)
+  {
+    case "Yr_lastname":
+      FriendlyName = "Applicant Last Name";
+      break;
+    case "Yr_firstname":
+      FriendlyName = "Applicant First Name";
+      break;
+    case "Yr_address":
+      FriendlyName = "Applicant Street Address";
+      break;
+    case "Yr_City":
+      FriendlyName = "Applicant City";
+      break;
+    case "Yr_State":
+      FriendlyName = "Applicant 2-digit State Code";
+      break;
+    case "Yr_zip01":
+      FriendlyName = "Applicant 5-digit Zip Code";
+      break;
+    case "Yr_zip02":
+      FriendlyName = "Applicant 4-digit Zip Code suffix";
+      break;
+    case "Yr_race":
+      FriendlyName = "Applicant Ethnicity Code";
+      break;
+    case "Yr_rtype":
+      FriendlyName = "Applicant Residence Type";
+      break;
+    case "Yr_Mo":
+      FriendlyName = "Applicant Birth Month";
+      break;
+    case "Yr_Day":
+      FriendlyName = "Applicant Birth Day of Month";
+      break;
+    case "Yr_Year":
+      FriendlyName = "Applicant Birth Year";
+      break;
+    case "Yr_ssn":
+      FriendlyName = "Applicant Social Security Number";
+      break;
+    case "Yr_phone01":
+      FriendlyName = "Applicant 3-digit Area Code";
+      break;
+    case "Yr_phone7":
+      FriendlyName = "Applicant 7-digit Telephone Number";
+      break;
+    case "Yr_mstat":
+      FriendlyName = "Marital Status";
+      break;
+    case "Sp_lastname":
+      FriendlyName = "Spouse Last Name";
+      break;
+    case "Sp_firstname":
+      FriendlyName = "Spouse First Name";
+      break;
+    case "Sp_address":
+      FriendlyName = "Spouse Street Address";
+      break;
+    case "Sp_City":
+      FriendlyName = "Spouse City";
+      break;
+    case "Sp_State":
+      FriendlyName = "Spouse 2-digit State Code";
+      break;
+    case "Sp_zip01":
+      FriendlyName = "Spouse 5-digit Zip Code";
+      break;
+    case "Sp_zip02":
+      FriendlyName = "Spouse 4-digit Zip Code suffix";
+      break;
+    case "Sp_race":
+      FriendlyName = "Spouse Ethnicity Code";
+      break;
+    case "Sp_rtype":
+      FriendlyName = "Spouse Residence Type";
+      break;
+    case "Sp_Mo":
+      FriendlyName = "Spouse Birth Month";
+      break;
+    case "Sp_Day":
+      FriendlyName = "Spouse Birth Day of Month";
+      break;
+    case "Sp_Year":
+      FriendlyName = "Spouse Birth Year";
+      break;
+    case "Sp_ssn":
+      FriendlyName = "Spouse Social Security Number";
+      break;
+    case "Sp_phone01":
+      FriendlyName = "Spouse 3-digit Area Code";
+      break;
+    case "Sp_phone7":
+      FriendlyName = "Spouse 7-digit Telephone Number";
+      break;
+    case "DSyear":
+      FriendlyName = "Year of Divorce or Separation";
+      break;
+    case "yrPOA_name":
+      FriendlyName = "Applicant Power of Attorney name";
+      break;
+    case "yrPOA_address":
+      FriendlyName = "Applicant Power of Attorney address";
+      break;
+    case "yrPOA_city":
+      FriendlyName = "Applicant Power of Attorney city";
+      break;
+    case "yrPOA_state":
+      FriendlyName = "Applicant Power of Attorney state";
+      break;
+    case "yrPOA_zip01":
+      FriendlyName = "Applicant Power of Attorney 5-digit Zip Code";
+      break;
+    case "yrPOA_zip02":
+      FriendlyName = "Applicant Power of Attorney 4-digit Zip Code suffix";
+      break;
+    case "yrPOA_phone01":
+      FriendlyName = "Applicant Power of Attorney area code";
+      break;
+    case "yrPOA_phone02":
+      FriendlyName = "Applicant Power of Attorney 3-digit section of phone number";
+      break;
+    case "yrPOA_phone03":
+      FriendlyName = "Applicant Power of Attorney 4-digit section of phone number";
+      break;
+    case "yrPOA_year":
+      FriendlyName = "Applicant Power of Attorney Year Assigned";
+      break;
+    case "spPOA_name":
+      FriendlyName = "Spouse Power of Attorney name";
+      break;
+    case "spPOA_address":
+      FriendlyName = "Spouse Power of Attorney address";
+      break;
+    case "spPOA_city":
+      FriendlyName = "Spouse Power of Attorney city";
+      break;
+    case "spPOA_state":
+      FriendlyName = "Spouse Power of Attorney state";
+      break;
+    case "spPOA_zip01":
+      FriendlyName = "Spouse Power of Attorney 5-digit Zip Code";
