<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>{$language.lblAffiliate} : {$language.lblAccounttInformation}</title>
{include file='CommonStyles.tpl'}
{include file='CommonJavaScript.tpl'}
<link rel="stylesheet" type="text/css" href="{$view_styles}/affiliates.css" />
<script type="text/javascript" src="{$common_js}/jquery-1.9.1.min.js"></script>
<script type="text/javascript" src="{$common_js}/jquery-migrate-1.1.1.js"></script>
<script type="text/javascript" src="{$view_javascript}/common.js"></script>

</head>
<body>
<!-- Outer container starts-->
<div class="outer_container"> 
  <!-- Header Container starts--> 
  {include file='CommonTop.tpl'} 
  <!-- Header Container ends--> 
  <!-- Content Container starts-->
  <div class="content_container">
    <div class="content_wrapper">
      <div class="submit-block"> {html->anchor name="My Profile" href="/user/" caption=$language.lblBack class="fixing_right textlink01"}</div>
      <h2 >{$language.lblMyProfile}</h2>
      <!-- Inner Content Container starts--> 
      {form->start name="formAffiliateProfile" id="formAffiliateProfile" action="" method="post" autocomplete="off"}
      {form->hidden name="hidPaswd"}
      {form->hidden name="statehidValue" id="statehidValue"  value=$affiliateStateID}
      <div class="inner_content_wrapper">
        <div class="form_listing02 clearfix">
          <h3><span>{$language.lblSiteInformation}</span></h3>
          <div class="clearfix">
            <div class="left fixing_left">
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblWebsiteUrl}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateWebsiteURL" type="text"  class="textbox" validate="required~*isUrl" error=$language.errWebsiteUrl|cat:"~*"|cat:$language.errValidWebsite tabindex=1 validate_event="submit"}</div>
                </li>
              </ul>
            </div>
            <div class="right fixing_right">
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblTypeOfWebsite}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateTypeofWebsite" type="text"  class="textbox" validate="required" error=$language.errWebsiteType tabindex=2 validate_event="submit"} </div>
                </li>
              </ul>
            </div>
          </div>
          <h3><span>{$language.lblContactInformation}</span></h3>
          <div class="clearfix">
            <div class="left fixing_left">
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblFirstName}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateFirstName" type="text"  class="textbox" validate="required" error=$language.errFirstName tabindex=3 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblCompanyName}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateCompanyName" type="text"  class="textbox" validate="required" error=$language.errCompany tabindex=5 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblAddress1}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateAddress1" type="text"  class="textbox" validate="required" error=$language.errAddress1 tabindex=7 validate_event="submit"} </div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblCountry}</div>
                  <div class="inner-right fixing_right">{form->select name="affiliateCountryID" options=$resListCountry class="select-box" onchange="listStates(this.value,'');" validate="required" error=$language.errCountry caption="->"|cat:$language.lblSelect tabindex=9 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblCity}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateCity" type="text"  class="textbox" validate="required"  error=$language.errCityName tabindex=11 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblPhone}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliatePhone" type="text"  class="textbox" validate="required" error=$language.errPhone tabindex=13 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblEmail}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateEmail" type="text"  class="textbox" validate="required~*email" error=$language.errEmail|cat:"~*"|cat:$language.errValidEmail tabindex=15 validate_event="submit"}</div>
                </li>
              </ul>
            </div>
            <div class="right fixing_right">
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblLastName}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateLastName" type="text"  class="textbox" validate="required" error=$language.errLastName tabindex=4 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblContactPerson}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateContactPerson" type="text"  class="textbox" validate="required" error=$language.errContactPerson tabindex=6 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblAddress2}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateAddress2" type="text"  class="textbox" tabindex=8}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblState}</div>
