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Submitted URL: http://www.eolss.net//DeswareRegister//DesInstiRegister.aspx
Effective URL: https://www.eolss.net//DeswareRegister//DesInstiRegister.aspx
Submission: On September 03 via api from US — Scanned from IT
Effective URL: https://www.eolss.net//DeswareRegister//DesInstiRegister.aspx
Submission: On September 03 via api from US — Scanned from IT
Form analysis 1 forms found in the DOM
POST ./DesInstiRegister.aspx
<form method="post" action="./DesInstiRegister.aspx" language="javascript" onsubmit="javascript:return WebForm_OnSubmit();" id="Form1">
<div class="aspNetHidden">
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__LASTFOCUS" id="__LASTFOCUS" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
value="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">
</div>
<script type="text/javascript">
<!--
var theForm = document.forms['Form1'];
if (!theForm) {
theForm = document.Form1;
}
function __doPostBack(eventTarget, eventArgument) {
if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
theForm.__EVENTTARGET.value = eventTarget;
theForm.__EVENTARGUMENT.value = eventArgument;
theForm.submit();
}
}
//
-->
</script>
<script src="/DeswareRegister/WebResource.axd?d=aJxP9N_qH7g5qRlKuDsm3HaVA3GAuUrGhHJj-MhbaUXuhIxhd4W67CR_F0t5eKB_8Cepf2XVvrNMTYRY0&t=638285827360000000" type="text/javascript"></script>
<script src="/DeswareRegister/WebResource.axd?d=EZKZFtWGcOG2AJQPXRQKdi9SUVaJa1keXdN0uQRMgUiQ69M9QUdfSol5ZAbvNZJykJLWR16VyRRNar5lPrcDdxE8sEk1&t=638285827360000000" type="text/javascript"></script>
<script type="text/javascript">
<!--
function WebForm_OnSubmit() {
if (typeof(ValidatorOnSubmit) == "function" && ValidatorOnSubmit() == false) return false;
return true;
}
//
-->
</script>
<div class="aspNetHidden">
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="5C1736F9">
<input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
value="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">
</div>
<div class="col-md-10 col-md-offset-1 PaddingBottom">
<div class="col-md-2">
<!-- GeoTrust True Site[tm] Smart Icon tag. Do not edit. -->
<script language="JavaScript" type="text/javascript" src="//smarticon.geotrust.com/si.js"></script>
<!-- end GeoTrust Smart Icon tag -->
</div>
<div class="col-md-10 text-center">
<h1>DESWARE ON-LINE REGISTRATION FOR INSTITUTIONS</h1>
<span class="text-purple">This Web site is secured by GeoTrust SSL certificate<br></span>
<span class="text-success">Your Privacy is Guaranteed</span>
</div>
<div class="col-md-11">
<h3>1. CONTACT INFORMATION<br>
<small>(Note: Type NA, if the field not applicable)</small>
</h3>
</div>
<div class="col-md-4">Title </div>
<div class="col-md-8">
<select name="txtTitle" id="txtTitle" class="dropdown TextBox" style="width:81px;">
<option value="Prof">Prof</option>
<option value="Dr">Dr</option>
<option value="Mr">Mr</option>
<option value="Mrs">Mrs</option>
<option value="Ms">Ms</option>
<option value="Miss">Miss</option>
</select>
<font color="red">*</font>
</div>
<div class="col-md-4"> First Name </div>
<div class="col-md-8">
<input name="txtFirstname" type="text" maxlength="25" size="30" id="txtFirstname" tabindex="1" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtFirstname" errormessage="Enter Firstname" id="RequiredFieldValidator3" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;height:17px;width:86px;visibility:hidden;">Enter Firstname</span>
</div>
<div class="col-md-4"> Last Name </div>
<div class="col-md-8">
