{include file="biz/biz_header.html"} 
<link rel="stylesheet" type="text/css" href="{$TMPL}/css/biz_join.css" />
<div class="blank"></div>
<div class="wrap">
{include file="biz/biz_step_nav.html"}
<div class="blank"></div>
<form method="post" action="{url x="biz" r="join#step4"}" name="biz_publish" enctype="multipart/form-data" >
				<table cellspacing="0" cellpadding="0" border="0" class="data-table" style="margin:0px auto;">
					<tr>
						<td class="dleft">企业名称：</td>
						<td>
							<input type="text" value="" class="f-input" id="h_name" name="h_name" size="80" tabindex="1">
							<span class="red">&nbsp;&nbsp; 必需填写 </span>
						</td>
					</tr>
					
					<tr>
						<td class="dleft">法人姓名：</td>
						<td>
							<input type="text" value="" class="f-input" id="h_faren" name="h_faren" size="80" tabindex="1">
							<span class="red">&nbsp;&nbsp; 必需填写 </span>
						</td>
					</tr>
					
					<tr>
						<td class="dleft">营业执照：</td>
						<td>
							<input type="file" name="h_license" />
							<span class="red">&nbsp;&nbsp; 请上传彩色的扫描件 </span>
						</td>
					</tr>
					
					<tr>
						<td class="dleft">其他资质：</td>
						<td>
							<input type="file" name="h_other_license" />
							<span class="red">&nbsp;&nbsp; 请上传彩色的扫描件，多张资质可以放在同一张图片上 </span>
						</td>
					</tr>
					{if $location_id eq 0}
					<tr>
						<td class="dleft">商户商标：</td>
						<td>
							<input type="file" name="h_supplier_logo" />
							
						</td>
					</tr>
					
					<tr>
						<td class="dleft">门店图片：</td>
						<td>
							<input type="file" name="h_supplier_image" />
						
						</td>
					</tr>
					{/if}
					
					<tr>
						<td class="dleft">申请会员：</td>
						<td>
							<input type="hidden" name="h_user_name" value="{$user_info.user_name}" />
							{$user_info.user_name}
						</td>
					</tr>
					
					<tr>
						<td class="dleft">联系电话：</td>
						<td>
							<input type="text" value="" class="f-input" id="h_tel" name="h_tel" size="40" tabindex="1">
							<span class="red">&nbsp;&nbsp; 请留下真实的联系电话，该号码不会在网站上公开 </span>
						</td>
					</tr>
					
					<tr>
						<td>&nbsp;
						<input type="hidden" name="base_data" value="{$base_data}" />
						</td>
						<td><input type="submit" value="提交" class="biz_pub_btn" /></td>
					</tr>
				</table>
			</form>
</div>
<div class="blank"></div>
{include file="biz/biz_footer.html"}