mirror of
https://github.com/mozilla/gecko-dev.git
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397 lines
10 KiB
HTML
397 lines
10 KiB
HTML
<html>
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<body bgcolor="#FFFFFF">
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<table border="1" width="590" cellspacing="0" bgcolor="#99CCCC"
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cellpadding="2">
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<tr>
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<td>
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<p align="center"><strong><font size="5">Step 1 -
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Initial Registration Form</font></strong></p>
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</td>
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</tr>
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</table>
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Simply fill out the information below and click the <b>
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continue</b> button.<br>
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<strong>Required entries</strong> are shown in <font color=
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"#006600"><strong>green</strong></font>.
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<form>
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<input type="HIDDEN" name="MfcISAPICommand" value=
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"RegisterPreview">
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<table border="1" width="590" cellspacing="0" cellpadding=
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"4">
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font size="3" color=
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"#006600"><strong>E-mail address</strong></font><br>
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<font size="2">e.g, username@aol.com</font></td>
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<td width="75%"><input type="text" name="email" size="40"
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maxlength="63"> <font size="2" color="#008000">
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(required)</font><br>
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<font size="2"><b><i>Note:</i></b> AOL and WebTV Users:
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Please remove any spaces from your username and add the
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domain suffix (@aol.com or @webtv.com to your username).
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For example, if your username is joecool, your e-mail
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address would be joecool@aol.com</font> </td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>Full name</strong><br>
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</font> <font size="2">e.g., John H. Doe</font> <font
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color="#006600" size="2"></font></td>
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<td width="75%"><input type="text" name="name" size="40"
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maxlength="63"> <font size="2" color="#008000">
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(required)</font><br>
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<font size="2">First M. Last</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF">Company</td>
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<td width="75%"><input type="text" name="company" size=
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"40" maxlength="63"> <font size="2">
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(optional)</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>Address</strong></font></td>
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<td width="75%"><input type="text" name="address" size=
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"40" maxlength="63"> <font size="2" color="#008000">
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(required)</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>City</strong></font></td>
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<td width="75%"><input type="text" name="city" size="40"
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maxlength="63"> <font size="2" color="#008000">
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(required)</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>State</strong></font></td>
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<td width="75%"><select name="state">
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<option selected value="other">
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Select State
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</option>
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<option value="AL">
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Alabama
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</option>
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<option value="AK">
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Alaska
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</option>
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<option value="AZ">
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Arizona
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</option>
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<option value="AR">
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Arkansas
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</option>
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<option value="CA">
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California
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</option>
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<option value="CO">
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Colorado
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</option>
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<option value="CT">
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Connecticut
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</option>
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<option value="DE">
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Delaware
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</option>
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<option value="DC">
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District of Columbia
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</option>
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<option value="FL">
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Florida
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</option>
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<option value="GA">
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Georgia
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</option>
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<option value="HI">
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Hawaii
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</option>
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<option value="ID">
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Idaho
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</option>
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<option value="IL">
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Illinois
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</option>
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<option value="IN">
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Indiana
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</option>
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<option value="IA">
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Iowa
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</option>
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<option value="KS">
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Kansas
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</option>
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<option value="KY">
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Kentucky
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</option>
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<option value="LA">
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Louisiana
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</option>
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<option value="ME">
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Maine
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</option>
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<option value="MD">
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Maryland
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</option>
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<option value="MA">
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Massachusetts
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</option>
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<option value="MI">
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Michigan
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</option>
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<option value="MN">
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Minnesota
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</option>
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<option value="MS">
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Mississippi
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</option>
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<option value="MO">
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Missouri
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</option>
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<option value="MT">
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Montana
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</option>
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<option value="NE">
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Nebraska
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</option>
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<option value="NV">
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Nevada
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</option>
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<option value="NH">
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New Hampshire
