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<!-- $Id$ -->
<!-- INCLUDE overall_header.html -->
<form method="post" action="{S_UCP_ACTION}"><table width="80%" cellspacing="2" cellpadding="2" border="0" align="center">
<tr>
<td class="nav"><a href="{U_INDEX}">{L_INDEX}</a></td>
</tr>
</table>
<table class="tablebg" width="80%" cellspacing="1" cellpadding="4" border="0" align="center">
<tr>
<th colspan="2" height="28" valign="middle">{L_REGISTRATION}</th>
</tr>
<!-- IF ERROR -->
<tr>
<td class="row3" colspan="2" align="center"><span class="gensmall" style="color:red">{ERROR}</td>
</tr>
<!-- ENDIF -->
<!-- IF L_ITEMS_REQUIRED -->
<tr>
<td class="row2" colspan="2"><span class="gensmall">{L_ITEMS_REQUIRED}</span></td>
</tr>
<!-- ENDIF -->
<tr>
<td class="row1" width="38%"><b class="genmed">{L_USERNAME}: </b><br /><span class="gensmall">{L_USERNAME_EXPLAIN}</span></td>
<td class="row2"><input class="post" type="text" name="username" size="25" maxlength="40" value="{USERNAME}" /></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_EMAIL_ADDRESS}: </b></td>
<td class="row2"><input class="post" type="text" name="email" size="25" maxlength="255" value="{EMAIL}" /></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_CONFIRM_EMAIL}: </b></td>
<td class="row2"><input class="post" type="text" name="email_confirm" size="25" maxlength="255" value="{EMAIL_CONFIRM}" /></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_NEW_PASSWORD}: </b><br /><span class="gensmall">{L_NEW_PASSWORD_EXPLAIN}</span></td>
<td class="row2"><input class="post" type="password" name="new_password" size="25" maxlength="100" value="{PASSWORD}" /></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_CONFIRM_PASSWORD}: </b></td>
<td class="row2"><input class="post" type="password" name="password_confirm" size="25" maxlength="100" value="{PASSWORD_CONFIRM}" /></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_LANGUAGE}: </b></td>
<td class="row2"><select name="lang">{S_LANG_OPTIONS}</select></td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_TIMEZONE}: </b></td>
<td class="row2"><select name="tz">{S_TZ_OPTIONS}</select></td>
</tr>
<!-- BEGIN profile_fields -->
<tr>
<td class="row1" width="35%"><b class="genmed">{profile_fields.LANG_NAME}: </b><!-- IF profile_fields.LANG_EXPLAIN --><br /><span class="gensmall">{profile_fields.LANG_EXPLAIN}</span><!-- ENDIF --></td>
<td class="row2">{profile_fields.FIELD}<!-- IF profile_fields.ERROR --><br /><span class="gensmall" style="color:red">{profile_fields.ERROR}</span><!-- ENDIF --></td>
</tr>
<!-- END profile_fields -->
<!-- IF S_CONFIRM_CODE -->
<tr>
<th colspan="2" height="28" valign="middle">{L_CONFIRMATION}</th>
</tr>
<tr>
<td class="row3" colspan="2"><span class="gensmall">{L_CONFIRM_EXPLAIN}</span></td>
</tr>
<tr>
<td class="row1" colspan="2" align="center">{CONFIRM_IMG}</td>
</tr>
<tr>
<td class="row1"><b class="genmed">{L_CONFIRM_CODE}: </b><br /><span class="gensmall">{L_CONFIRM_CODE_EXPLAIN}</span></td>
<td class="row2"><input class="post" type="text" name="confirm_code" size="6" maxlength="6" /></td>
</tr>
<!-- ENDIF -->
<!-- IF S_COPPA -->
<tr>
<th colspan="2" height="28" valign="middle">{L_COPPA_COMPLIANCE}</th>
</tr>
<tr>
<td class="row3" colspan="2"><span class="gensmall">{L_COPPA_EXPLAIN}</span></td>
</tr>
<!-- ENDIF -->
<tr>
<td class="cat" colspan="2" align="center" height="28">{S_HIDDEN_FIELDS}<input class="btnmain" type="submit" name="submit" value="{L_SUBMIT}" /> <input class="btnlite" type="reset" value="{L_RESET}" name="reset" /></td>
</tr>
</table></form>
<!-- INCLUDE overall_footer.html -->
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