+      break;
+    case "spPOA_zip02":
+      FriendlyName = "Spouse Power of Attorney 4-digit Zip Code suffix";
+      break;
+    case "spPOA_phone01":
+      FriendlyName = "Spouse Power of Attorney area code";
+      break;
+    case "spPOA_phone02":
+      FriendlyName = "Spouse Power of Attorney 3-digit section of phone number";
+      break;
+    case "spPOA_phone03":
+      FriendlyName = "Spouse Power of Attorney 4-digit section of phone number";
+      break;
+    case "spPOA_year":
+      FriendlyName = "Spouse Power of Attorney Year Assigned";
+      break;
+    case "Scan01":
+      FriendlyName = "Valid Proof of Age Image";
+      break;
+    case "Scan02":
+      FriendlyName = "Valid Proof of Residence Image";
+      break;
+    case "Scan03":
+      FriendlyName = "Valid Proof of Income Image";
+      break;
+    default:
+      FriendlyName = field + ' [discription missing]';
+  }
+  return (FriendlyName + ' is a required field.');
+}
+function RequiredFields(page)
+{
+  errmsg = "";
+  blnReqFlds = false;
+  Statchecked = false;
+  switch(page)
+  {
+    case "002":
+      frmObj = document.frmSect02;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Yr_lastname":
+          case "Yr_firstname":
+          case "Yr_address":
+          case "Yr_City":
+          case "Yr_State":
+          case "Yr_zip01":
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          default:
+        }
+      }
+      break;
+    case "003":
+      frmObj = document.frmSect03;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Yr_Mo":
+          case "Yr_Day":
+          case "Yr_Year":
+            if (frmObj.elements[i].value.length < 1 || frmObj.elements[i].value == 0)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          case "Yr_BDate":
+            if (frmObj.Yr_Mo.value > 0 && frmObj.Yr_Day.value > 0 && frmObj.Yr_Year.value > 0)
+            {
+              if (DateCheck(frmObj.Yr_Mo.value, frmObj.Yr_Day.value, frmObj.Yr_Year.value) == false)
+                blnReqFlds = true;
+            }
+            break;
+          case "Yr_ssn":
+            frmObj.elements[i].value = frmObj.Yr_ssn01.value + frmObj.Yr_ssn02.value + frmObj.Yr_ssn03.value;
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.Yr_ssn01.style);
+              HighlightField(frmObj.Yr_ssn02.style);
+              HighlightField(frmObj.Yr_ssn03.style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.Yr_ssn01.style);
+              UnHighlightField(frmObj.Yr_ssn02.style);
+              UnHighlightField(frmObj.Yr_ssn03.style);
+              if (IndividualEdits('ssn', frmObj.elements[i], true) == false)
+              {
+                frmObj.Yr_ssn01.focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          /* 09/01/2002 - Now, remove requirement on AreaCode and Phone
+          case "Yr_phone01":
+            if (frmObj.elements[i].value.length < 1 || frmObj.elements[i].value == 0)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+              if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+              {
+                frmObj.elements[i].focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          */
+          case "Yr_phone7":
+            frmObj.elements[i].value = frmObj.Yr_phone02.value + frmObj.Yr_phone03.value;
+            if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+            {
+              frmObj.Yr_phone02.focus();
+              blnReqFlds = true;
+            }
+            break;
+          /*
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.Yr_phone02.style);
+              HighlightField(frmObj.Yr_phone03.style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.Yr_phone02.style);
+              UnHighlightField(frmObj.Yr_phone03.style);
+              if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+              {
+                frmObj.Yr_phone02.focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          */
+          default:
+        }
+      }
+      break;
+    case "004":
+      frmObj = document.frmSect04;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Sp_lastname":
+          case "Sp_firstname":
+          case "Sp_address":
+          case "Sp_City":