<input name="txtLastname" type="text" maxlength="25" size="30" id="txtLastname" tabindex="2" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtLastname" errormessage="Enter LastName " id="RequiredFieldValidator4" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;height:16px;width:86px;visibility:hidden;">Enter LastName </span>
</div>
<div class="col-md-4"> Organization/Company </div>
<div class="col-md-8">
<input name="txtCompany" type="text" maxlength="50" size="30" id="txtCompany" tabindex="3" class="TextBox">
</div>
<div class="col-md-4"> Address </div>
<div class="col-md-8">
<input name="txtAddress" type="text" maxlength="150" size="30" id="txtAddress" tabindex="4" class="TextBox">
</div>
<div class="col-md-4"> City </div>
<div class="col-md-8">
<input name="txtCity" type="text" maxlength="25" size="30" id="txtCity" tabindex="5" class="TextBox">
</div>
<div class="col-md-4"> Province/State </div>
<div class="col-md-8">
<input name="txtState" type="text" maxlength="30" size="30" id="txtState" tabindex="6" class="TextBox">
</div>
<div class="col-md-4"> Postal code </div>
<div class="col-md-8">
<input name="txtPostalcode" type="text" maxlength="10" size="30" id="txtPostalcode" tabindex="7" class="TextBox">
</div>
<div class="col-md-4"> Country </div>
<div class="col-md-8">
<select name="txtCountry" id="txtCountry" tabindex="8" class="dropdown TextBox">
<option value="OTH">Select a country</option>
<option value="OTH Afghanistan">Afghanistan</option>
<option value="EUR Albania">Albania</option>
<option value="OTH Algeria">Algeria</option>
<option value="OTH American Samoa">American Samoa</option>
<option value="OTH Andorra">Andorra</option>
<option value="OTH Angola">Angola</option>
<option value="OTH Anguilla">Anguilla</option>
<option value="OTH Antarctica">Antarctica</option>
<option value="OTH Antigua and Barbuda">Antigua and Barbuda</option>
<option value="OTH Argentina">Argentina</option>
<option value="OTH Armenia">Armenia</option>
<option value="OTH Aruba">Aruba</option>
<option value="OTH Australia">Australia</option>
<option value="EUR Austria">Austria</option>
<option value="OTH Azerbaijan">Azerbaijan</option>
<option value="OTH Bahamas">Bahamas</option>
<option value="OTH Bahrain">Bahrain</option>
<option value="OTH Bangladesh">Bangladesh</option>
<option value="OTH Barbados">Barbados</option>
<option value="OTH Belarus">Belarus</option>
<option value="EUR Belgium">Belgium</option>
<option value="OTH Belize">Belize</option>
<option value="OTH Benin">Benin</option>
<option value="OTH Bermuda">Bermuda</option>
<option value="OTH Bhutan">Bhutan</option>
<option value="OTH Bolivia">Bolivia</option>
<option value="EUR Bosnia and Herzegowina">Bosnia and Herzegowina</option>
<option value="OTH Botswana">Botswana</option>
<option value="OTH Bouvet Island">Bouvet Island</option>
<option value="OTH Brazil">Brazil</option>
<option value="OTH British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="OTH Brunei Darussalam">Brunei Darussalam</option>
<option value="EUR Bulgaria">Bulgaria</option>
<option value="OTH Burkina Faso">Burkina Faso</option>
<option value="OTH Burundi">Burundi</option>
<option value="OTH Cambodia">Cambodia</option>
<option value="OTH Cameroon">Cameroon</option>
<option value="OTH Cape Verde">Cape Verde</option>
<option value="OTH Canada">Canada</option>
<option value="OTH Cayman Islands">Cayman Islands</option>
<option value="OTH Central African Republic">Central African Republic</option>
<option value="OTH Chad">Chad</option>
<option value="OTH Chile">Chile</option>
<option value="OTH Christmas Island">Christmas Island</option>
