var mydate= new Date()



chk1="1234567890-";



var day_31 = new Array(1,3,5,7,8,10,12);



function showAge(dob)

{

	

var d =dob.split('/');

var now=new Date();

var today=new Date(now.getFullYear(),now.getMonth()+1,now.getDate());



var bday=new Date(d[2],d[0],d[1]);

var by=bday.getFullYear();



var bm=bday.getMonth();



var bd=bday.getDate();



/*age=today.getFullYear()-by;

alert(now.getMonth());

if(bm>today.getMonth()){age=age-1;}

alert(age);

return age;*/

var age=0;

var dif=bday;



	if(dif>today)

	{

	return -10;

	}



while(dif<today)

{

	

	

	var dif = new Date(by+age,bm,bd);

	

	age++;

}

	age +=-2 ;

	

	return age;

} 



function isNumber(val,msg)

{



	//alert(val.value.length);



	for(i=0;i < val.value.length;i++)

	{

		ch1=val.value.charAt(i);

		rtn1=chk1.indexOf(ch1);

		if(rtn1==-1)

		{

			alert(msg);

			val.focus();

			return false;

		}



	}

	return true;



}





/*BY PG*/



var startyear = "1950";

var endyear = "2010";

var dat = new Date();



var curday = dat.getDate();

var curmon = dat.getMonth()+1;

var curyear = dat.getFullYear();



function checkleapyear(datea)

{

	if(datea.getYear()%4 == 0)

	{

		if(datea.getYear()% 10 != 0)

		{

			return true;

		}

		else

		{

			if(datea.getYear()% 400 == 0)

				return true;

			else

				return false;

		}

	}

return false;

}

function DaysInMonth(Y, M) {

    with (new Date(Y, M, 1, 12)) {

        setDate(0);

        return getDate();

    }

}

function datediff(date1, date2) {

    var y1 = date1.getFullYear(), m1 = date1.getMonth(), d1 = date1.getDate(),

	 y2 = date2.getFullYear(), m2 = date2.getMonth(), d2 = date2.getDate();



    if (d1 < d2) {

        m1--;

        d1 += DaysInMonth(y2, m2);

    }

    if (m1 < m2) {

        y1--;

        m1 += 12;

    }

    return [y1 - y2, m1 - m2, d1 - d2];

}



function calage(dob)

{

	

	

	var d =dob.split('/');

	var now=new Date();

	var today=new Date(now.getFullYear(),now.getMonth()+1,now.getDate());

	

	var bday=new Date(d[2],d[0],d[1]);

	

	var by=bday.getFullYear();

	

	var bm=bday.getMonth();

	

	var bd=bday.getDate();

	

/*var calday = document.birthday.day.options[document.birthday.day.selectedIndex].value;

var calmon = document.birthday.month.options[document.birthday.month.selectedIndex].value;

var calyear = document.birthday.year.options[document.birthday.year.selectedIndex].value;*/

var calday = bd;

var calmon = bm;

var calyear = by;

	if(curday == "" || curmon=="" || curyear=="" || calday=="" || calmon=="" || calyear=="")

	{

		alert("please fill all the values and click go -");

	}	

	else

	{

		var curd = new Date(curyear,curmon-1,curday);

		var cald = new Date(calyear,calmon-1,calday);

		

		var diff =  Date.UTC(curyear,curmon,curday,0,0,0) - Date.UTC(calyear,calmon,calday,0,0,0);



		var dife = datediff(curd,cald);

		//document.birthday.age.value=dife[0]+" years, "+dife[1]+" months, and "+dife[2]+" days";

		var monleft = (dife[0]*12)+dife[1];

		var secleft = diff/1000/60;

		var hrsleft = secleft/60;

		var daysleft = hrsleft/24;

		//alert(daysleft);

