Wed Oct 26, 2011 12:35 am
<script language="javascript" src="<?php echo $HOST."/".$JavaScript; ?>/SignUp.js"></script>
<table>
<form name="form" action="newregister.php" onsubmit="javascript:return CheckEntery(this);" method="post">
<tr>
<td><input type="text" name="username" size="20" /> </td><td colspan="2">:
<?php echo _USERNAME ; ?></td>
</tr>
<tr>
<td><input type="password" name="password" /></td><td colspan="2"> :
<?php echo _PASSWORD ; ?></td>
</tr>
<tr>
<td><input type="password" name="password_again" /></td><td colspan="2"> :
<?php echo _PASSWORD_AGAIN ; ?></td>
</tr>
<tr>
<td><input type="text" name="first_name" /></td><td colspan="2"> :
<?php echo _FIRST_NAME ; ?></td>
</tr>
<tr>
<td><input type="text" name="last_name" /></td><td colspan="2">:
<?php echo _LAST_NAME; ?></td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td><input type="text" name="address1" /></td><td colspan="2">:
<?php echo _ADDRESS1 ; ?></td>
</tr>
<tr>
<td><input type="text" name="address2" /></td><td colspan="2">:
<?php echo _ADDRESS2 ; ?></td>
</tr>
<tr>
<td><input type="text" name="telephone" /></td><td colspan="2">:
<?php echo _TELEPHONE; ?></td>
</tr>
<tr>
<td><input type="text" name="mobile" /></td><td colspan="2">:
<?php echo _MOBILE ; ?></td>
</tr>
<tr>
<td><input type="text" name="email" /></td><td colspan="2">:
<?php echo _EMAIL ; ?></td>
</tr>
<tr bgcolor="#CCCCCC">
<td colspan=3><b> <?php echo _BIRTHDAY; ?></b></font></div></td>
</tr>
<tr bgcolor="#CCCCCC">
<td width="43" bgcolor="#0099CC"> <div align="center">
<font color="#FFFFFF" size=2 face=arial><b><?php echo _DAY; ?></b></font></div></td>
<td width="85" bgcolor="#0099CC"> <div align="center">
<font color="#FFFFFF" size=2 face=arial><b><?php echo _MONTH; ?></b></font></div></td>
<td width="56" bgcolor="#0099CC"> <div align="center">
<font color="#FFFFFF" size=2 face=arial><b><?php echo _YEAR; ?></b></font></div></td>
</tr>
<tr>
<td align="center" width="43" bgcolor="#eeeeee"> <select name="day" id="cmbday">
<option value="0"><?php echo _DAY; ?></option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select> </td>
<td align=center width="85" bgcolor="#eeeeee"> <font face="Arial">
<select name="month" size="1" id="cmbmonth">
<option value="0"><?php echo _MONTH; ?></option>
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
</font> </td>
<td align=center width="56" bgcolor="#eeeeee"> <select name="year" id="cmbyear">
<option value="2009"><?php echo _YEAR; ?></option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
</select></td>
</tr>
<tr>
<td colspan ="3">
<?php
$lookup_type=_COUNTRY;
include 'control/show_lookup_body.php';
?>
<br/>
</td>
</tr>
<script type="text/javascript">
DrawCity();
document.getElementById('csel_field8').onchange= DrawCity;
</script>
<tr>
<td> <select name="gender" >
<option value="0"><?php echo _MALE; ?></option>
<option value="1"><?php echo _FEMALE ; ?></option>
</select> </td><td colspan="2">: <?php echo _GENDER ; ?></td>
</tr>
<tr>
<td>
</td>
</tr>
<tr>
<td>
<img id="captcha" src="<?php echo $HOST;?>/lib/securimage/securimage_show.php" alt="CAPTCHA Image" /><br/>
<a href="#" onclick="document.getElementById('captcha').src = '<?php echo $HOST;?>
/lib/securimage/securimage_show.php?' + Math.random(); return false">
<img src ="<?php echo $HOST;?>/lib/securimage/images/refresh.gif"></img></a>
<input type="text" name="captcha_code" size="10" maxlength="6" />
</td>
</tr>
<tr>
<td colspan="2"><input type="submit" value="<?php echo _REGISTER_BUTTON ; ?>" />
<input type="hidden" name="operation" value="<?php echo _OPERATION_ENTRY ; ?>" />
</td>
</tr>
</form>
</table>
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