<option value="OTH Cocoa (Keeling) Islands">Cocoa (Keeling) Islands</option>
<option value="OTH Colombia">Colombia</option>
<option value="OTH Comoros">Comoros</option>
<option value="OTH Cook Islands">Cook Islands</option>
<option value="OTH Cote Divoire">Cote Divoire</option>
<option value="EUR Croatia">Croatia</option>
<option value="OTH Cuba">Cuba</option>
<option value="EUR Cyprus">Cyprus</option>
<option value="EUR Czech Republic">Czech Republic</option>
<option value="EUR Denmark">Denmark</option>
<option value="OTH Djibouti">Djibouti</option>
<option value="OTH Dominica">Dominica</option>
<option value="OTH Dominican Republic">Dominican Republic</option>
<option value="OTH East Timor">East Timor</option>
<option value="OTH Ecuador">Ecuador</option>
<option value="OTH Egypt">Egypt</option>
<option value="OTH El Salvador">El Salvador</option>
<option value="OTH Equatorial Guinea">Equatorial Guinea</option>
<option value="OTH Eritrea">Eritrea</option>
<option value="EUR Estonia">Estonia</option>
<option value="OTH Ethiopia">Ethiopia</option>
<option value="OTH Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="OTH Faroe Islands">Faroe Islands</option>
<option value="OTH Fiji">Fiji</option>
<option value="EUR Finland">Finland</option>
<option value="EUR France, Metropolitan">France, Metropolitan</option>
<option value="OTH French Guiana">French Guiana</option>
<option value="OTH French Polynesia">French Polynesia</option>
<option value="OTH French Southern Territories">French Southern Territories</option>
<option value="OTH Gabon">Gabon</option>
<option value="OTH Gambia">Gambia</option>
<option value="OTH Georgia">Georgia</option>
<option value="EUR Germany">Germany</option>
<option value="OTH Ghana">Ghana</option>
<option value="OTH Gibraltar">Gibraltar</option>
<option value="EUR Greece">Greece</option>
<option value="OTH Greenland">Greenland</option>
<option value="OTH Grenada">Grenada</option>
<option value="OTH Guadeloupe">Guadeloupe</option>
<option value="OTH Guam">Guam</option>
<option value="OTH Guatemala">Guatemala</option>
<option value="OTH Guinea">Guinea</option>
<option value="OTH Guinea-Bissau">Guinea-Bissau</option>
<option value="OTH Guyana">Guyana</option>
<option value="OTH Haiti">Haiti</option>
<option value="OTH Honduras">Honduras</option>
<option value="OTH Hong Kong">Hong Kong</option>
<option value="EUR Hungary">Hungary</option>
<option value="OTH Iceland">Iceland</option>
<option value="OTH India">India</option>
<option value="OTH Indonesia">Indonesia</option>
<option value="OTH Iran">Iran</option>
<option value="OTH Iraq">Iraq</option>
<option value="UKK Ireland">Ireland</option>
<option value="OTH Israel">Israel</option>
<option value="EUR Italy">Italy</option>
<option value="OTH Jamaica">Jamaica</option>
<option value="OTH Japan">Japan</option>
<option value="OTH Jordan">Jordan</option>
<option value="OTH Kazakhstan">Kazakhstan</option>
<option value="OTH Kenya">Kenya</option>
<option value="EUR Kosovo">Kosovo</option>
<option value="OTH Kiribati">Kiribati</option>
<option value="OTH South Korea">South Korea</option>
<option value="OTH North Korea">North Korea</option>
<option value="OTH Kuwait">Kuwait</option>
<option value="OTH Kyrgyzstan">Kyrgyzstan</option>
<option value="OTH Lao">Lao</option>
<option value="EUR Latvia">Latvia</option>
<option value="OTH Lebanon">Lebanon</option>
<option value="OTH Lesotho">Lesotho</option>
<option value="OTH Liberia">Liberia</option>
<option value="OTH Libya">Libya</option>
<option value="OTH Liechtenstein">Liechtenstein</option>
<option value="EUR Lithuania">Lithuania</option>