		/*document.birthday.months.value=monleft+" Month since your birth";	

		document.birthday.daa.value=daysleft+" days since your birth";	

		document.birthday.hours.value=hrsleft+" hours since your birth";

		document.birthday.min.value=secleft+" minutes since your birth";*/

		var as = parseInt(calyear)+dife[0]+1;

		var diff =  Date.UTC(as,calmon,calday,0,0,0) - Date.UTC(curyear,curmon,curday,0,0,0);

		var datee = diff/1000/60/60/24;

		

		return dife[2];

		/*document.birthday.nbday.value=datee+" days left for your next birthday";	*/





	}

}





/**/

//check form

function check_form()

{	



   //Applicant

	

	if(document.form1.sSex.options[document.form1.sSex.selectedIndex].value=="")

	{

		alert("Please Select Applicant's Gender");

		document.form1.sSex.focus();

		return false;

	}

	if(document.form1.t1.value=="")

	{

		alert("Please Enter Applicant's Date of Birth");

		document.form1.t1.focus();

		return false;

	}

	if(document.form1.t2.value=="")

	{

		alert("Please Enter Applicant's Month of Birth");

		document.form1.t2.focus();

		return false;



	}

	if(document.form1.t3.value=="")	

	{

		alert("Please Enter Applicant's Year of Birth");

		document.form1.t3.focus();

		return false;

	}

	

		if(!isNumber(document.form1.t1,"Please Enter Number in Month Field!"))

		return false;



	else if(document.form1.t1.value > 12 || document.form1.t1.value < 1) 

		{alert("Please Enter valid Month between 1 to 12 !"); document.form1.t1.focus(); return false;}



	var day = 0;

	if(document.form1.t1.value != 0 )

	{	



		var count = 0;

		for(i=0;i< day_31.length;i++)

		{



			//alert(day_31[i]);

			if(document.form1.t1.value == day_31[i])

				{day = 31;break;}

			else if(document.form1.t1.value == 2)

				{day = 28;if(document.form1.t3.value % 4==0)day=29; break;}

			

		}

		if(day==0){day=30;}

		

		



		//alert(day);



	}

	

	



		



	if(!isNumber(document.form1.t2,"Please Enter Number in Day Field!"))

		return false;



	if(document.form1.t2.value < 1 || document.form1.t2.value > day)

		{alert("Please Enter valid Day Between 1 to "+day); document.form1.t2.focus(); return false;}



	if(!isNumber(document.form1.t3,"Please Enter Number in Year Field!"))

		return false;



	else if(document.form1.t3.value.length < 4)

		{
			alert("Please Enter Valid Year !"); document.form1.t3.focus(); 
			return false;
			}
		
	var apdob=document.form1.t1.value+'/'+document.form1.t2.value+'/'+document.form1.t3.value;
	var apage=showAge(apdob);
	
	/*var apage=calage(apdob);*/

	
	//return false;

		
    if(apage < -1 || apage > 65)

	{

		alert("Please Enter Applicant's Age Between 0-64 Years");

		document.form1.t1.focus();

		return false;

	}
/*	else if(apage>18 && apage<65)

	{

		alert("Please Enter Applicant's Age Between 0-64 Years");

		document.form1.t1.focus();

		return false;
	

	}*/



	//Spouse



	if(document.form1.spSex.options[document.form1.spSex.selectedIndex].value!="")

	{



			if(document.form1.t4.value=="")

			{

				alert("Please Enter Spouse Month of Birth");

				document.form1.t4.focus();

				return false;

			}

			if(document.form1.t5.value=="")

			{

				alert("Please Enter Spouse Date of Birth");

				document.form1.t5.focus();

				return false;

			

			}

			if(document.form1.t6.value=="")	

			{

				alert("Please Enter Spouse Year of Birth");

				document.form1.t6.focus();

				return false;

			}

			

			if(!isNumber(document.form1.t4,"Please Enter Number in Month Field!"))

			return false;

			

			else if(document.form1.t4.value > 12 || document.form1.t4.value < 1) 