+          case "Sp_State":
+          case "Sp_zip01":
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          default:
+        }
+      }
+      break;
+    case "005":
+      frmObj = document.frmSect05;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Sp_Mo":
+          case "Sp_Day":
+          case "Sp_Year":
+            if (frmObj.elements[i].value.length < 1 || frmObj.elements[i].value == 0)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          case "Sp_BDate":
+            if (frmObj.Sp_Mo.value > 0 && frmObj.Sp_Day.value > 0 && frmObj.Sp_Year.value > 0)
+            {
+              if (DateCheck(frmObj.Sp_Mo.value, frmObj.Sp_Day.value, frmObj.Sp_Year.value) == false)
+                blnReqFlds = true;
+            }
+            break;
+          case "Sp_ssn":
+            frmObj.elements[i].value = frmObj.Sp_ssn01.value + frmObj.Sp_ssn02.value + frmObj.Sp_ssn03.value;
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.Sp_ssn01.style);
+              HighlightField(frmObj.Sp_ssn02.style);
+              HighlightField(frmObj.Sp_ssn03.style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.Sp_ssn01.style);
+              UnHighlightField(frmObj.Sp_ssn02.style);
+              UnHighlightField(frmObj.Sp_ssn03.style);
+              if (IndividualEdits('ssn', frmObj.elements[i], true) == false)
+              {
+                frmObj.Sp_ssn01.focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          /* 09/01/2002 - Now, remove requirement on AreaCode and Phone
+          case "Sp_phone01":
+            if (frmObj.elements[i].value.length < 1 || frmObj.elements[i].value == 0)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+              if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+              {
+                frmObj.elements[i].focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          */
+          case "Sp_phone7":
+            frmObj.elements[i].value = frmObj.Sp_phone02.value + frmObj.Sp_phone03.value;
+            if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+            {
+              frmObj.Sp_phone02.focus();
+              blnReqFlds = true;
+            }
+            break;
+          /*
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.Sp_phone02.style);
+              HighlightField(frmObj.Sp_phone03.style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.Sp_phone02.style);
+              UnHighlightField(frmObj.Sp_phone03.style);
+              if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+              {
+                frmObj.Sp_phone02.focus();
+                blnReqFlds = true;
+              }
+            }
+            break;
+          */
+          default:
+        }
+      }
+      break;
+    case "006":
+      frmObj = document.frmSect06;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Yr_rtype":
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          default:
+            switch (frmObj.elements[i].id)
+            {
+              case "Yr_mstat":
+                if (frmObj.elements[i].value.length < 1)
+                {
+                  errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+                  HighlightField(frmObj.elements[i].style);
+                  blnReqFlds = true;
+                }
+                else
+                {
+                  UnHighlightField(frmObj.elements[i].style);
+                }
+                break;
+              case "DSyear":
+                if (frmObj.Yr_mstat.value == '3' || frmObj.Yr_mstat.value == '4')
+                {
+                  if (frmObj.elements[i].value.length < 1)
+                  {
+                    errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+                    HighlightField(frmObj.elements[i].style);
+                    blnReqFlds = true;
+                  }
+                  else
+                  {
+                    UnHighlightField(frmObj.elements[i].style);
+                  }
+                }
+              default:
+            }
+        }
+      }
+      break;
+    case "007":
+      frmObj = document.frmSect07;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "Sp_rtype":
+            if (frmObj.elements[i].value.length < 1)