                  <div class="inner-right01 fixing_left"> <span id="stateInput"> {form->select name="stateID" type="text"  class="select-box" onchange="getStateHiddenValue(this.value);" validate="stateSelectedType->isequal->stateID~*required" error=$language.errState tabindex=10 validate_event="submit"} </span> <span id="stateProvinceInput"> {form->textbox  name="province" tabindex="1"  maxlength="100" class="textbox" value=$affiliateStateProvince validate="stateSelectedType->isequal->province~*required"  error=$language.errProvince tabindex=10 validate_event="submit"} </span> <span id="loadProcessImage"></span> {form->hidden id="stateSelectedType"  name="stateSelectedType"} </div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblZipCode}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateZipcode" type="text"  class="textbox" validate="required~*isZipCode" error=$language.errZIP|cat:"~*"|cat:$language.errValidZip tabindex=12 validate_event="submit"}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblFax}</div>
                  <div class="inner-right01 fixing_left">{form->textbox name="affiliateFax" type="text"  class="textbox" tabindex=14}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left mantatory">{$language.lblPreferredLanguage}</div>
                  <div class="inner-right01 fixing_left">{form->select name="preferredLanguage" class="select-box" options=$view_common_languages validate="required" error=$language.errPeferredLanguage tabindex=16 validate_event="submit"}</div>
                </li>
              </ul>
            </div>
          </div>
         
        
          <div class="detail-list clearfix">
            <div class="left fixing_left">
              <h3><span>{$language.lblPaymentInformation}</span></h3>  
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblAccountType}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateAccountType" type="text"  class="textbox" tabindex=17}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblNameOnAccount}</div>
                  <div class="inner-right fixing_right">{form->textbox name="affiliateAccountName" type="text"  class="textbox" tabindex=18}</div>
                </li>  
                 <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblAccountDetails}</div>
                  <div class="inner-right fixing_right">{form->textarea name="affiliateAccountDetails" class="textarea01" tabindex=19}</div>
                </li>               
              </ul>
            </div>
            <div class="right fixing_right">
             <h3><span>{$language.lblLoginInformation}</span></h3>
              <ul>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblLogin}</div>
                  <div class="inner-right01 fixing_left">{$affiliateUserName}</div>
                </li>
                <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblPassword}</div>
                  <div class="inner-right01 fixing_left">{form->password name="affiliatePassword" type="text" class="textbox" validate="isSecurePassword" maxlength="15" error=$language.errValidPassword tabindex=20 validate_event="submit"}</div>
                </li>                
                 <li class="clearfix">
                  <div class="inner-left fixing_left">{$language.lblConfirmPassword}</div>
                  <div class="inner-right01 fixing_left">{form->password name="affiliatePasswordnew" type="text" class="textbox" validate="affiliatePassword->compare->affiliatePasswordnew" maxlength="15" error=$language.errPasswordMismatch tabindex=20 validate_event="submit"}</div>
                </li>
           </ul>
            </div>            
          </div>          
          <div class="submit-block clearfix "> <span></span>
            <div class="left clearfix ">
              <div class="inner-left fixing_left"></div>
              <div class="inner-right fixing_right">{form->submit name="submitProfile" type="submit" value=$language.lblSubmit class="curve-3" tabindex=20} {$language.lblOr} {html->anchor href="user/" caption=$language.lblCancel tabindex=21} </div>
            </div>
          </div>
        </div>
      </div>
      {form->close} 
      <!-- Inner Content Container ends-->
      <div class="clear"></div>
    </div>
  </div>
  <!-- Content Container ends--> 
  <!-- Footer starts--> 
  {include file='CommonBottom.tpl'} 
   <script type="text/javascript" src="{$view_javascript}/profilemanage.page.js"></script>
   <script type="text/javascript" src="{$common_js}/validate.plugin.js"></script>
   {form->validate_script form="formAffiliateProfile"}
  <!-- Footer ends--> 
  {form->basepath_script}
  {form->rootpath_script}
</div>
<!-- Outer container ends-->
</body>
</html>
