<!-- BEGIN: reg -->
{JS_COUNTY_OPTIONS}

<div class="txtContentTitle">{LANG_REGISTER}</div>
<div class="boxContent">
	<!-- BEGIN: checkout_progress -->
	<div style="text-align: center; height: 25px;">
		<div class="cartProgress">
		{LANG_CART} --- <span class="txtcartProgressCurrent">{LANG_CHECKOUT}</span> --- {LANG_PAYMENT} --- {LANG_COMPLETE}
		</div>
	</div>
	<!-- END: checkout_progress -->
	 
	<!-- BEGIN: no_error -->
	<p>{LANG_REGISTER_DESC}</p>
	<!-- END: no_error -->
	<!-- BEGIN: error -->
	<p class="txtError">{VAL_ERROR}</p>
	<!-- END: error -->
	<form name="registerForm" method="post" action="{VAL_ACTION}">
	<table  border="0" cellspacing="0" cellpadding="3" width="100%">
	  <tr>
		<td colspan="2" class="tdcartTitle">{LANG_PERSONAL_DETAILS}</td>
		<td colspan="2" class="tdcartTitle">{LANG_ADDRESS}</td>
	  </tr>
	  <tr>
	    <td>{LANG_TITLE}</td>
	    <td nowrap="nowrap"><input name="title" type="text" class="textbox" id="title" size="5" value="{VAL_TITLE}" tabindex="1" />
	      {LANG_TITLE_DESC} </td>
	    <td>{LANG_COMPANY_NAME}</td>
	    <td nowrap="nowrap"><input name="companyName" type="text" class="textbox" id="companyName" size="16" value="{VAL_COMPANY_NAME}" tabindex="7" /></td>
	    </tr>
	  <tr>
	    <td>{LANG_FIRST_NAME}</td>
	    <td nowrap="nowrap"><input name="firstName" type="text" class="textbox" id="firstName" size="16" value="{VAL_FIRST_NAME}" tabindex="2" />
	      {ICON_REQUIRED}</td>
	    <td>{LANG_ADDRESS_FORM}</td>
	    <td nowrap="nowrap"><input name="add_1" type="text" class="textbox" id="add_1" size="16" value="{VAL_ADD_1}" tabindex="7" />
{ICON_REQUIRED}</td>
	    </tr>
	  <tr>
	    <td>{LANG_LAST_NAME}</td>
	    <td nowrap="nowrap"><input name="lastName" type="text" class="textbox" id="lastName" size="16" value="{VAL_LAST_NAME}" tabindex="3" />
	      {ICON_REQUIRED} </td>
		<td>&nbsp;</td>
		<td nowrap="nowrap"><input name="add_2" type="text" class="textbox" id="add_2" size="16" value="{VAL_ADD_2}" tabindex="8" /></td>
	  </tr>
	  <tr>
	    <td>{LANG_EMAIL_ADDRESS}</td>
	    <td nowrap="nowrap"><input name="email" type="text" class="textbox" id="email" size="16" value="{VAL_EMAIL}" tabindex="4" />
	      {ICON_REQUIRED} </td>
		<td>{LANG_TOWN}</td>
		<td nowrap="nowrap"><input name="town" type="text" class="textbox" id="town" size="16" value="{VAL_TOWN}" tabindex="9" />
{ICON_REQUIRED}</td>
	  </tr>
	  <tr>
	    <td>{LANG_TELEPHONE}</td>
	    <td nowrap="nowrap"><input name="phone" type="text" class="textbox" id="phone" size="16" value="{VAL_PHONE}" tabindex="5" />
	      {ICON_REQUIRED} </td>
		<td>{LANG_COUNTRY}</td>
	    <td nowrap="nowrap"><select name="country" class="textbox" tabindex="10" onchange="updateCounty(this.form);" style="width: 138px;">
          <!-- BEGIN: repeat_countries -->
          <option value="{VAL_COUNTRY_ID}" {VAL_COUNTRY_SELECTED}>{VAL_COUNTRY_NAME}</option>
          <!-- END: repeat_countries -->
        </select>
		  {ICON_REQUIRED}</td>
	  </tr>
	  <tr>
	    <td>{LANG_MOBILE}</td>
	    <td nowrap="nowrap"><input name="mobile" type="text" class="textbox" id="mobile" size="16" value="{VAL_MOBILE}" tabindex="6" /></td>
		<td>{LANG_COUNTY}</td>
		<td nowrap="nowrap">
		<div id="divCountyText" {VAL_COUNTY_TXT_STYLE}>
		  <input name="county" type="text" class="textbox" id="county" value="{VAL_DEL_COUNTY}" maxlength="50"  tabindex="10" />
		</div>
		<div id="divCountySelect" {VAL_COUNTY_SEL_STYLE}>
		  <select name="county_sel" id="county_sel" class="textbox"  tabindex="11">
		  <!-- 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}" />
		{ICON_REQUIRED}</td>
	  </tr>
	  <tr>
		<td>&nbsp;</td>
		<td nowrap="nowrap">&nbsp;</td>
	    <td>{LANG_POSTCODE}</td>
	    <td nowrap="nowrap"><input name="postcode" type="text" class="textbox" id="postcode" size="16" value="{VAL_POSTCODE}" tabindex="12" />
{ICON_REQUIRED}</td>
	  </tr>
	  <tr>
		<td colspan="4" class="tdcartTitle">{LANG_SECURITY_DETAILS}</td>
	  </tr>
	  <!-- BEGIN: account_opt -->
	  <tr>
		<td colspan="4">{LANG_NO_ACCOUNT_WANTED}
		  <input name="skipReg" type="checkbox" onclick="toggleReg();" value="1" {VAL_SKIP_REG_CHECKED} /></td>
		</tr>
	  <!-- END: account_opt -->
	  <tr>
		<td>{LANG_CHOOSE_PASSWORD}</td>
		<td nowrap="nowrap"><input name="password" type="password" class="{VAL_PASS_CLASS}" id="password" size="16" value="{VAL_PASSWORD}" tabindex="13" /> 
		  {ICON_REQUIRED_SECURITY} </td>
		<td>{LANG_CONFIRM_PASSWORD}</td>
		<td nowrap="nowrap"><input name="passwordConf" type="password" class="{VAL_PASS_CLASS}" id="passwordConf" size="16" value="{VAL_PASSWORD_CONF}" tabindex="14" /> 
		  {ICON_REQUIRED_SECURITY} </td>
	  </tr>
	  <!-- BEGIN: spambot -->
	  <tr>
		<td>{TXT_SPAMBOT}<br />
{IMG_SPAMBOT}</td>
		<td colspan="3"><input name="spamcode" type="text" class="textbox" value="" tabindex="15" size="5" maxlength="5" /> {ICON_REQUIRED}</td>
	  </tr>
	  <!-- END: spambot -->
	  
