<html>
<head>
<title>Untitled Document</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
</head>
<body class="sub">
<form name="@@FormName@@" method="@@FormMethod@@" action="@@FormAction@@">
<table width="90%" border="0" cellpadding="8">
<tr>
<td colspan="3" class="HeaderColor"> <h4>Register</h4></td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor" nowrap><label for="username">
User Name*</label></td>
<td colspan="2" class="TitleColor"> <input type="text" id="username" name="textfield">
<br> <span class="small">*Lorem ipsum dolor sit amet, consetetur sadipscing
elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna
aliquyam erat, sed diam voluptua.</span></td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"><label for="password">
Password</label></td>
<td colspan="2" class="TitleColor"> <input type="text" id="password" name="textfield2">
</td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"><label for="confirmpassword">
Confirm<br>
Password*</label></td>
<td colspan="2" class="TitleColor"> <input type="text" id="confirmpassword" name="textfield3">
<br> <span class="small">* Lorem ipsum dolor sit amet, consetetur sadipscing
elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna
aliquyam erat, sed diam voluptua.</span></td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"> Name</td>
<td width="43%" class="TitleColor"> <label for="first">First: </label> <input type="text" id="first" name="textfield4">
</td>
<td width="46%" class="TitleColor"> <label for="last">Last: </label> <input type="text" id="last" name="textfield5">
</td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"><label for="email"> Email</label></td>
<td colspan="2" class="TitleColor"> <input type="text" id="email" name="textfield6" size="50">
</td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"> Gender</td>
<td colspan="2"> <p class="TitleColor">
<label for="male">Male </label>
<input type="radio" id="male" name="radiobutton1" value="radiobutton">
<label for="female">Female </label>
<input type="radio" id="female" name="radiobutton1" value="radiobutton">
</p></td>
</tr>
<tr style="vertical-align: top">
<td style="text-align: right" class="LabelColor"> Birth Date</td>
<td colspan="2"> <table border="0" cellspacing="2" cellpadding="0">
<tr style="text-align: left">
<td class="TitleColor"><label for="month">MM </label> <input type="text" id="month" name="textfield7" size="2"></td>
<td class="TitleColor"><label for="day">DD </label> <input type="text" id="day" name="textfield8" size="2"></td>
<td class="TitleColor"><label for="year">YYYY </label> <input type="text" id="year" name="textfield9" size="4"></td>
</tr>
</table></td>
</tr>
<tr style="vertical-align: top">
<td colspan="3"> <p class="StoryContentColor">Lorem ipsum dolor sit amet,
consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt
ut labore et dolore magna aliquyam erat, sed diam voluptua.<br>
<label for="yes1">Yes </label>
<input type="radio" id="yes1" name="radiobutton2" value="radiobutton" checked>
<br>
<label for="no1"> No </label>
<input type="radio" id="no1" name="radiobutton2" value="radiobutton">
</p>
<p class="StoryContentColor">Lorem ipsum dolor sit amet, consetetur sadipscing
elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna
aliquyam erat, sed diam voluptua. <br>
<label for="yes2">Yes </label>
<input type="radio" id="yes2" name="radiobutton3" value="radiobutton" checked>
<br>
<label for="no2"> No </label>
<input type="radio" id="no2" name="radiobutton3" value="radiobutton">
</p></td>
</tr>
<tr style="vertical-align: top" class="FooterColor">
<td colspan="3"><input type="submit" name="SubmitName" value="@@SubmitLabel@@"></td>
</tr>
</table>
</form>
</body>
</html>