			{alert("Please Enter valid Month between 1 to 12 !"); document.form1.t4.focus(); return false;}

			

			var day = 0;

			if(document.form1.t4.value != 0 )

			{	

			

				var count = 0;

				for(i=0;i< day_31.length;i++)

				{



					//alert(day_31[i]);

					if(document.form1.t4.value == day_31[i])

						{day = 31;break;}

					else if(document.form1.t4.value == 2)

						{day = 28;if(document.form1.t6.value % 4==0)day = 29; break;}

			

				}

				if(day==0){day=30;}

			

			//alert(day);

			

			}

			

			

			

			if(!isNumber(document.form1.t5,"Please Enter Number in Day Field!"))

			return false;

			

			if(document.form1.t5.value < 1 || document.form1.t5.value > day)

			{alert("Please Enter valid Day Between 1 to "+day); document.form1.t5.focus(); return false;}

			

			if(!isNumber(document.form1.t6,"Please Enter Number in Year Field!"))

			return false;

			

			else if(document.form1.t6.value.length < 4)

			{alert("Please Enter Valid Year !"); document.form1.t6.focus(); return false;}

			var apdob=document.form1.t4.value+'/'+document.form1.t5.value+'/'+document.form1.t6.value;
			
			var apage=showAge(apdob);
			//var apage=calage(apdob);

	

		//alert(apage);

		//return false;
		
		/*if(apage < -1 || apage > 65)

	{

		alert("Please Enter Spouse's Age Between 0-64 Years");

		document.form1.t4.focus();

		return false;

	}
		*/

		if(apage < 18 || apage > 65)

		{

				alert("Please Enter Spouse's Age Between 18-64 years");

				document.form1.t4.focus();

				return false;

			

			}



	}
	




	//Child 1



	if(document.form1.c1Sex.options[document.form1.c1Sex.selectedIndex].value!="")

	{

		if(document.form1.t7.value=="")

			{

				alert("Please Enter Child 1 Month of Birth");

				document.form1.t7.focus();

				return false;

			}

			if(document.form1.t8.value=="")

			{

				alert("Please Enter Child 1 Date of Birth");

				document.form1.t8.focus();

				return false;

			

			}

			if(document.form1.t9.value=="")	

			{

				alert("Please Enter Child 1 Year of Birth");

				document.form1.t9.focus();

				return false;

			}

			

			if(!isNumber(document.form1.t7,"Please Enter Number in Month Field!"))

			return false;

			

			else if(document.form1.t7.value > 12 || document.form1.t7.value < 1) 

			{alert("Please Enter valid Month between 1 to 12 !"); document.form1.t7.focus(); return false;}

			

			var day = 0;

			if(document.form1.t7.value != 0 )

			{	

			

				var count = 0;

				for(i=0;i< day_31.length;i++)

					{



						//alert(day_31[i]);

						if(document.form1.t7.value == day_31[i])

							{day = 31;break;}

						else if(document.form1.t7.value == 2)

							{day = 28;if(document.form1.t9.value % 4==0)day = 29; break;}

			

					}

					if(day==0){day=30;}

						

						//alert(day);

			

			}

			

			

			

			if(!isNumber(document.form1.t8,"Please Enter Number in Day Field!"))

			return false;

			

			if(document.form1.t8.value < 1 || document.form1.t8.value > day)

			{alert("Please Enter valid Day Between 1 to "+day); document.form1.t8.focus(); return false;}

			

			if(!isNumber(document.form1.t8,"Please Enter Number in Year Field!"))

			return false;

			

			else if(document.form1.t9.value.length < 4)

			{alert("Please Enter Valid Year !"); document.form1.t9.focus(); return false;}

			var apdob=document.form1.t7.value+'/'+document.form1.t8.value+'/'+document.form1.t9.value;

			//var apage=calage(apdob);
			var apage=showAge(apdob);
			//alert(apage);

			if(apage < -1 || apage > 17)

