/lenasys/trunk

<div id="bigwrapper">

	<div id="regWrapper">

		<div id="regHeader">

			<span id="regHeader">

				Welcome to LenaSYS

			</span>

		</div>

		<div id="regformcontenttext">

			To complete your registration,</br>

			please enter your account information.</div>	

		<div id="regForm">

			<table>

				<tr>

					<td>Username:</td><td><?php echo $userName; ?></td>

				</tr>

				<tr>

					<td>Full Name:</td><td><input id="fullName" type="text" name="fullName" placeholder="--Full name--"></td>

				</tr>

				<tr>

					<td>Social Security Number:</td><td><input id="ssn" type="text" name="ssn" placeholder="--YYMMDD-XXXX--"></td>

				</tr>

				<tr>

					<td>New Password:</td><td id="grayText"><input id="newPassword" type="text" name="password" placeholder="--Password--"></td>

				</tr>

				<tr>

					<td>Repeat Password:</td><td><input id="repeatPassword" type="text" name="repeatPassword" placeholder="--Repeat Password--"></td>

				</tr>

				<tr>

					<td>Password Hint:</td><td><input id="pHint" type="text" name="hint" placeholder="--Password Hint--"></td>

				</tr>	

				<tr>

					<td colspan="2"><div id="buttonposition"><input type="submit" value="Confirm" class="confirmbuttonlooks"></div></td>

				</tr>	

			</table>

		</div>

	</div>	

</div>