{header}
<div id="main">
<table width="96%" border="0" cellpadding="1" cellspacing="1" align="center" class="tbtitle" style="	background:#D9D9FF;">
  <tr>
    <td height="30">&nbsp;&nbsp;&nbsp;{l_title_current}</td>
  </tr>
</table>
<table width="96%" border="0" cellpadding="1" cellspacing="1" align="center" class="tbtitle" style="	background:#D9D9FF;">
<tr>
  <td bgcolor="#FFFFFF"><script Language="JavaScript" type="text/javascript">
			function onChangeCompanyName() {
			  checkPayee.innerHTML = document.JoinForm.name.value;
			}
			function confirmCheckPayee() {
			  message = new String("{l_your_checks}: %1. {l_once_set}");
			  message = message.replace('%1', document.JoinForm.name.value);
			  if (!confirm(message)) {
			    return false;
			  }
			  return true;
			}
			</script>
    <script Language="JavaScript" type="text/javascript">
			  function onValidateJoinForm() {
			    var form = document.forms['JoinForm'];
			    // "name" field validation.
			    if (!validateRequiredField(form['name'], '{l_name}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "name" field validation.
			    if (!validateMaxLength(form['name'], '{l_name}','100')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "referring_domains" field validation.
			    if (!validateRequiredField(form['referring_domains'], '{l_referring_domains}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "referring_domains" field validation.
			    if (!validateMaxLength(form['referring_domains'], '{l_referring_domains}','2000')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "referring_domains" field validation.
			    if (!validateMultipleDomainField(form['referring_domains'], '{l_referring_domains}', '2147483647')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "contact_name" field validation.
			    if (!validateRequiredField(form['contact_name'], '{l_name}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "contact_name" field validation.
			    if (!validateMaxLength(form['contact_name'], '{l_name}','200')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "phone" field validation.
			    if (!validateRequiredField(form['phone'], '{l_phone_number}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "phone" field validation.
			    if (!validateMaxLength(form['phone'], '{l_phone_number}','15')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "phone" field validation.
			    if (!validateNumericWS(form['phone'], '{l_phone_number}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateRequiredField(form['email'], '{l_email_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateMaxLength(form['email'], '{l_email_address}','100')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateEmailField(form['email'], '{l_email_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateRequiredField(form['email'], '{l_email_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateMaxLength(form['email'], '{l_email_address}','100')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "email" field validation.
			    if (!validateEmailField(form['email'], '{l_email_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "addr1" field validation.
			    if (!validateRequiredField(form['addr1'], '{l_billing_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "addr1" field validation.
			    if (!validateMinLength(form['addr1'], '{l_billing_address}','2')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "addr1" field validation.
			    if (!validateMaxLength(form['addr1'], '{l_billing_address}','50')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "addr1" field validation.
			    if (!validateRequiredField(form['addr1'], '{l_billing_address}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "country" field validation.
			    if (!validateRequiredSelect(form['country'],'{l_country}','-1')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "country" field validation.
			    if (!validateRequiredField(form['country'], '{l_country}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "state" field validation.
			    if (!validateRequiredSelect(form['state'],'{l_state_province}','-1')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "state" field validation.
			    if (!validateRequiredField(form['state'], '{l_state_province}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "city" field validation.
			    if (!validateRequiredSelect(form['city'],'{l_city}','-1')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "city" field validation.
			    if (!validateRequiredField(form['city'], '{l_city}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "zip" field validation.
			    if (!validateMaxLength(form['zip'], '{l_zip_code}','10')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "zip" field validation.
			    if (!validateZip(form['zip'], '{l_zip_code}', form['country'])) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "tax_id" field validation.
			    if (!validateTaxID(form['tax_id'], '{l_tax_id}', form['country'])) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "join_password" field validation.
			    if (!validateRequiredField(form['join_password'], '{l_password}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "join_password" field validation.
			    if (!validateMinLength(form['join_password'], '{l_password}','4')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "join_password" field validation.
			    if (!validateMaxLength(form['join_password'], '{l_password}','30')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "join_password" field validation.
			    if (!validateAlphaNumeric(form['join_password'], '{l_password}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    // "join_password" field validation.
			    if (!validateTwoFields(form['join_password'],'{l_password}',form['verify_password'],'{l_verify_password}')) {
			      removeSubmissionBlock();
			      return false;
			    }
			    return true;
			  }
			
			  function validateJoinForm() {
			    blockSubmission = true;
			     if (typeof beforeJoinFormValidation != 'undefined') {
			      beforeJoinFormValidation();
			    }
			    var validated = onValidateJoinForm();
			    if (validated && (typeof uponSuccessfulJoinFormValidation != 'undefined')) {
			      validated = uponSuccessfulJoinFormValidation();
			    }
			    else if (!validated && (typeof uponUnsuccessfulJoinFormValidation != 'undefined')) {
			      uponUnsuccessfulJoinFormValidation();
			    }
			    if (!validated) {
			      removeSubmissionBlock();
			    }
			    return validated;
			  }
			
