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commercialsignup.html
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commercialsignup.html
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<!DOCTYPE html>
<html>
<head>
<!-- Parse Script -->
<link rel="stylesheet" href="css/threecoldiv.css">
<script type="text/javascript" src="api/jquery-1.11.2.min.js"></script>
<script type="text/javascript" src="api/parse-1.3.5.js"></script>
<script type="text/javascript" src="js/signup.js"></script>
<script type="text/javascript" src="js/signin.js"></script>
<script type="text/javascript" src="js/birthdate.js"></script>
<script type="text/javascript" src="js/reformatter.js"></script>
<script type="text/javascript" src="js/customertopmenu.js"></script>
<link rel="stylesheet" type="text/css" href="css/customertopmenu.css">
</head>
<body>
<div class="jbTitle">
<h1>Telegroup Company</h1>
</div>
<div class="jbMenu">
<p>
<span class = "menu-item">
<a href="home.html">Home</a>
<a href="addservice.html">Add Service</a>
<a href="myaccount.html">My Account</a>
<span id = "signbtn"> </span>
</span>
<a class = "submenu-item" href="signup.html">Are You New User?</a>
</p>
</div>
</br></br>
<div class="jbContent">
<span class = "body-item">
<h1>Telecom Company Commercial Customer Sign Up</h1>
<button class="myButton" type="button" onclick= 'window.location.href="signup.html"'>Are You Retail User?</button></br></br>
<form>
<fieldset>
<h4>Business Information</h4>
Company Name:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="company" type="string" >
</br>
Billing Department Phone Number
<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="bareacode" type="string" placeholder = "213" size = "3" maxlength = "3"> -
<input class="shortinputs" id="bphonemid" type="string" placeholder = "389" size = "3" maxlength = "3"> -
<input class="shortinputs" id="bphoneend" type="string" placeholder = "7890" size = "4" maxlength = "4">
</br>
Billing Department Address
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="baddress" type="string" >
</br>
City:<span style = "color:red"> * </span>
</br>
<input class="inputs" id="bcity" type="string" >
</br>
State:<span style = "color:red"> * </span>
</br>
<select class="inputs" id="bstate">
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</br>
Zip Code:<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="bzip" type="string" placeholder = "90000" size = "5" min = "00001" max = "99999">
</br>
</br></br>
<h4>Account Information</h4>
Username:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="username" type="string" >
</br>
Password:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="password" type="password" >
</br>
Confirm Password:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="confirmpassword" type="password" >
</br>
</br></br>
<h4>Billing Information for Responsible Party:</h4>
First Name:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="firstname" type="string" >
</br>
Last Name:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="lastname" type="string" >
</br>
</br>
E-mail:
<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="email" type="string" placeholder = "username" size = "20" > @
<input class="inputs" id="domain" type="string" placeholder = "domain.com" size = "20" >
</br>
Date of Birth:
<span style = "color:red"> * </span>
</br>
<select class="shortinputs" id ="dobmo" name = "mm"></select>
<select class="shortinputs" id ="dobdate" name = "dd"></select>
<select class="shortinputs" id ="dobyr" name = "yyyy"></select>
<script type="text/javascript">date_populate("dobdate", "dobmo", "dobyr");</script>
</br>
SSN:
<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="SSN1" type="string" placeholder = "123" size = "3" maxlength = "3"> -
<input class="shortinputs" id="SSN2" type="string" placeholder = "45" size = "2" maxlength = "2"> -
<input class="shortinputs" id="SSN3" type="string" placeholder = "7890" size = "4" maxlength = "4">
</br>
Gender:
<span style = "color:red"> * </span>
</br>
<input type="radio" name="gender" id="gender" value="M" checked>Male
</br>
<input type="radio" name="gender" id="gender" value="F" >Female
</br>
Phone Number:
<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="areacode" type="string" placeholder = "213" size = "3" maxlength = "3"> -
<input class="shortinputs" id="phonemid" type="string" placeholder = "389" size = "3" maxlength = "3"> -
<input class="shortinputs" id="phoneend" type="string" placeholder = "7890" size = "4" maxlength = "4">
</br>
Address:
<span style = "color:red"> * </span>
</br>
<input class="inputs" id="address" type="string" >
</br>
City:<span style = "color:red"> * </span>
</br>
<input class="inputs" id="city" type="string" >
</br>
State:<span style = "color:red"> * </span>
</br>
<select class="inputs" id="state">
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</br>
Zip Code:<span style = "color:red"> * </span>
</br>
<input class="shortinputs" id="zip" type="string" placeholder = "90000" size = "5" min = "00001" max = "99999">
</br></br>
<i>
<span style = "color:red"> * </span>
are required field
</i>
</br></br>
<button class = "myButton" type="button" onclick="signUp2()">Submit</button>
</fieldset>
</form>
</form>
<p id="demo"></p>
</span></div>
</body>
</html>