<!-- BEGIN: profile -->
<div id="ContentBox">
{JS_COUNTY_OPTIONS}
<div class="Title"><h1>{LANG_PERSONAL_INFO_TITLE}</h1></div>
<!-- BEGIN: session_true -->
<!-- BEGIN: no_error -->
<p>{LANG_PROFILE_DESC}</p>
<!-- END: no_error -->
<!-- BEGIN: error -->
<p class="txtError">{VAL_ERROR}</p>
<!-- END: error -->
<form action="index.php?_a=profile{VAL_EXTRA_GET}" target="_self" method="post">
<table border="0" cellspacing="0" cellpadding="3" id="Profile">
<tr>
<td align="right"><strong>{TXT_TITLE}</strong></td>
<td><input name="title" type="text" class="textbox" id="title" value="{VAL_TITLE}" size="7" maxlength="30" /> {LANG_TITLE_DESC}</td>
</tr>
				
<tr>
<td align="right"><strong>{TXT_FIRST_NAME}</strong></td>
<td><input name="firstName" type="text" class="textbox" id="firstName" value="{VAL_FIRST_NAME}" maxlength="100" /> *</td>
</tr>
				
<tr>
<td align="right"><strong>{TXT_LAST_NAME}</strong></td>
<td><input name="lastName" type="text" class="textbox" id="lastName" value="{VAL_LAST_NAME}" maxlength="100" /> *</td>
</tr>
				
<tr>
<td align="right"><strong>{TXT_EMAIL}</strong></td>
<td><input name="email" type="text" class="textbox" id="" value="{VAL_EMAIL}" maxlength="100" /> *</td>
</tr>

<tr>
<td align="right" valign="top"><strong>{TXT_COMPANY_NAME}</strong></td>
<td><input name="companyName" type="text" class="textbox" id="companyName" value="{VAL_COMPANY_NAME}" maxlength="150" /></td>
</tr>

<tr>
<td align="right" valign="top"><strong>{TXT_ADD_1}</strong></td>
<td><input name="add_1" type="text" class="textbox" id="add_1" value="{VAL_ADD_1}" maxlength="100" /> *</td>
</tr>
				
<tr>
<td align="right" valign="top"><strong>{TXT_ADD_2}</strong></td>
<td><input name="add_2" type="text" class="textbox" id="add_2" value="{VAL_ADD_2}" maxlength="100" />&nbsp;</td>
</tr>
				
<tr>
<td align="right" valign="top"><strong>{TXT_TOWN}</strong></td>
<td><input name="town" type="text" class="textbox" id="town" value="{VAL_TOWN}" maxlength="100" /> *</td>
</tr>
				
<tr>
  <td align="right" valign="top"><strong>{TXT_POSTCODE}</strong></td>
  <td><input name="postcode" type="text" class="textbox" id="postcode" value="{VAL_POSTCODE}" maxlength="100" />
    *</td>
</tr>
<tr>
  <td align="right" valign="top"><strong>{TXT_COUNTRY}</strong></td>
  <td><select name="country" id="country" class="textbox" onchange="updateCounty(this.form);">
    <!-- BEGIN: country_opts -->
    <option value="{VAL_COUNTRY_ID}" {COUNTRY_SELECTED}>{VAL_COUNTRY_NAME}</option>
    <!-- END: country_opts -->
  </select> *</td>
</tr>
<tr>
<td align="right" valign="top"><strong>{TXT_COUNTY}</strong></td>
<td>
<div id="divCountyText" {VAL_COUNTY_TXT_STYLE}> 
<input name="county" type="text" class="textbox" id="county" value="{VAL_DEL_COUNTY}" maxlength="50" />
</div>

<div id="divCountySelect" {VAL_COUNTY_SEL_STYLE}> 
<select name="county_sel" id="county_sel" class="textbox">
<!-- BEGIN: county_opts -->
<option value="{VAL_DEL_COUNTY_ID}" {COUNTY_SELECTED}>{VAL_DEL_COUNTY_NAME}</option>
<!-- END: county_opts -->
</select> *
</div>
<input name="which_field" type="hidden" id="which_field" value="{VAL_COUNTY_WHICH_FIELD}" /></td>
 </tr>
				
<tr>
<td align="right"><strong>{TXT_PHONE}</strong></td>
<td><input name="phone" type="text" class="textbox" id="phone" value="{VAL_PHONE}" maxlength="100" /> *</td>
</tr>
				
<tr>
<td align="right"><strong>{TXT_MOBILE}</strong></td>
<td><input name="mobile" type="text" class="textbox" id="mobile" value="{VAL_MOBILE}" maxlength="100" /></td>
</tr>
</tr>
</table>

<div class="BlueBg">
<div class="Button"><input name="submit" type="submit" value="{TXT_SUBMIT}" class="submit" /></div>
</div>
</form>
<!-- END: session_true -->
<!-- BEGIN: session_false -->
<p>{LANG_LOGIN_REQUIRED}</p>
<!-- END: session_false -->
</div>
<!-- END: profile -->