{load(fhead)}
<body class="mainbg">
	<div id="mainhearder"><span>您的位置：<a href="{$vd['root']}index.php?m=mod_b2b&c=Dealer&a=home">经销商管理系统</a> >> 下属客户管理 >> 代下级注册帐号</span></div>
	<div id="hearder"><span>代下级注册账号</span></div>
	<FORM name="register" method="post" action="index.php?m=mod_agent&c=Underling&a=RegSave">
	<div id="heardersub"><span>基本信息</span>(*表示必填项)</div>
	<table width="98%" border="0" align="center" cellpadding="0" cellspacing="0">
	<tr>
	<td class="tableleft">
		<table width="100%" border="0" align="center" cellpadding="0" cellspacing="0" class="table1">
		<tr>
		<td width="22%" class="tableleft1"><span class="star">*</span>账户用户名：</td>
		<td width="78%" align="left" class="tableright1"><input type='text' size='30' maxlength='20' name='ubzcname' class='input' datatype="Username" msg="登录用户名不符合要求">  <font color=#cccccc>6-20位之间的数字或英文字母</font></td>
		</tr>
		<tr>
		<td class="tableleft1"><span class="star">*</span>登录/交易密码：</td>
		<td align="left" class="tableright1"><input type='password' size='30' maxlength='30' name='ubzcpwd' class='input' datatype="NewPass" msg="登录/交易密码不符合要求"> <font color=#cccccc>密码必须为6-30位之间的数字或字母</font></td>
		</tr>
		<tr>
		<td class="tableleft1"><span class="star">*</span>重复密码：</td>
		<td align="left" class="tableright1"><input type='password' size='30' maxlength='30' name='reubzcpwd' class='input' datatype="Repeat" to="CustomerLoginPassword" msg="两次输入的密码不一致" /> <font color=#cccccc>重复输入登录/交易密码</font></td>
		</tr>
		<tr>
		<td class="tableleft1"><span class="star">*</span>商户名称：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='50' name='ubzcompany' class='input' datatype="LimitB" min="4" max="50" msg="公司名称必须填写且在25个汉字以内"> <font color=#cccccc>50个汉字以内</font></td>
		</tr>
		
		<tr>
		<td class="tableleft1">所在区域：</td>
		<td align="left" class="tableright1">
		<select name="ubzprv" id="prv" OnChange="setcity();" style="border:1px groove #C0C0C0; width:80px; font-family:宋体; font-size:9pt; text-decoration:none; color:#000000; padding-left:4; padding-right:4; padding-top:1; padding-bottom:1"> 
        <option value="">-所在省份-</option>
        <option value="安徽">安徽</option>
        <option value="北京">北京</option>
        <option value="重庆">重庆</option>
        <option value="福建">福建</option>
        <option value="甘肃">甘肃</option>
        <option value="广东">广东</option>
        <option value="广西">广西</option>
        <option value="贵州">贵州</option>
        <option value="海南">海南</option>
        <option value="河北">河北</option>
        <option value="黑龙江">黑龙江</option>
        <option value="河南">河南</option>
        <option value="香港">香港</option>
        <option value="湖北">湖北</option>
        <option value="湖南">湖南</option>
        <option value="江苏">江苏</option>
        <option value="江西">江西</option>
        <option value="吉林">吉林</option>
        <option value="辽宁">辽宁</option>
        <option value="澳门">澳门</option>
        <option value="内蒙古">内蒙古</option>
        <option value="宁夏">宁夏</option>
        <option value="青海">青海</option>
        <option value="山东">山东</option>
        <option value="上海">上海</option>
        <option value="山西">山西</option>
        <option value="陕西">陕西</option>
        <option value="四川">四川</option>
        <option value="台湾">台湾</option>
        <option value="天津">天津</option>
        <option value="新疆">新疆</option>
        <option value="西藏">西藏</option>
        <option value="云南">云南</option>
        <option value="浙江">浙江</option>
      </select>
      省   
      <select NAME="ubzcity" id="city" style="border:1px groove #C0C0C0; width:80px; font-family:宋体; font-size:9pt"> 
      </select> 
      市
      </span>
		</td>
		</tr>
		
		<tr>
		<td class="tableleft1"><span class="star">*</span>联系人姓名：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='20' name='ubzcrealname' class='input' datatype="Chinese" msg="真实姓名只允许填写中文"> <font color=#cccccc>2-4个中文汉字</font></td>
		</tr>
		<tr>
		<td class="tableleft1"><span class="star">*</span>身份证号：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='18' name='ubzidcard' class='input' datatype="IdCard" msg="身份证号码不正确"> <font color=#cccccc>15或18位数字</font></td>
		</tr>
		
		</table>
	</td>
	</tr>
	</table>
	<div id="heardersub"><span>联系方式</span>(*表示必填项)</div>
	<table width="98%" border="0" align="center" cellpadding="0" cellspacing="0">
	<tr>
	<td class="tableleft">
		<table width="100%" border="0" align="center" cellpadding="0" cellspacing="0" class="table1">
		
		<tr>
		<td class="tableleft1"><span class="star">*</span>手机号码：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='20' name='ubzcmobile' class='input' datatype="Mobile" msg="手机号码不正确"> <font color=#cccccc>11位以13或15或18开头的手机号码</font></td>
		</tr>
		<tr>
		<td class="tableleft1"><span class="star">*</span>联系电话：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='20' name='ubzctel' class='input' datatype="Phone" msg="联系电话不符合要求"> <font color=#cccccc>号码格式为：021-88888888</font></td>
		</tr>
		
		<tr>
		<td width="22%" class="tableleft1"><span class="star">*</span>联系QQ：</td>
		<td width="78%" align="left" class="tableright1"><input type='text' size='30' maxlength='20' name='ubzcqq' class='input' datatype="QQ" msg="QQ号码不符合要求"> <font color=#cccccc>5-12位数字号码</font></td>
		</tr>
		<tr>
		<td class="tableleft1">电子信箱：</td>
		<td align="left" class="tableright1"><input type='text' size='30' maxlength='50' name='ubzcmail' class='input' require="false" datatype="Email" msg="电子邮箱格式不符"> <font color=#cccccc>以@相隔的电子邮件地址</font></td>
		</tr>
		<tr>
		<td class="tableleft1">联系地址：</td>
		<td align="left" class="tableright1"><input type='text' size='50' maxlength='100' name='ubzcaddr' class='input' require="false" datatype="LimitB" min="1" max="100" msg="联系地址必须在50个汉字之内"> <font color=#cccccc>50个汉字以内</font></td>
		</tr>
		</table>
	</td>
	</tr>
	</table>
	<br>
	<input type="submit" name="Submit" value="确认注册" class="button">
	<input type="reset" name="reset" value="重新填写" class="button">
	</form>
	<br>
	<script src="{$vd['content']}js/city.js" type="text/javascript"></script>
</body>
</html>