<option value="EUR Luxembourg">Luxembourg</option>
<option value="OTH Macau">Macau</option>
<option value="OTH Macedonia">Macedonia</option>
<option value="OTH Madagascar">Madagascar</option>
<option value="OTH Malawi">Malawi</option>
<option value="OTH Malaysia">Malaysia</option>
<option value="OTH Maldives">Maldives</option>
<option value="OTH Mali">Mali</option>
<option value="EUR Malta">Malta</option>
<option value="OTH Marshall Islands">Marshall Islands</option>
<option value="OTH Martinique">Martinique</option>
<option value="OTH Mauritania">Mauritania</option>
<option value="OTH Mauritius">Mauritius</option>
<option value="OTH Mayotte">Mayotte</option>
<option value="OTH Mexico">Mexico</option>
<option value="OTH Monaco">Monaco</option>
<option value="OTH Mongolia">Mongolia</option>
<option value="EUR Montenegro">Montenegro</option>
<option value="OTH Montserrat">Montserrat</option>
<option value="OTH Morocco">Morocco</option>
<option value="OTH Mozambique">Mozambique</option>
<option value="OTH Myanmar">Myanmar</option>
<option value="OTH Namibia">Namibia</option>
<option value="OTH Nepal">Nepal</option>
<option value="EUR Netherlands">Netherlands</option>
<option value="EUR Netherlands Antilles">Netherlands Antilles</option>
<option value="OTH New Caledonia">New Caledonia</option>
<option value="OTH New Zealand">New Zealand</option>
<option value="OTH Nicaragua">Nicaragua</option>
<option value="OTH Niger">Niger</option>
<option value="OTH Nigeria">Nigeria</option>
<option value="OTH Niue">Niue</option>
<option value="OTH Norfolk Island">Norfolk Island</option>
<option value="OTH Norway">Norway</option>
<option value="OTH Oman">Oman</option>
<option value="OTH Pakistan">Pakistan</option>
<option value="OTH Palestine">Palestine</option>
<option value="OTH Palau">Palau</option>
<option value="OTH Panama">Panama</option>
<option value="OTH Papua New Guinea">Papua New Guinea</option>
<option value="OTH Paraguay">Paraguay</option>
<option value="OTH People's Republic of China">People's Republic of China</option>
<option value="OTH Peru">Peru</option>
<option value="OTH Pitcairn">Pitcairn</option>
<option value="EUR Poland">Poland</option>
<option value="EUR Portugal">Portugal</option>
<option value="OTH Puerto Rico">Puerto Rico</option>
<option value="OTH Qatar">Qatar</option>
<option value="OTH Reunion">Reunion</option>
<option value="EUR Romania">Romania</option>
<option value="OTH Russia">Russia</option>
<option value="OTH Rwanda">Rwanda</option>
<option value="OTH Saint Lucia">Saint Lucia</option>
<option value="OTH Samoa">Samoa</option>
<option value="OTH San Marino">San Marino</option>
<option value="OTH Sao Tome Principe">Sao Tome Principe</option>
<option value="OTH Saudi Arabia">Saudi Arabia</option>
<option value="OTH Senegal">Senegal</option>
<option value="EUR Serbia">Serbia</option>
<option value="OTH Seychelles">Seychelles</option>
<option value="OTH Sierra Leone">Sierra Leone</option>
<option value="OTH Singapore">Singapore</option>
<option value="EUR Slovakia">Slovakia</option>
<option value="EUR Slovenia">Slovenia</option>
<option value="OTH Solomon Islands">Solomon Islands</option>
<option value="OTH Somalia">Somalia</option>
<option value="OTH South Africa">South Africa</option>
<option value="OTH South Georgia">South Georgia</option>
<option value="EUR Spain">Spain</option>
<option value="OTH Sri Lanka">Sri Lanka</option>
<option value="OTH St. Helena">St. Helena</option>
<option value="OTH St. Pierre - Miquelon">St. Pierre - Miquelon</option>
<option value="OTH Sudan">Sudan</option>
