{exp:safecracker channel="clients" datepicker="no" include_jquery="no" return="dashboard/refer/success" rules:client_first_name="required" rules:client_last_name="required" rules:client_home_number="required|numeric" rules:client_mobile_number="numeric" rules:client_address_line_1="required" rules:client_address_town="required" rules:client_address_city="required" rules:client_address_postcode="required" rules:client_number_of_adults="required" rules:client_number_of_children="required" rules:client_referrer_disclaimer="required" } {!-- Hidden Fields --} {!-- END --} Organisation * {exp:query sql="SELECT member_id, screen_name FROM exp_members WHERE group_id = 7;" } {screen_name} {/exp:query} First name * Last name * Home number * Mobile number Address * Number of adults * 0 {options:client_number_of_adults} {option_name} {/options:client_number_of_adults} Number of children * 0 {options:client_number_of_children} {option_name} {/options:client_number_of_children} Notes {field:client_referrer_notes} Disclaimer - by entering a client's details you thereby confirm that this client would benefit from receiving free groceries from {site_name} * {/exp:safecracker}