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<?php
error_reporting(7);
session_start();
if (!$_SESSION["logged_1"] )
header("Location: abstract_failed.html");
?><!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Untitled Document</title>
<script language='JavaScript' type='text/javascript' src='../mac/HDWRegistrationAndLogin/validatescripts.js.php'></script>
<style type="text/css">
<!--
.style1 { font-family: Verdana, Arial, Helvetica, sans-serif;
font-size: 24px;
}
.style29 {font-size: 14px; font-family: Arial, Helvetica, sans-serif;}
.style31 { font-family: Arial, Helvetica, sans-serif;
font-size: 12px;
}
.style60 {font-family: Arial, Helvetica, sans-serif;
font-size: 24px;
}
.style60 {font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-weight: bold; }
.style62 { font-size: 16px;
font-family: Arial, Helvetica, sans-serif;
font-style: italic;
font-weight: bold;
}
-->
</style>
</head>
<body>
<table width="645" border="0" cellpadding="10" cellspacing="0">
<tbody>
<tr>
<td height="576"><form action="/HDWRegistrationAndLogin/RegistrationAndLogin.php" method="post" name="mmc-15reg" id="mmc-15reg" onsubmit="return HDW_validate_registration(this)">
<label></label>
<p><span class="style62">Welcome to the registrants area.</span> <br />
<br />
<span class="style29"><strong>To Upload your abstract</strong> (<u><a href="abstracts-login.html">click here</a></u>) </span><br />
<br />
<span class="style29">You may add an additional registrant or optional activities and events here.</span> </p>
<table class="personal_table">
<tbody>
<tr bgcolor="#E2E2E2">
<td height="31" colspan="2" class="style60"> Personal Information: <span class="style29">Your name:
<label>
<input type="text" name="textfield" />
</label>
</span></td>
</tr>
<tr>
<td width="178" class="style31">Attendee's FIRST NAME*</td>
<td width="402" class="style31"><input name="firstname" type="text" />
LAST NAME*
<input name="lastname" type="text" />
</td>
</tr>
<tr>
<td class="style31">Email Address*</td>
<td class="style31"><input name="email_address" type="text" />
</td>
</tr>
<tr bgcolor="#E2E2E2">
<td height="26" colspan="2" class="style31"> <strong> Registrations</strong></td>
</tr>
</tbody>
</table>
<table width="585" class="smart_table">
<colgroup>
<col />
<col />
<col />
<col width="80px" />
<col />
</colgroup>
<tbody>
</tbody>
<tr>
<td width="145" class="style31"><input class="first_representative_registration sum_qty" id="radio2" name="registration_type" value="first_representative_registration" type="radio" />
</td>
<td width="28" class="style31">$250</td>
<td width="268" class="style31">MMC-15 Spouse Registration</td>
<td width="69" class="style31">Subtotal:</td>
<td width="51" class="registration_subtotal style1"></td>
</tr>
<tr bgcolor="#E2E2E2">
<td height="26" colspan="5" class="style60"> OPTIONAL ACTIVITIES </td>
</tr>
<tr>
<td class="style31"><label>
<input name="visa_application_letter" type="radio" value="Yes" />
Yes </label>
<label>
<input name="visa_application_letter" type="radio" value="No" />
No </label></td>
<td class="style31"> </td>
<td class="style31"> Is an official US entry visa application letter required? </td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="cpe_credits_participant sum_qty sum_checkbox" id="cpe_credits_participant" name="cpe_credits_participants" value="1" type="checkbox" />
</td>
<td class="style31">$25</td>
<td class="style31"><a href="http://www.milb.com/index.jsp?sid=t428" target="_blank">Local Baseball Game</a></td>
<td class="style31">Subtotal:</td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_spouse sum_qty sum_checkbox" id="registering_spouse" name="spouse" value="1" type="checkbox" />
</td>
<td class="style31">$5</td>
<td class="style31"><a href="http://www.bmwusfactory.com/zentrum/" target="_blank">BMW Factory Tour</a></td>
<td class="style31">Subtotal:</td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_business360 sum_qty sum_checkbox" id="registering_business360" name="business360" value="1" type="checkbox" /></td>
<td class="style31">$59</td>
<td class="style31">Golf: Clemson's <a href="http://www.clemson.edu/centers-institutes/madren/golf/" target="_blank">Walker Course</a> </td>
<td class="style31">Subtotal:</td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_business360 sum_qty sum_checkbox" id="registering_business360" name="business360" value="1" type="checkbox" />
</td>
<td class="style31">$25</td>
<td class="style31">Recreational Boating on Lake Hartwell</td>
<td class="style31">Subtotal:</td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="banquet_guests sum_qty" id="banquet_guests" name="banquet_guests" type="text" />
</td>
<td class="style31">$75</td>
<td class="style31">Banquet Guest Tickets—Each registration receives one complimentary
ticket. Additional guests are $75 each.</td>
<td class="style31">Subtotal:</td>
<td class="style31">$0</td>
</tr>
</table>
<hr />
<h4 class="style31">Payment Information<br />
<strong>Total Due:</strong> </h4>
<table width="609">
<tbody>
<tr>
<td class="style31"><input name="payment_method" class="radio_button" value="credit_card" checked="checked" type="radio" />
</td>
<td width="351" class="style31">Pay Now</td>
</tr>
<tr>
<td class="style60"></td>
<td class="style31">Name on Credit Card*</td>
<td width="181" class="style31"><input name="credit_card_name" type="text" />
</td>
</tr>
<tr>
<td class="style60"></td>
<td class="style31">Credit Card Number (No spaces or dashes)*</td>
<td class="style31"><input name="credit_card_number" type="text" />
</td>
</tr>
<tr>
<td class="style60"></td>
<td class="style31">Credit Card Security Code (three-digit number located on the back
of your credit card.)*</td>
<td class="style31"><input name="credit_card_security_code" type="text" />
</td>
</tr>
<tr>
<td class="style60"></td>
<td class="style31">Credit Card Expiration Date (Format: mm/yy)</td>
<td class="style31"><input name="credit_card_expiration_month" class="ultra_tiny" type="text" />
/
<input name="credit_card_expiration_year" class="ultra_tiny" type="text" />
</td>
</tr>
<tr> </tr>
</tbody>
</table>
<p class="style31"><strong>NOTE:</strong> Please review your submission before clicking "Register."</p>
<div class="style60" id="error" style="-webkit-border-radius: 10px;-moz-border-radius: 10px;border-radius: 10px;display:none;background-color:#EDABAB;padding:10px;margin-bottom:10px;"></div>
<span class="style31">
<input name="option" value="com_conferenceregistration" type="hidden" />
<input name="view" value="default" type="hidden" />
<input name="task" value="register" type="hidden" />
<input name="submit" type="submit" value="Register" />
</span>
<table border="0" cellpadding="3" cellspacing="0" width="565">
</table>
<input type="hidden" name="hdwtablename" id="hdwtablename" value="1" />
<input type="hidden" name="hdwusername" id="hdwusername" value="username" />
<input type="hidden" name="hdwpassword" id="hdwpassword" value="Password" />
<input type="hidden" name="hdwconfirm" id="hdwconfirm" value="Password again" />
<input type="hidden" name="hdwok" id="hdwok" value="register-success.html" />
<input type="hidden" name="hdwemail" id="hdwemail" value="aguiseppi+http://macromolecularcomplexes.org" />
<input type="hidden" name="hdwnook" id="hdwnook" value="register-failed.html" />
<input type="hidden" name="hdwactivation_email" id="hdwactivation_email" value="email_address" />
</form></td>
</tr>
</tbody>
</table>
</body>
</html>