+            {
+              errmsg = errmsg + FieldFriendlyDisc(frmObj.elements[i].id) + "\n";
+              HighlightField(frmObj.elements[i].style);
+              blnReqFlds = true;
+            }
+            else
+            {
+              UnHighlightField(frmObj.elements[i].style);
+            }
+            break;
+          default:
+        }
+      }
+      break;
+    case "008":
+      frmObj = document.frmSect08;
+      Inc01 = frmObj.Tot_Income1;
+      Inc02 = frmObj.Tot_Income2;
+      Inc03 = frmObj.Tot_Income3;
+      Inc04 = frmObj.Tot_Income4;
+      Inc05 = frmObj.Tot_Income5;
+      Inc06 = frmObj.Tot_Income6;
+      spInc01 = frmObj.sp_Tot_Income1;
+      spInc02 = frmObj.sp_Tot_Income2;
+      spInc03 = frmObj.sp_Tot_Income3;
+      spInc04 = frmObj.sp_Tot_Income4;
+      spInc05 = frmObj.sp_Tot_Income5;
+      spInc06 = frmObj.sp_Tot_Income6;
+      tvalue = 0;
+      tvalue = tvalue + parseFloat(Inc01.value) + parseFloat(Inc02.value);
+      tvalue = tvalue + parseFloat(Inc03.value) + parseFloat(Inc04.value);
+      tvalue = tvalue + parseFloat(Inc05.value) + parseFloat(Inc06.value);
+      tvalue = tvalue + parseFloat(spInc01.value) + parseFloat(spInc02.value);
+      tvalue = tvalue + parseFloat(spInc03.value) + parseFloat(spInc04.value);
+      tvalue = tvalue + parseFloat(spInc05.value) + parseFloat(spInc06.value);
+      frmObj.Tot_Income7.value = Math.round(tvalue * Math.pow(10, 2)) / Math.pow(10, 2);
+      blnReqFlds = false;
+      break;
+    case "888":
+      //There is a bug here.  Since boolean value can be
+      //changed on just either Applicant or spouse being
+      //correct, only having one correct can bypass the check.
+      //SIW  07.21.2004
+      frmObj = document.frmSect888;
+      if ((frmObj.CertFirstA.value == frmObj.hdn888AF.value) && (frmObj.CertLastA.value == frmObj.hdn888AL.value) && (frmObj.CertMiA.value == frmObj.hdn888AM.value))
+      {
+        blnReqFlds = false;
+      }
+      else
+      {
+        errmsg = errmsg + "The entered name must exactly match that entered for the Applicant." + "\n";
+        blnReqFlds = true;
+      }
+      if (frmObj.hdn888SF.value.length > 0)
+      {
+        if ((frmObj.CertFirstS.value == frmObj.hdn888SF.value) && (frmObj.CertLastS.value == frmObj.hdn888SL.value) && (frmObj.CertMiS.value == frmObj.hdn888SM.value))
+        {
+          blnReqFlds = false;
+        }
+        else
+        {
+          errmsg = errmsg + "The entered name must exactly match that entered for the Spouse." + "\n";
+          blnReqFlds = true;
+        }
+      }
+      break;
+    case "009":
+      frmObj = document.frmSect09;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "yrPOA_check":
+            if (frmObj.yrPOA_check.checked)
+            {
+              if (frmObj.yrPOA_name.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_name.id) + "\n";
+                HighlightField(frmObj.yrPOA_name.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_name.style);
+              }
+              if (frmObj.yrPOA_address.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_address.id) + "\n";
+                HighlightField(frmObj.yrPOA_address.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_address.style);
+              }
+              if (frmObj.yrPOA_city.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_city.id) + "\n";
+                HighlightField(frmObj.yrPOA_city.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_city.style);
+              }
+              if (frmObj.yrPOA_state.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_state.id) + "\n";
+                HighlightField(frmObj.yrPOA_state.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_state.style);
+              }
+              if (frmObj.yrPOA_zip01.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_zip01.id) + "\n";
+                HighlightField(frmObj.yrPOA_zip01.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_zip01.style);
+              }
+              //yrPOAyr = frmObj.yrPOA_year;
+              //valYear = yrPOAyr.options[yrPOAyr.selectedIndex].value;
+              //if (valYear.length < 1)
+              //{
+              //  errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_year.id) + "\n";