	  <!-- BEGIN: recaptcha -->
	  <tr>
		<td valign="top"><strong>{TXT_SPAMBOT}</strong></td>
		<td colspan="3">{RECAPTCHA}</td>
	  </tr>
	 <!-- END: recaptcha -->
	  
	  <tr>
		<td colspan="4" class="tdcartTitle">{LANG_PRIVACY_SETTINGS}</td>
	  </tr>
	  <tr>
		<td colspan="2">{LANG_RECIEVE_EMAILS}
		  <input type="checkbox" name="optIn1st" value="1" tabindex="16" {VAL_OPTIN1ST_CHECKED}/></td>
		<td>{LANG_EMAIL_FORMAT}</td>
		<td>
		<select name="htmlEmail" class="textbox" tabindex="17">
		<option value="1">{LANG_HTML_FORMAT}</option>
		<option value="0" {VAL_HTMLEMAIL_SELECTED}>{LANG_PLAIN_TEXT}</option>
		</select>	    </td>
	  </tr>
	  <tr>
		<td colspan="4">{LANG_PLEASE_READ} <a href="{LINK_TANDCS}" target="_blank" class="txtSession">{LANG_TANDCS}</a> <input type="checkbox" name="tandc" value="checkbox" /></td>
		</tr>
	  <tr>
		<td colspan="4"><input name="ESC" type="hidden" value="{VAL_ESC}" /></td>
		</tr>
	  <tr>
		<td colspan="4" align="right"><a href="javascript:submitDoc('registerForm');" class="txtButton" tabindex="17">{LANG_REGISTER_SUBMIT}</a></td>
		</tr>
	</table>

	</form>
</div>
<!-- END: reg -->