Order Takings

Delivery Date
Delivery Time
Funeral Time
Delivery Name

DELIVER TO - PERSON

Block No.

DELIVERY BLOCK NUMBER

1st Digit:
2nd Digit:
3rd Digit:
Door No.

DELIVERY DOOR NUMBER

1st Digit:
2nd Digit:
3rd Digit:
Extension

DELIVERY ALPHABET

ABCD...:
Postcode:

DELIVERY POSTCODE

NOTES

DELIVERY INSTRUCTIONS

Delivery Telephone
What to send
Occassion
Card Message
Spend / Cost
Delivery Charge
Customer Name
Customer Postcode & Door No
Customer Telephone
Paid / To Pay / On Account
JS // This script requires jQuery and jquery-form plugin // You can use these ones from Cloudflare CDN: // // // $('#bootstrapForm').submit(function (event) { event.preventDefault() var extraData = {} { /* Parsing input date id=5267775 */ var dateField = $("#5267775_date").val() var timeField = $("#5267775_time").val() let d = new Date(dateField) if (!isNaN(d.getTime())) { extraData["entry.5267775_year"] = d.getFullYear() extraData["entry.5267775_month"] = d.getMonth() + 1 extraData["entry.5267775_day"] = d.getUTCDate() } if (timeField && timeField.split(':').length >= 2) { let values = timeField.split(':') extraData["entry.5267775_hour"] = values[0] extraData["entry.5267775_minute"] = values[1] } } $('#bootstrapForm').ajaxSubmit({ data: extraData, dataType: 'jsonp', // This won't really work. It's just to use a GET instead of a POST to allow cookies from different domain. error: function () { // Submit of form should be successful but JSONP callback will fail because Google Forms // does not support it, so this is handled as a failure. alert('Form Submitted. Thanks.') // You can also redirect the user to a custom thank-you page: // window.location = 'http://www.mydomain.com/thankyoupage.html' } }) })