] [[!Register? &activation=`0` &submittedResourceId=`65` &usernameField=`email` &emailField=`email`]][[$hsRegisterForm]] [
] <div class="register"> <div class="registerMessage">[[+error.message]]</div> <form name="reg_form" id="reg_form" class="form" action="[[~[[*id]]]]" method="post"> <input type="hidden" name="nospam:blank" value="" /> <h2>Login Info</h2> <div class="col2"> <label for="email">Your Email</label> </div> <div class="col6 last"> <input type="text" name="email:required:required:minLength=6" id="email" value="[[+email]]" /> <label>*</label> <span class="error">[[+error.email]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="password">Password</label> </div> <div class="col6 last"> <input type="password" name="password:required:minLength=6" id="password" value="[[+password]]" /> <label>*</label> <span class="smlltxt">(Must be 6 characters or longer)</span> <span class="error">[[+error.password]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="password_confirm">Confirm Password</label> </div> <div class="col6 last"> <input type="password" name="password_confirm:password_confirm=`password`" id="password_confirm" value="[[+password_confirm]]" /> <label>*</label> <span class="error">[[+error.password_confirm]]</span> </div> <div class="clear"></div> <h2>Contact Info</h2> <div class="col2"> <label for="fullname">Your Full Name</label> </div> <div class="col6 last"> <input type="text" name="fullname:required" id="fullname" value="[[+fullname]]" /> <label>*</label> <span class="error">[[+error.fullname]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="mobilephone">Mobile Number</label> </div> <div class="col6 last"> <input type="text" name="mobilephone:required" id="mobilephone" value="[[+mobilephone]]" /> <label>*</label> <span class="error">[[+error.mobilephone]]</span> </div> <div class="clear"></div> <h2>Billing Info</h2> <div class="col2"> <label for="address">Billing Address</label> </div> <div class="col6 last"> <textarea name="address:required" id="address" rows="2">[[+address]]</textarea> <label>*</label> <span class="error">[[+error.address]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="city">City</label> </div> <div class="col6 last"> <input type="text" name="city" id="city" value="[[+city]]" /> </div> <div class="clear"></div> <div class="col2"> <label for="zip">Postal Code</label> </div> <div class="col6 last"> <input type="text" name="zip" id="zip" value="[[+zip]]" /> </div> <div class="clear"></div> <div class="col2"> <label for="state">County/Region</label> </div> <div class="col6 last"> <input type="text" name="state:required" id="state" value="[[+state]]" /> <label>*</label> <span class="error">[[+error.state]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="country">Country</label> </div> <div class="col6 last"> <select name="country" id="country" title="Please indicate your country of residence"> <option value="Ireland"[[+country:ifequalto=`Ireland`:then=` selected="selected"`]]>Ireland</option> <option value="United Kingdom"[[+country:ifequalto=`United Kingdom`:then=` selected="selected"`]]>United Kingdom</option> </select> <label>*</label> </div> <div class="clear"></div> <h2>Delivery Info</h2> <p> <label for="chk_ship">My delivery info is the same as my billing info</label> <input type="checkbox" id="chk_ship" value="The Same"/> </p> <div class="clear"></div> <div class="col2"> <label for="ship_fullname">Name</label> </div> <div class="col6 last"> <input type="text" name="ship_fullname:required" id="ship_fullname" value="[[+ship_fullname]]"/> <label>*</label> <span class="error">[[+error.ship_fullname]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="ship_address">Address</label> </div> <div class="col6 last"> <textarea name="ship_address:required" id="ship_address" rows="2">[[+ship_address]]</textarea> <label>*</label> <span class="error">[[+error.ship_address]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="ship_city">City</label> </div> <div class="col6 last"> <input type="text" name="ship_city" id="ship_city" value="[[+ship_city]]" /> </div> <div class="clear"></div> <div class="col2"> <label for="ship_zip">Postal Code</label> </div> <div class="col6 last"> <input type="text" name="ship_zip" id="ship_zip" value="[[+ship_zip]]" /> </div> <div class="clear"></div> <div class="col2"> <label for="ship_state">County/Region</label> </div> <div class="col6 last"> <input type="text" name="ship_state:required" id="ship_state" value="[[+ship_state]]" /> <label>*</label> <span class="error">[[+error.ship_state]]</span> </div> <div class="clear"></div> <div class="col2"> <label for="ship_country">Country</label> </div> <div class="col6 last"> <select name="ship_country" id="ship_country" title="Please indicate the address you wish to have your current order shipped to"> <option value="Ireland"[[+ship_country:ifequalto=`Ireland`:then=` selected="selected"`]]>Ireland</option> <option value="United Kingdom"[[+ship_country:ifequalto=`United Kingdom`:then=` selected="selected"`]]>United Kingdom</option> </select> <label>*</label> </div> <div class="clear"></div> <div class="form-buttons"> <input type="submit" name="login-register-btn" value="Register" /> </div> </form> </div> [
[[!$hsRegisterForm]]