{include file='inc_header.tpl'}

	<!-- ######################################################################################################### -->

	<tr>
	  <td valign="top">
		<div id="leftcontent">
		  {include file='inc_left.tpl'}
		</div>
	  </td>

	  <!-- ######################################################################################################### -->

	  <td valign="top">
		<div id="centercontent">
		  {include file='inc_menu.tpl'}
		  <div class="box_titre">Identification</div>
		  <div class="box">

			<form method="post" action="identification.php" id="form_identification">
			<table width="100%">
			  <tr>
				<td align="right" width="25%">Email :</td>
				<td align="left" width="75%"><input type="text" name="Email" id="Email" tabindex="1" /></td>
			  </tr>
			  <tr>
				<td align="right">Mot de passe :</td>
				<td align="left"><input type="password" name="Password" id="Password" tabindex="2" /></td>
			  </tr>
			  <tr>
				<td align="right">&nbsp;</td>
				<td align="left"><input type="submit" style="width: 70px;" tabindex="3" value="Valider" id="btnF01"/>&nbsp;&nbsp;&nbsp;<em><a href="pass_recup.php">Mot de passe perdu ?</a></em></td>
			  </tr>
			</table>
			</form>

		  </div>

		  <div class="box_titre">Enregistrez-vous</div>
		  <div class="box">

			<form method="post" action="sauver_adresse.php" id="saisie_adresse">
			  <fieldset>
				<legend>Adresse de facturation</legend>
				<table width="100%">
				  <tr>
					<td align="right" width="25%">Civilit&eacute; :</td>
					<td align="left" width="75%"><select name="C_ID_Gender" id="C_ID_Gender" tabindex="4">{$ID_GENDER}</select></td>
				  </tr>
				  <tr>
					<td align="right">Nom :</td>
					<td align="left"><input type="text" name="C_FirstName" id="C_FirstName" tabindex="5" /></td>
				  </tr>
				  <tr>
					<td align="right">Pr&eacute;nom :</td>
					<td align="left"><input type="text" name="C_LastName" id="C_LastName" tabindex="6" /></td>
				  </tr>
				  <tr>
					<td align="right">T&eacute;l&eacute;phone :</td>
					<td align="left"><input type="text" name="C_Telephone" id="C_Telephone" tabindex="7" /></td>
				  </tr>
				  <tr>
					<td align="right">Portable :</td>
					<td align="left"><input type="text" name="C_Gsm" id="C_Gsm" tabindex="8" /></td>
				  </tr>
				  <tr>
					<td align="right">Email :</td>
					<td align="left"><input type="text" name="C_Email" onBlur="verrifData('C_Email', 1)" id="C_Email" tabindex="9" /></td>
				  </tr>
				  <tr>
					<td align="right">Mot de passe :</td>
					<td align="left"><input type="password" name="C_Password" id="C_Password" tabindex="10" /></td>
				  </tr>
				  <tr>
					<td align="right">Pays :</td>
					<td align="left"><select name="B_ID_Country" id="B_ID_Country" onChange="accountGeoData('StateList', 'B_ID_Country', 'B')" tabindex="11"><option value="0">--[ Choissez votre pays ]--</option>{$ID_COUNTRY}</select></td>
				  </tr>
				  <tr>
					<td align="right">D&eacute;partement :</td>
					<td align="left"><span id="B_StateList"><select name="B_ID_State" id="B_ID_State" onChange="accountGeoData('CityList', 'B_ID_State', 'B', 1)" tabindex="12">{$ID_STATE}</select></span></td>
				  </tr>
				  <tr>
					<td align="right">Ville :</td>
					<td align="left"><span id="B_CityList"><select name="B_ID_City" id="B_ID_City" tabindex="13"><option value="X"></option></select></span></td>
				  </tr>
				  <!--<tr id="B_NoCity"></tr>-->
				  <!--<p id="B_NoCity"></p>-->
				  <tr>
					<td align="right">Adresse :</td>
					<td align="left"><textarea name="B_Street" id="B_Street" cols="30" rows="3" tabindex="14"></textarea></td>
				  </tr>
				</table>
			  </fieldset>

			  <fieldset>
				<legend>Adresse de livraison</legend>
				<em style="text-align:center; color:#FF3300;">(Ne pas remplir si l'adresse est identique &agrave; celle de facturation)</em>
				<table width="100%">
				  <tr>
					<td align="right" width="25%">Civilit&eacute; :</td>
					<td align="left" width="75%"><select name="D_ID_Gender" id="D_ID_Gender" tabindex="15">{$ID_GENDER}</select></td>
				  </tr>
				  <tr>
					<td align="right">Nom :</td>
					<td align="left"><input type="text" name="D_FirstName" id="D_FirstName" tabindex="16" /></td>
				  </tr>
				  <tr>
					<td align="right">Pr&eacute;nom :</td>
					<td align="left"><input type="text" name="D_LastName" id="D_LastName" tabindex="17" /></td>
				  </tr>
				  <tr>
					<td align="right">Pays :</td>
					<td align="left"><select name="D_ID_Country" id="D_ID_Country" onChange="accountGeoData('StateList', 'D_ID_Country', 'D')" tabindex="18"><option value="0">--[ Choissez votre pays ]--</option>{$ID_COUNTRY}</select></td>
				  </tr>
				  <tr>
					<td align="right">D&eacute;partement :</td>
					<td align="left"><span id="D_StateList"><select name="D_ID_State" id="D_ID_State" onChange="accountGeoData('CityList', 'D_ID_State', 'D', 1)" tabindex="19">{$ID_STATE}</select></span></td>
				  </tr>
				  <tr>
					<td align="right">Ville :</td>
					<td align="left"><span id="D_CityList"><select name="D_ID_City" id="D_ID_City" tabindex="20"><option value="X"></option></select></span></td>
				  </tr>
				  <!--<tr id="D_NoCity"></tr>-->
				  <!--<p id="D_NoCity"></p>-->
				  <tr>
					<td align="right">Adresse :</td>
					<td align="left"><textarea name="D_Street" id="D_Street" cols="30" rows="3" tabindex="21"></textarea></td>
				  </tr>
				  <tr>
					<td align="right">&nbsp;</td>
					<td align="left">
                      <input type="button" value="Envoyer" style="width: 70px;" onClick="checkForm('saisie_adresse')" tabindex="22" />
                    </td>
				  </tr>
				</table>
			  </fieldset>
			</form>

		  </div>
		</div>
	  </td>

	  <!-- ######################################################################################################### -->

	</tr>
  </table>
</div>

{include file='inc_footer.tpl'}