			{

				alert("Please Enter Child 1 Age to be 0-18 years");

				document.form1.t7.focus();

				

				return false;

			

			}



    }



	//Child X



	var t = document.getElementById('counter').value;

	var flag = 0;

	for(var id=2;id<=t;id++)

	{

		if(document.getElementById('c'+id+'Sex').value == '')

		{

			flag = 1;

			alert('Please Select Sex of child '+id);   

			document.getElementById('c'+id+'Sex').focus();

			return false;

		}else

		if(document.getElementById('c'+id+'mnth').value == '')

		{

			flag = 1;

			alert('Please Enter Month of Child '+id);

			document.getElementById('c'+id+'mnth').focus();

			return false;

		}else

		if(document.getElementById('c'+id+'dte').value == '')

		{

			flag = 1;

			alert('Please Enter Date of Child'+id);

			document.getElementById('c'+id+'dte').focus();

			return false;

		}else

		if(document.getElementById('c'+id+'yr').value == '')

		{

			flag = 1;

			alert('Please Enter Year of Child'+id);

			document.getElementById('c'+id+'yr').focus();

			return false;

		}



		

		

			if(!isNumber(document.getElementById('c'+id+'mnth'),"Please Enter Number in Month Field!"))

			return false;

			

			else if(document.getElementById('c'+id+'mnth').value > 12) 

			{alert("Please Enter valid Month between 1 to 12 !"); document.getElementById('c'+id+'mnth').focus(); return false;}

			

			var day = 0;

			if(document.getElementById('c'+id+'mnth').value != 0 )

			{	

			

				var count = 0;

				for(i=0;i< day_31.length;i++)

				{

		

					//alert(day_31[i]);

					if(document.getElementById('c'+id+'mnth').value == day_31[i])

						{day = 31;break;}

					else if(document.getElementById('c'+id+'mnth').value == 2)

						{day = 28;if(document.getElementById('c'+id+'yr').value % 4==0)day = 29; break;}

					

				}

				if(day==0){day=30;}

			

			//alert(day);

			

			}

			

			

			

			if(!isNumber(document.getElementById('c'+id+'dte'),"Please Enter Number in Day Field!"))

			return false;

			

			if(document.getElementById('c'+id+'dte').value < 1 || document.getElementById('c'+id+'dte').value > day)

			{alert("Please Enter valid Day Between 1 to "+day); document.getElementById('c'+id+'dte').focus(); return false;}

			

			if(!isNumber(document.getElementById('c'+id+'yr'),"Please Enter Number in Year Field!"))

			return false;

			

			else if(document.getElementById('c'+id+'yr').value.length < 4)

			{alert("Please Enter Valid Year !"); document.getElementById('c'+id+'yr').focus(); return false;}



			var chdob=document.getElementById('c'+id+'mnth').value+'/'+document.getElementById('c'+id+'dte').value+'/'+document.getElementById('c'+id+'yr').value;

			
			//var chage=showAge(chdob);

			//alert(chage);

			if(chage < -1 || chage > 17)

			{

			alert("Please Enter Child"+id+" Age to be 0-18 years");

			document.getElementById('c'+id+'mnth').focus();

			return false;

			

			}	

		//return true;

		}





	//ZIP validation

	if(document.form1.zipCode.value=="")

	{

		alert("Please Enter ZIP Code");

		document.form1.zipCode.focus();

		return false;

	}	



	



	if(document.form1.zipCode.value!="")

	{

		if(document.form1.zipCode.value > 96162)

		{

			alert("PLEASE ENTER A CA ZIP CODE !");

			document.form1.zipCode.focus();	

			return false;

		}



		if(document.form1.zipCode.value < 90001)

		{



			alert("PLEASE ENTER A CA ZIP CODE !");

			document.form1.zipCode.focus();	

			return false;

		}



	}

}







	

	