+              //  HighlightField(frmObj.yrPOA_year.style);
+              //  blnReqFlds = true;
+              //}
+              //else
+              //{
+              //  UnHighlightField(frmObj.yrPOA_year.style);
+              //}
+              /*
+              if (frmObj.yrPOA_phone01.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_phone01.id) + "\n";
+                HighlightField(frmObj.yrPOA_phone01.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_phone01.style);
+              }
+              if (frmObj.yrPOA_phone02.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_phone02.id) + "\n";
+                HighlightField(frmObj.yrPOA_phone02.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_phone02.style);
+              }
+              if (frmObj.yrPOA_phone03.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.yrPOA_phone03.id) + "\n";
+                HighlightField(frmObj.yrPOA_phone03.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.yrPOA_phone03.style);
+              }
+            */
+            }
+            break;
+          case "yrPOA_phone10":
+            frmObj.elements[i].value = frmObj.yrPOA_phone01.value;
+            if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+            {
+              frmObj.yrPOA_phone01.focus();
+              blnReqFlds = true;
+            }
+            frmObj.elements[i].value = frmObj.yrPOA_phone02.value + frmObj.yrPOA_phone03.value;
+            if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+            {
+              frmObj.yrPOA_phone02.focus();
+              blnReqFlds = true;
+            }
+            if (blnReqFlds == false)
+              frmObj.elements[i].value = frmObj.yrPOA_phone01.value + frmObj.yrPOA_phone02.value + frmObj.yrPOA_phone03.value;
+            break;
+          default:
+        }
+      }
+      break;
+    case "010":
+      frmObj = document.frmSect10;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "spPOA_check":
+            if (frmObj.spPOA_check.checked)
+            {
+              if (frmObj.spPOA_name.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_name.id) + "\n";
+                HighlightField(frmObj.spPOA_name.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_name.style);
+              }
+              if (frmObj.spPOA_address.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_address.id) + "\n";
+                HighlightField(frmObj.spPOA_address.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_address.style);
+              }
+              if (frmObj.spPOA_city.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_city.id) + "\n";
+                HighlightField(frmObj.spPOA_city.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_city.style);
+              }
+              if (frmObj.spPOA_state.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_state.id) + "\n";
+                HighlightField(frmObj.spPOA_state.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_state.style);
+              }
+              if (frmObj.spPOA_zip01.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_zip01.id) + "\n";
+                HighlightField(frmObj.spPOA_zip01.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_zip01.style);
+              }
+              //spPOAyr = frmObj.spPOA_year;
+              //valYear = spPOAyr.options[spPOAyr.selectedIndex].value;
+              //if (valYear.length < 1)
+              //{
+              //  errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_year.id) + "\n";
+              //  HighlightField(frmObj.spPOA_year.style);
+              //  blnReqFlds = true;
+              //}
+              //else
+              //{
+              //  UnHighlightField(frmObj.spPOA_year.style);
+              //}
+              /*
+              if (frmObj.spPOA_phone01.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_phone01.id) + "\n";
+                HighlightField(frmObj.spPOA_phone01.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_phone01.style);
+              }
+              if (frmObj.spPOA_phone02.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_phone02.id) + "\n";