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</option>
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<option value="NJ">
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New Jersey
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</option>
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<option value="NM">
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New Mexico
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</option>
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<option value="NY">
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New York
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</option>
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<option value="NC">
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North Carolina
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</option>
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<option value="ND">
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North Dakota
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</option>
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<option value="OH">
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Ohio
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</option>
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<option value="OK">
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Oklahoma
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</option>
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<option value="OR">
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Oregon
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</option>
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<option value="PA">
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Pennsylvania
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</option>
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<option value="RI">
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Rhode Island
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</option>
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<option value="SC">
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South Carolina
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</option>
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<option value="SD">
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South Dakota
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</option>
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<option value="TN">
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Tennessee
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</option>
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<option value="TX">
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Texas
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</option>
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<option value="UT">
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Utah
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</option>
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<option value="VT">
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Vermont
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</option>
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<option value="VA">
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Virginia
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</option>
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<option value="WA">
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Washington
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</option>
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<option value="WV">
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West Virginia
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</option>
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<option value="WI">
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Wisconsin
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</option>
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<option value="WY">
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Wyoming
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</option>
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<option value="PR">
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Puerto Rico
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</option>
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<option value="VI">
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Virgin Island
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</option>
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<option value="MP">
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Northern Mariana Islands
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</option>
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<option value="GU">
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Guam
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</option>
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<option value="AS">
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American Samoa
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</option>
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<option value="PW">
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Palau
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</option>
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</select> <font size="2" color="#008000">
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(required)</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>Zip Code</strong></font></td>
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<td width="75%"><input type="text" name="Home.PostalCode" size="12"
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maxlength="12"> <font size="2" color="#008000">
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(required)</font></td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF"><font color="#006600">
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<strong>Primary phone #<br>
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</strong></font> <font size="2">e.g., (408) 555 -
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1234</font><font color=
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"#006600"><strong></strong></font></td>
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<td width="75%">( <input type="text" name="Home.Phone.LocCode"
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size="4" maxlength="3"> ) <input type="text" name=
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"Home.Phone.Number.Prefix" size="4" maxlength="3"> - <input type="text"
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name="Home.Phone.Number.Suffix" size="5" maxlength="4"> <font size="2"
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color="#008000">(required)</font>
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<input type="text" name=
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"Home.Phone.Extension" size="5" maxlength="10"> <font size="2">
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(extension)</font> </td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF">Secondary phone #</td>
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<td width="75%">( <input type="text" name="Home.AltPhone.LocCode"
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size="4" maxlength="3"> ) <input type="text" name=
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"Home.AltPhone.Number.Prefix" size="4" maxlength="3"> - <input type=
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"text" name="Home.AltPhone.Number.Suffix" size="5" maxlength="4"> <font
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size="2">(optional)</font> <input
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type="text" name="Home.AltPhone.Extension" size="5" maxlength="10">
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<font size="2">(extension)</font> </td>
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</tr>
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<tr>
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<td width="25%" bgcolor="#EFEFEF">Fax #</td>
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<td width="75%">( <input type="text" name="Home.Fax.LocCode"
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size="4" maxlength="3"> ) <input type="text" name=
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"Home.Fax.Number.Prefix" size="4" maxlength="3"> - <input type="text"
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name="Home.Fax.Number.Suffix" size="5" maxlength="4"> <font size="2">
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(optional)</font></td>
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</tr>
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</table>
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<p><input type="HIDDEN" name="country" value=
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"United States"><input type="HIDDEN" name="countryid" value=
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"1"></p>
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<table border="0" cellpadding="3" cellspacing="1" width=
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"590">
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<tr>
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<td>
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<strong>Note to Aol Users:</strong> make sure your mail
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filters are off<br>
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<blockquote>
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<b>Click</b> <input type="submit" value=
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"continue"> <b>to register!</b>
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</blockquote>
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<blockquote>
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Click <input type="reset" value="clear form">
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to start over
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</blockquote>
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</td>
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</tr>
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</table>
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</form>
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<hr>
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</body>
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</html>
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