	/*if(flag == 0)

	{

		document.form1.submit();

		return false;

	}*/

		

		

	







		



	///Spouse validation



	/*if(document.form1.spSex.value!="")

	{



		if(!isNumber(document.form1.t4,"Please Enter Number in Month Field!"))

			return false;

		else if(document.form1.t4.value > 12) 

			{alert("Please Enter valid Month between 1 to 12 !"); document.form1.t4.focus(); return false;}



		var day = 0;

		if(document.form1.t4.value != 0 )

		{	

			var count = 0;			



			for(i=0;i< day_31.length;i++)

			{

				//alert(day_31[i]);

				if(document.form1.t4.value == day_31[i])

					day = 31;



				else if(document.form1.t4.value == 2)

					day = 28;

				else day = 30;

			}



			//alert(day);

		}

		if(document.form1.t5.value < 1 || document.form1.t5.value > day)

		{alert("Please Enter valid Day between 1 to "+day); document.form1.t5.focus(); return false;}



	}	



	



		/// validation for child



	if(document.form1.c1Sex.value!="")

	{

		if(!isNumber(document.form1.t7,"Please Enter Number in Month Field!"))

		return false;

	else if(document.form1.t7.value > 12) 

		{alert("Please Enter valid Month between 1 to 12 !"); document.form1.t7.focus(); return false;}

	var day = 0;



	if(document.form1.t7.value != 0 )

	{	



		var count = 0;	

		for(i=0;i< day_31.length;i++)

		{



		//	alert(day_31[i]);

			if(document.form1.t7.value == day_31[i])

				day = 31;



			else if(document.form1.t7.value == 2)

				day = 28;



			else day = 30;



		}



		//alert(day);



	}	





	if(!isNumber(document.form1.t8,"Please Enter Number in Day Field!"))

		return false;



	if(document.form1.t8.value < 1 || document.form1.t8.value > day)

		{alert("Please Enter valid Day Between 1 to "+day); document.form1.t8.focus(); return false;}



	if(!isNumber(document.form1.t9,"Please Enter Number in Year Field!"))

		return false;



	else if(document.form1.t9.value.length < 4)

		{alert("Please Enter Valid Year !"); document.form1.t9.focus(); return false;}



	}

	



	//alert(mydate.getYear());



	year_validation(document.form1.t3);

	if(document.form1.spSex.value!="")

	{year_validation(document.form1.t6);}



	if(document.form1.c1Sex.value!="")

	{year_validation(document.form1.t9);}













	//if(!isNumber(document.form1.textfield4,"Please Enter Number in Zip Field!"))



		//return false;



//	document.form1.t2.value



	//document.form1.t3.value



	/*



		bdate = document.form1.t1.value+"-"+document.form1.t2.value+"-"+document.form1.t3.value;



		//alert(bdate);



		bdate1 = mydate.getDate()+"-"+mydate.getMonth()+"-"+(parseInt(mydate.getYear())-18);



		//alert(bdate1);



		current_date = mydate.getDate()+"-"+mydate.getMonth()+"-"+mydate.getYear();



		year = (parseInt(mydate.getYear())-18);



		if(parseInt(document.form1.t3.value) < year)



			//alert("hi");



		if(bdate < bdate1)



		{



			alert("Child's Age should not be more then 18 ");



			document.form1.t1.focus();



			return false;



		}



		*/















/*function year_validation(val)

{



		if(val.value > mydate.getYear() || val.value < "1907")

		{alert("Year Should be between 1907 to " + mydate.getFullYear());val.focus(); return false;}



}*/



/*if(document.form1.checkbox.checked!=true)



	{



		alert("Please Select Applicant's Tobacco usage");



		document.form1.checkbox.focus();



		return false;



	}



	if(document.form1.checkbox8.checked!=true)



	{



		alert("Please Select Wather You are full time student or not");



		document.form1.checkbox8.focus();



		return false;



	}*/