+                HighlightField(frmObj.spPOA_phone02.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_phone02.style);
+              }
+              if (frmObj.spPOA_phone03.value.length < 1)
+              {
+                errmsg = errmsg + FieldFriendlyDisc(frmObj.spPOA_phone03.id) + "\n";
+                HighlightField(frmObj.spPOA_phone03.style);
+                blnReqFlds = true;
+              }
+              else
+              {
+                UnHighlightField(frmObj.spPOA_phone03.style);
+              }
+            */
+            }
+            break;
+          case "spPOA_phone10":
+            frmObj.elements[i].value = frmObj.spPOA_phone01.value;
+            if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+            {
+              frmObj.spPOA_phone01.focus();
+              blnReqFlds = true;
+            }
+            frmObj.elements[i].value = frmObj.spPOA_phone02.value + frmObj.spPOA_phone03.value;
+            if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+            {
+              frmObj.spPOA_phone02.focus();
+              blnReqFlds = true;
+            }
+            if (blnReqFlds == false)
+              frmObj.elements[i].value = frmObj.spPOA_phone01.value + frmObj.spPOA_phone02.value + frmObj.spPOA_phone03.value;
+            break;
+          default:
+        }
+      }
+      break;
+    case "011":
+      frmObj = document.frmSect11;
+      for (i=0; i<frmObj.length; i++)
+      {
+        switch (frmObj.elements[i].id)
+        {
+          case "yr_prepphone10":
+            frmObj.elements[i].value = frmObj.yr_prepphone01.value;
+            if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+            {
+              frmObj.yr_prepphone01.focus();
+              blnReqFlds = true;
+            }
+            frmObj.elements[i].value = frmObj.yr_prepphone02.value + frmObj.yr_prepphone03.value;
+            if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+            {
+              frmObj.yr_prepphone02.focus();
+              blnReqFlds = true;
+            }
+            if (blnReqFlds == false)
+              frmObj.elements[i].value = frmObj.yr_prepphone01.value + frmObj.yr_prepphone02.value + frmObj.yr_prepphone03.value;
+            break;
+          default:
+        }
+      }
+      break;
+    //case "012":
+    //  frmObj = document.frmSect12;
+    //  for (i=0; i<frmObj.length; i++)
+    //  {
+    //    switch (frmObj.elements[i].id)
+    //    {
+    //      case "sp_prepphone10":
+    //        frmObj.elements[i].value = frmObj.sp_prepphone01.value;
+    //        if (IndividualEdits('areacode', frmObj.elements[i], true) == false)
+    //        {
+    //          frmObj.sp_prepphone01.focus();
+    //          blnReqFlds = true;
+    //        }
+    //        frmObj.elements[i].value = frmObj.sp_prepphone02.value + frmObj.sp_prepphone03.value;
+    //        if (IndividualEdits('phone', frmObj.elements[i], true) == false)
+    //        {
+    //          frmObj.sp_prepphone02.focus();
+    //          blnReqFlds = true;
+    //        }
+    //        if (blnReqFlds == false)
+    //          frmObj.elements[i].value = frmObj.sp_prepphone01.value + frmObj.sp_prepphone02.value + frmObj.sp_prepphone03.value;
+    //        break;
+    //    }
+    //  }
+    //  break;
+    default:
+  }
+  if (blnReqFlds)
+  {
+    if (errmsg.length > 0)
+      alert(errmsg);
+  }
+  return(blnReqFlds);
+}
+function GoSubmit(frmObj)
+{
+  if (RequiredFields(frmObj.hdnfrm.value) == false)
+  {
+    frmObj.submit();
+  }
+}
+function popUp(url)
+{
+  sealWin=window.open(url,"win",'toolbar=0,location=0,directories=0,status=1,menubar=1,scrollbars=1,resizable=1,width=500,height=450');
+  self.name = "mainWin";
+}
+function AddPrepName(Obj)
+{
+  var typeObj = Obj.id;
+  var frmObj = Obj.form;
+  if (typeObj.substr(0, 2) == "yr")
+  {
+    frmObj.yr_prepname.value = frmObj.hdnPrepAppFirst.value + ' ' + frmObj.hdnPrepAppLast.value;
+    frmObj.yr_prepphone01.value = frmObj.hdnPrepAppAC.value;
+    frmObj.yr_prepphone02.value = frmObj.hdnPrepAppPhone.value.substr(0, 3);
+    frmObj.yr_prepphone03.value = frmObj.hdnPrepAppPhone.value.substr(3, 4);
+  }
+  else
+  {
+    frmObj.sp_prepname.value = frmObj.hdnPrepSpFirst.value + ' ' + frmObj.hdnPrepSpLast.value;
