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">Username |
"/> |
| Password |
" /> |
| ">Confirm Password |
" /> |
| Email Address |
"/> |
| Confirm Email Address |
"/> |
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| Personal Information |
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| ">First Name |
"/> |
| ">Middle Name |
"/> |
| ">Last Name |
"/> |
| ">Gender |
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| ">Date of birth |
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| ">Address |
"/> |
| ">Mobile Number |
"/> |
| ">Phone Number |
"/> |
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| Business Information |
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| Business Category |
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| Business Names |
" size="40"/> |
| ">Business Address |
" size="40"/> |
| ">Business Email Address |
" size="40"/> |
| ">Business Website |
" size="40"/> |
| Business Phone Number |
"/> |
| Business Mobile Number |
"/> |
| Business Fax Number |
"/> |
| ">Business Contact Personel |
" size="40"/> |
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| ");
}
else
{
print("");
}
?>
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