enroll.html

---
title: Course Enrollment
description: Please fill out this form to enroll your child in a class.
---

<script type="text/javascript">var submitted=false;</script>
 <iframe name="hidden_iframe" id="hidden_iframe" style="display:none;" onload="if(submitted)  {window.location='{{site.url}}{{site.baseurl}}/enroll-success/';}"></iframe>

<div class="contact-box">

  <form action="https://docs.google.com/forms/u/2/d/e/1FAIpQLScMexV1teb2xaWqbh9xwwHrIm3zlyHd8PFgV2veFb09M1VL_A/formResponse" target="hidden_iframe" onsubmit="submitted=true;" class="contact-form">
    <input type="hidden" name="_to" value="info@artificechicago.org" />
    <input type="text" name="_gotcha" style="display: none;">

    <label for="name">Parent Name</label>
    <input type="text" name="entry.852720456" id="name" placeholder="Enter your name..." required />

    <label for="email">Email Address</label>
    <input type="email" name="entry.1373297091" id="email" placeholder="Enter your email..." required />    

    <label for="phone">Phone Number</label>
    <input type="phone" name="entry.238732337" id="phone" placeholder="Enter your phone number..." required />

    <label for="name">Student Name</label>
    <input type="text" name="entry.1327065882" id="name" placeholder="Enter student name..." required />

    <label for="course">Select Class</label>
    <select name="entry.21653650" id="course">
      <option name="entry.21653650" value="Ray Elementary: Beginner">Ray Elementary: Beginner </option>
      <option name="entry.21653650" value="Ray Elementary: Advanced">Ray Elementary: Advanced </option>
      <option name="entry.21653650" value="Bret Harte Elementary">Bret Harte Elementary </option>
      <option name="entry.21653650" value="Hyde Park Neighborhood Club">Hyde Park Neighborhood Club </option>
    </select>
    <div>
     <label for="media_release" style="font-size:0.7em;display:inline-block;"><input type="checkbox" name="entry.1373764636" value="Yes, I agree" id="media_release" style="display:inline; width:20px" checked/>
     I grant permission for my child's image to be used in newsletters, websites and other media. (<a href="https://docs.google.com/document/d/e/2PACX-1vSSQ9BpQgxC9cBQDhIcYDdmAz1JmKUS4koXzgRPUW4iQPw3gfEtU9oG1HtwnAyUb3JS_irAIeFIzq-x/pub" target="_blank">More Information</a>) </label>
    </div>
    <input type="hidden" name="entry.1482540669" id="paypal_opened"/>
    <input type="hidden" name="entry.2128531668" id="secret_google"/>


    <input type="submit" id="submit-form" style="display:none;" value="Enroll In Course" />
  </form>


<div class="contact-details">
    <form action="https://www.paypal.com/cgi-bin/webscr" method="post" target="_blank" class="contact-form" onsubmit="submitPay()">
      <input type="hidden" name="cmd" value="_s-xclick">
      <input type="hidden" name="hosted_button_id" value="CT3BNANEBYKG4">

<input type="hidden" name="on0" value="transaction_secret">
<input type="hidden" name="os0" value="blank_secret" id="secret_paypal">

<input type="hidden" name="on1" value="student_name">
<input type="hidden" name="os1" value="blank_name" id="name_paypal">

<input type="hidden" name="return" value="http://www.artificechicago.org/enroll/" id="paypal_return">

<input type="submit" value="Pay for Class Now*" name="submitBoth" title="PayPal - The safer, easier way to pay online!" class="button" id="paypal_button">
    </form>
    <p>*You will be taken to a paypal page and you should return here to complete form when finished.</p>
<label id="enroll_button" class="special_button" for="submit-form" tabindex="0">Enroll In Course</label>

</div>


<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>

<script>
function getParameterByName(name, url) {
    if (!url) url = window.location.href;
    name = name.replace(/[\[\]]/g, '\\$&');
    var regex = new RegExp('[?&]' + name + '(=([^&#]*)|&|#|$)'),
        results = regex.exec(url);
    if (!results) return null;
    if (!results[2]) return '';
    return decodeURIComponent(results[2].replace(/\+/g, ' '));
}

function submitPay() {
    $( "#name_paypal" ).val( $( "#name" ).val() );
    $( "#paypal_return" ).val( "http://www.artificechicago.org/enroll/?transaction=" + $( "#secret_paypal" ).val() );
    $( "#paypal_opened" ).val( 'Yes' );
    $( "#enroll_button").css('background-color','#4182e4');
    $( "#paypal_button").css('background-color','rgba(120,120,120,.5)');
}

var str = getParameterByName('transaction');
if (str != null){
  $( "#secret_paypal" ).val( str );
  $( "#secret_google" ).val( str );
  $( "#paypal_opened" ).val( 'Yes' );
  $( "#enroll_button").css('background-color','#4182e4');
  $( "#paypal_button").css('background-color','rgba(120,120,120,.5)');
} else{
  str = Math.random().toString(36).substr(2, 5)
  $( "#secret_paypal" ).val( str );
  $( "#secret_google" ).val( str );
}

</script>