/lenasys/trunk

<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 $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"></div></td>

                        </tr>   

                </table>

        </div>

</div>