<table align=center width=100% border="1" bordercolor="#8080C0">
<tr><td colspan=2 background="img/nav_bg.jpg" align=center valign=middle>
User Registration Form</td></tr>
</table>
<p>By registering you are agreeing to the Dreamers' Athenaeum <a href="terms.php">Terms of Use</a>.</p>
<form action="<?php echo $_SERVER['PHP_SELF']; ?>" method="post">
<table align=center width=100% >
<tr>
<td width=20%>First Name:</td>
<td><input type="text" name="first_name" size="20" maxlength="25" value="<?php if (isset($POST['first_name'])) echo $POST['first_name']; ?>" /></td>
</tr>
<tr>
<td>Last Name:</td>
<td><input type="text" name="last_name" size="25" maxlength="25" value="<?php if (isset($POST['last_name'])) echo $POST['last_name']; ?>" /></td>
</tr>
<TR>
<TD>Birthdate</td>
<TD>
<select name="month">
<option>January
<option>February
<option>March
<option>April
<option>May
<option>June
<option>July
<option>August
<option>September
<option>October
<option>November
<option>December
</select>
<select name="day">
<option>01
<option>02
<option>03
<option>04
<option>05
<option>06
<option>07
<option>08
<option>09
<option>10
<option>11
<option>12
<option>13
<option>14
<option>15
<option>16
<option>17
<option>18
<option>19
<option>20
<option>21
<option>22
<option>23
<option>24
<option>25
<option>26
<option>27
<option>28
<option>29
<option>30
<option>31
</select>
<select name="year">
<option>2002
<option>2001
<option>2000
<option>1999
<option>1998
<option>1997
<option>1996
<option>1995
<option>1994
<option>1993
<option>1992
<option>1991
<option>1990
<option>1989
<option>1988
<option>1987
<option>1986
<option>1985
<option>1984
<option>1983
<option>1982
<option>1981
<option>1980
<option>1979
<option>1978
<option>1977
<option>1976
<option>1975
<option>1974
<option>1973
<option>1972
<option>1971
<option>1970
<option>1969
<option>1968
<option>1967
<option>1966
<option>1965
<option>1964
<option>1963
<option>1962
<option>1961
<option>1960
<option>1959
<option>1958
<option>1957
<option>1956
<option>1955
<option>1954
<option>1953
<option>1952
<option>1951
<option>1950
<option>1949
<option>1948
<option>1947
<option>1946
<option>1945
<option>1944
<option>1943
<option>1942
<option>1941
<option>1940
</select>
</td>
</tr>
<tr>
<td>Location:</td>
<td>
<select name="location">
<option>No country</option>
<option>Argentina</option>
<option>Australia</option>
<option>Austria</option>
<option>Belgium</option>
<option>Bosnia</option>
<option>Brazil</option>
<option>Bulgaria</option>
<option>Canada</option>
<option>Chile</option>
<option>Croatia</option>
<option>Cyprus</option>
<option>Czechoslavakia</option>
<option>Denmark</option>
<option>England</option>
<option>Finland</option>
<option>France</option>
<option>Georgia</option>
<option>Germany</option>
<option>Greece</option>
<option>Holland</option>
<option>Hong Kong</option>
<option>Hungary</option>
<option>Iceland</option>
<option>India</option>
<option>Indonesia</option>
<option>Iran</option>
<option>Iraq</option>
<option>Ireland</option>
<option>Israel</option>
<option>Italy</option>
<option>Japan</option>
<option>Leichenstein</option>
<option>Luxembourg</option>
<option>Malaysia</option>
<option>Malta</option>
<option>Mexico</option>
<option>Morocco</option>
<option>New Zealand</option>
<option>North Vietnam</option>
<option>Norway</option>
<option>Poland</option>
<option>Portugal</option>
<option>Puerto Rico</option>
<option>Qatar</option>
<option>Rumania</option>
<option>Russia</option>
<option>Scotland</option>
<option>Singapore</option>
<option>South Africa</option>
<option>Spain</option>
<option>Sweden</option>
<option>Switzerland</option>
<option>Turkey</option>
<option>United Kingdom</option>
<option>United States</option>
</select>
</td>
</tr>
<tr>
<td>Email Address:</td>
<td><input type="text" name="email" size="40" maxlength="40" value="<?php if (isset($POST['email'])) echo $POST['email']; ?>" /></td>
</tr>
<tr>
<td>Homepage:</td>
<td><input type="text" name="homepage" size="50" maxlength="50" value="<?php if (isset($POST['homepage'])) echo $POST['homepage']; ?>" /></td>
</tr>
<tr>
<td> Biography:</td>
<td><textarea name="biography" cols="50" rows="15" value="<?php if (isset($POST['biography'])) echo $POST['biography']; ?>" /></textarea>
</td>
</tr>
<tr>
<td> Interests:</td>
<td><textarea name="interests" cols="50" rows="5" value="<?php if (isset($POST['interests'])) echo $POST['interests']; ?>" /></textarea>
</td>
</tr>
<tr>
<td height="47">Occupation:</td>
<td><input type="text" name="occupation" size="50" maxlength="50" value="<?php if (isset($POST['occupation'])) echo $POST['occupation']; ?>" /></td>
</tr>
<tr>
<td>User Name:</td>
<td><input type="text" name="username" size="20" maxlength="20" value="<?php if (isset($POST['username'])) echo $POST['username']; ?>" /><br/><small>Use only letters, numbers, and the underscore. Must be between 4 and 20 characters long.</small></td>
</tr>
<tr>
<td>Password:</td>
<td><input type="password" name="password1" size="20" maxlength="20" /><br/><small>Use only letters and numbers. Must be between 4 and 16 characters long.</small></td>
</tr>
<tr>
<td>Confirm Password:</p></td>
<td><input type="password" name="password2" size="20" maxlength="20" /></td>
</tr>
<tr>
<td colspan=2><div align="center"><input type="submit" name="submit" value="Register" /></div></td>
</tr>
</table>
</form><!-- End of Form -->
// Include the HTML footer file.
include_once ('incl/footer.html');