477bcbdcc0
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69 lines
2.1 KiB
HTML
Executable file
69 lines
2.1 KiB
HTML
Executable file
<form name="userform" action="http://[target]/register.php" method="post">
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<input name="step" type="hidden" value="regform">
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<tr>
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<td class='tableh2' colspan='2'>Account Information</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>Username</td>
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<td class='tableb'>
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</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>Password</td>
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<td class='tableb'><input type='password' name='password' class='textinput' value="" size='25' maxlength="16">
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</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>Confirm Password</td>
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<td class='tableb'><input type='password' name='password_confirm' class='textinput' value="" size='25' maxlength="16">
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</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>E-mail Address</td>
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<td class='tableb'><input type='text' name='email' class='textinput' value="" size='25'>
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</td>
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</tr>
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<tr>
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<td class='tableh2' colspan='2'>Other Details</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>First Name</td>
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<td class='tableb'><input type='text' name='firstname' class='textinput' value="" size='25'>
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</td>
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</tr>
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<tr>
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<td class='tableb' width='160'>Last Name</td>
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<td class='tableb'><input type='text' name='lastname' class='textinput' value="" size='25'>
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</td>
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<tr>
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<td class='tableb' width='160'>Home page</td>
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<td class='tableb'><input type='text' name='user_website' class='textinput' value="" size='25'>
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</td>
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<tr>
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<td class='tableb' width='160'>Location</td>
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<td class='tableb'><input type='text' name='user_location' class='textinput' value="" size='25'>
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</td>
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<tr>
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<td class='tableb' width='160'>Occupation</td>
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<td class='tableb'><input type='text' name='user_occupation' class='textinput' value="" size='25'>
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</td>
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</tr>
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<tr>
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<td class='tablec' colspan='2' align='center' valign='middle' height='40'>
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<input name='submit' type='submit' value=" Submit my registration " class='button'>
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</td>
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</tr>
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<!-- END submit_row -->
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</form>
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# milw0rm.com [2007-01-31]
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