			  function submitJoinForm() {
			   if (validateJoinForm()) document.JoinForm.submit();
			    }
			</script>
    <form  name="JoinForm" method="POST" action="{url_main}admin/partner_edit.php?cmd=edit&id={partner_id}" onSubmit="return validateJoinForm();" style="padding: 0px; margin: 0px;">
      <div align="justify" class="ter_text_bold">{l_primary_contact_information}</div>
      <div align="justify" class="body_text">-&nbsp;{l_fields_with} ( <span class="red">*</span> ) {l_are_required}</div>
      <div align="justify" class="body_text">-&nbsp;{l_zip_code_is}</div>
      <div align="justify" class="body_text">-&nbsp;{l_all_checks}</div>
      <br>
      <div align="justify">
        <table border="0" cellpadding="0" cellspacing="0" width="100%">
          <tr>
            <td>{l_company_name}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="name" value="{company}" style="width: 155px;" tabindex="a" onChange="onChangeCompanyName();"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_referring_domains}:</td>
            <td align="right"><input type="text" name="referring_domains" value="{domain}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td colspan="3" class="body_text"> - {l_enter_domains}<br>
              - {l_campaign_tracking}
              <div style="height: 5px;"></div></td>
          </tr>
          <tr>
            <td colspan="3" class="body_text"><b>{join_message}</b> </td>
          </tr>
          <tr>
            <td>{l_name}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="contact_name" value="{real_name}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_phone}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="phone" value="{phone}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_email}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="email" value="{mail}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
        </table>
      </div>
      <br>
      <div align="justify" class="ter_text_bold">{l_payment_information}</div>
      <div align="justify" class="body_text">{l_enter_details}</div>
      <br>
      <div align="justify">
        <table border="0" cellpadding="0" cellspacing="0" width="100%">
          <tr>
            <td>{l_address_1}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="addr1" value="{adress}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_address_2}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="addr2" value="{adress2}" style="width: 155px;" tabindex="a"></td>
            <td align="right"></td>
          </tr>
          <tr>
            <td>{l_country}:&nbsp;&nbsp;</td>
            <td align="right"><select style="width: 155px;" name="country" tabindex="a" onChange="submitForm(document.JoinForm, '{url_main}admin/partner_edit.php?id={partner_id}&focusField=state&focusForm=JoinForm')">
                
			    {country_options}
				
              </select>
            </td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_state_province}:&nbsp;&nbsp;</td>
            <td align="right"><select name="state" tabindex="a" onChange="submitForm(document.JoinForm, '{url_main}admin/partner_edit.php?id={partner_id}&focusField=city&focusForm=JoinForm')" style="width: 155px;">
                <option>{l_please_select}</option>
                
			    {state_options}
			   
              </select></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>City:&nbsp;&nbsp;</td>
            <td align="right"><select name="city" tabindex="a" style="width: 155px;">
                <option>{l_please_select}</option>
                
			    {city_options}
			    
              </select></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_zip_postal_code}:&nbsp;&nbsp;</td>
            <td align="right"><input type="text" name="zip" value="{zip}" style="width: 155px;" tabindex="a"></td>
            <td align="right"></td>
          </tr>
        </table>
      </div>
      <br>
      <div align="justify" class="ter_text_bold">{l_username_password}</div>
      <div align="justify" class="body_text">{l_you_will_use}</div>
      <br>
      <div align="justify">
        <table border="0" cellpadding="0" cellspacing="0" width="100%">
          <tr>
            <td colspan="3" class="body_text"><div style="height: 10px;"><span></span></div>
              {l_password_must_be}
              <div style="height: 5px;"><span></span></div></td>
          </tr>
          <tr>
            <td>{l_password}:&nbsp;&nbsp;</td>
            <td align="right"><input type="password" name="join_password" value="{password}" style="width: 155px;" tabindex="a"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>{l_confirm_password}:&nbsp;&nbsp;</td>
            <td align="right"><input type="password" name="verify_password" value="{password}" style="width: 155px;"></td>
            <td align="right"><span class="red">*</span></td>
          </tr>
          <tr>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
            <td>&nbsp;</td>
          </tr>
          <tr>
            <td style="padding-right: 10px;" align="left"></td>
            <td align="right"><input type="button" value="{l_edit_information}" onClick=" submitJoinForm();" class="button"></td>
            <td></td>
          </tr>
        </table>
      </div>
    </form>
</div>
</div>
</div>
{footer}