+    frmObj.sp_prepphone01.value = frmObj.hdnPrepSpAC.value;
+    frmObj.sp_prepphone02.value = frmObj.hdnPrepSpPhone.value.substr(0, 3);
+    frmObj.sp_prepphone03.value = frmObj.hdnPrepSpPhone.value.substr(3, 4);
+  }
+}
+</script>
+</head>
+<body bgcolor=GhostWhite>
+  <table border=0 cellpadding=0 cellspacing=0 width="600" align=center>
+    <tr>
+      <td width="50%" align=center>
+        <img src="/images/NewColorLogo.gif" border=0
+             align=absmiddle alt="First Health Services Corporation logo"
+             title="First Health Services Corporation logo">
+      </td>
+      <td width="50%" align=center valign=middle>
+        <img src="/images/PaPACE.gif" border=0
+             align=absmiddle alt="Pennsylvania Department of Aging logo"
+             title="Pennsylvania Department of Aging logo">
+      </td>
+    </tr>
+    <tr>
+      <td width="50%" valign=top nowrap>
+        <b><font size=3 face="Arial">
+        PACE/PACENET Enrollment</font></b>
+      </td>
+      <td width="50%" valign=top nowrap>
+        <b><font size=2 face="Arial">
+        Need Assistance?<br>
+        Call: Inside PA <font color="Red">1-800-225-7223</font> Outside PA <font color="Red">717-651-3600</font><br>
+        Email: <a href="mailto:PACECares@fhsc.com"
+                  title="Email: PACECares@fhsc.com">PACECares@fhsc.com</a>
+        </font></b>
+      </td>
+    </tr>
+  </table>
+  <form id="frmSect11" name="frmSect11" method=get
+        enctype="multipart/form-data" action="PaceWizardDataSet.asp">
+  <table border=2 cellpadding=0 cellspacing=0 width="600" bgcolor="#000066" align=center>
+    <tr><td>
+    <table border=0 cellpadding=0 cellspacing=0 width="100%" bgcolor="#000066" align=center>
+      <tr>
+        <td width="100%" colspan=3><br></td>
+      </tr>
+      <tr bgcolor="LightGrey">
+        <td width="100%" colspan=3 valign=top>
+          <font size=3><b>
+          <input type="checkbox" id="yrprep_check" name="yrprep_check"
+                 onClick="AddPrepName(this)">Check if same
+          as Applicant</b></font>
+        </td>
+      </tr>
+      <tr bgcolor="LightGrey">
+        <td width="20%" nowrap><font size=3><b>Preparer's Name</b></font></td>
+        <td width="80%" colspan=2 valign=bottom nowrap>
+        <input id="yr_prepname" name="yr_prepname" size=30 maxlength=100>
+        <font size=3><b>Preparer's Phone</b></font>
+        (<input id="yr_prepphone01" name="yr_prepphone01" size=3 maxlength=3
+                onKeyUp="AutoTabCheck(this, this.form)">)
+         <input id="yr_prepphone02" name="yr_prepphone02" size=3 maxlength=3
+                onKeyUp="AutoTabCheck(this, this.form)">-<input
+                id="yr_prepphone03" name="yr_prepphone03" size=4 maxlength=4>
+         <input type="hidden" id="yr_prepphone10" name="yr_prepphone10">
+         <input type="hidden" id="hdnPrepAppLast" name="hdnPrepAppLast" value="Doe">
+         <input type="hidden" id="hdnPrepAppFirst" name="hdnPrepAppFirst" value="John">
+         <input type="hidden" id="hdnPrepAppAC" name="hdnPrepAppAC" value="215">
+         <input type="hidden" id="hdnPrepAppPhone" name="hdnPrepAppPhone" value="5551212">
+        </td>
+      </tr>
+      <tr>
+        <td width="100%" align=center nowrap colspan=3><br>
+        <font color="white" size=3><b>Please enter the Preparer's Name & Phone #.<br>
+        When you are done, click on 'Continue'.<br></b></font>
+        </td>
+      </tr>
+      <tr>
+        <td width="100%" align=right nowrap colspan=3><br><br>
+        <input type="button" value="Continue" id=button2 name=button2
+               onClick="Javascript:GoSubmit(document.frmSect11)">
+        <input type="button" value="Cancel" id=button1 name=button1
+               onClick="Javascript:CancelOutWizard()">
+        <input type="hidden" value="011" id="hdnfrm" name="hdnfrm">
+        <br><br>
+        </td>
+      </tr>
+    </table>
+    </td></tr>
+  </table>
+<!--
+     <input type="hidden" id="hdnSpouse" name="hdnSpouse"
+            value="2">
+     <input type="hidden" id="hdnRecIDwr" name="hdnRecIDwr"
+            value="45791">
+     <input type="hidden" id="hdnMiscInfo" name="hdnMiscInfo"
+            value="BFC">
+  </form>
+</body>
+</html>