{template "phpcms","header"}
<script LANGUAGE="javascript">
<!--
function CheckForm()
{
    if(document.myform.truename.value=="")
	{
	  alert("請填寫姓名！")
	  document.myform.truename.focus()
	  return false
	 }
    if(document.myform.alipay.value=="")
	{
	  alert("請填寫支付寶帳號！")
	  document.myform.alipay.focus()
	  return false
	 }
    if(document.myform.telephone.value=="")
	{
	  alert("請填寫聯繫電話！")
	  document.myform.telephone.focus()
	  return false
	 }
    if(document.myform.mobile.value=="")
	{
	  alert("請填寫手機號！")
	  document.myform.mobile.focus()
	  return false
	 }
    if(document.myform.address.value=="")
	{
	  alert("請填寫地址！")
	  document.myform.address.focus()
	  return false
	 }
    if(document.myform.postid.value=="")
	{
	  alert("請填寫郵編！")
	  document.myform.postid.focus()
	  return false
	 }
    if(document.myform.qq.value=="")
	{
	  alert("請填寫QQ號！")
	  document.myform.qq.focus()
	  return false
	 }
    if(document.myform.homepage.value=="")
	{
	  alert("請填寫主頁！")
	  document.myform.homepage.focus()
	  return false
	 }
	{if $MOD['enablecheckcode']}
    if(document.myform.checkcode.value=="")
	{
	  alert("請填寫驗證碼！")
	  document.myform.checkcode.focus()
	  return false
	 }
	{/if}
}
//-->
</script>
<table cellspacing="0" cellpadding="0" class="member">
<tr>
<td valign="top" class="left">
{template "member","left"}
</td>
<td width="10">
</td>
<td class="right" valign="top">
{template "union","menu"}
<div class="memberborder_1">
<div class="memberborder_2">
<h1>申請加入推廣聯盟</h1>
<form name="myform" method="post" action="{$MOD[linkurl]}register.php" onSubmit="return CheckForm();">
<table cellpadding="2" cellspacing="1" class="righttable">
  <tr>
    <td class="td_left" width="20%">用戶名：</td>
    <td class="td_left">{$_username}</td>
  </tr>
  <tr>
    <td class="td_left">姓名：</td>
    <td class="td_left"><input name="truename" type="text" id="truename" size="20" value="{$truename}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">支付寶帳號：</td>
    <td class="td_left"><input name="alipay" type="text" id="alipay" size="20" maxlength="50" value="{$alipay}" /> <font color="red">* 請認真填寫，我們將通過支付寶帳號付款！</font></td>
  </tr>
  <tr>
    <td class="td_left">電話：</td>
    <td class="td_left"><input name="telephone" type="text" id="telephone" size="20" value="{$telephone}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">手機：</td>
    <td class="td_left"><input name="mobile" type="text" id="mobile" size="20" value="{$mobile}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">地址：</td>
    <td class="td_left"><input name="address" type="text" id="address" size="50" value="{$address}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">郵編：</td>
    <td class="td_left"><input name="postid" type="text" id="postid" size="10" value="{$postid}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">主頁：</td>
    <td class="td_left"><input name="homepage" type="text" id="homepage" size="20" value="{$homepage}" /> <font color="red">*</font></td>
  </tr>
  <tr>
    <td class="td_left">QQ號碼：</td>
    <td class="td_left"><input name="qq" type="text" id="qq" size="20" maxlength="20" value="{$qq}" /> <font color="red">*</font></td>
  </tr>
	{if $MOD['enablecheckcode']}
    <tr> 
      <td class="td_left">驗證碼：</td>
      <td class="td_left"><input name="checkcode" type="text" size="4" id="checkcode">
	  <img src="{PHPCMS_PATH}checkcode.php" id="checkcode" onclick="this.src='{PHPCMS_PATH}checkcode.php?id='+Math.random()*5;" style="cursor:pointer;" alt="驗證碼,看不清楚?請點擊刷新驗證碼" align="absmiddle"/></td>
    </tr>
	{/if}
  <tr>
    <td class="td_left" width="20%">&nbsp;</td>
    <td class="td_left">
        <input type="submit" name="dosubmit" value=" 確 定 " class="btn" />&nbsp;&nbsp;
        <input type="reset" name="reset" value=" 清 除 " class="btn" /></td>
  </tr>
  </table>
</form>
</div></div>

</td>
</tr>
</table>
{template "phpcms","footer"}