<option value="OTH Suriname">Suriname</option>
<option value="OTH Swaziland">Swaziland</option>
<option value="EUR Sweden">Sweden</option>
<option value="EUR Switzerland">Switzerland</option>
<option value="OTH Syria">Syria</option>
<option value="OTH Taiwan">Taiwan</option>
<option value="OTH Tajikistan">Tajikistan</option>
<option value="OTH Tanzania">Tanzania</option>
<option value="OTH Thailand">Thailand</option>
<option value="OTH Togo">Togo</option>
<option value="OTH Tokelau">Tokelau</option>
<option value="OTH Tonga">Tonga</option>
<option value="OTH Trinidad-Tobago">Trinidad-Tobago</option>
<option value="OTH Tunisia">Tunisia</option>
<option value="EUR Turkey">Turkey</option>
<option value="OTH Turkmenistan">Turkmenistan</option>
<option value="OTH Tuvalu">Tuvalu</option>
<option value="OTH Uganda">Uganda</option>
<option value="OTH Ukraine">Ukraine</option>
<option value="OTH United Arab Emirates">United Arab Emirates</option>
<option value="UKK United Kingdom">United Kingdom</option>
<option value="OTH Uruguay">Uruguay</option>
<option value="OTH United States of America">United States of America</option>
<option value="OTH Uzbekistan">Uzbekistan</option>
<option value="OTH Vatican City State">Vatican City State</option>
<option value="OTH Venezuela">Venezuela</option>
<option value="OTH Vietnam">Vietnam</option>
<option value="OTH Virgin Islands (British)">Virgin Islands (British)</option>
<option value="OTH Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
<option value="OTH Wallis and Futuna Islands">Wallis and Futuna Islands</option>
<option value="OTH Western Sahara">Western Sahara</option>
<option value="OTH Yemen">Yemen</option>
<option value="OTH Yugoslavia">Yugoslavia</option>
<option value="OTH Zaire">Zaire</option>
<option value="OTH Zambia">Zambia</option>
<option value="OTH Zimbabwe">Zimbabwe</option>
<option value="OTH">Other</option>
</select>
</div>
<div class="col-md-4"> Phone Number </div>
<div class="col-md-8">
<input name="txtPhoneno" type="text" maxlength="20" size="30" id="txtPhoneno" tabindex="9" class="TextBox">
</div>
<div class="col-md-4"> Fax Number </div>
<div class="col-md-8">
<input name="txtFaxno" type="text" maxlength="50" size="30" id="txtFaxno" tabindex="10" class="TextBox">
</div>
<div class="col-md-4"> Email Address </div>
<div class="col-md-8">
<input name="txtEmail" type="text" maxlength="50" size="30" id="txtEmail" tabindex="11" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtEmail" errormessage="Enter email" id="RequiredFieldValidator5" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;width:61px;visibility:hidden;">Enter
email</span><span controltovalidate="txtEmail" errormessage="Invalid email " id="RegularExpressionValidator1" evaluationfunction="RegularExpressionValidatorEvaluateIsValid" validationexpression="\w+([-+.]\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"
style="color:Red;font-size:X-Small;width:76px;visibility:hidden;">Invalid email </span>
</div>
<div class="col-md-4">Confirm Email Address </div>
<div class="col-md-8"><input name="txtconfirmemail" type="text" maxlength="50" size="30" id="txtconfirmemail" tabindex="4" class="TextBox">
<font color="red">*</font>
</div>
<div class="col-md-2">
</div>
<div class="col-md-9">
<strong>Administrator Details</strong>
</div>
<div class="col-md-4"> Name </div>
<div class="col-md-8">
<input name="txtadminInst" type="text" maxlength="25" size="30" id="txtadminInst" tabindex="12" class="TextBox">
<font color="red"><strong>*</strong></font>
<span controltovalidate="txtadminInst" errormessage="Enter administrator name" id="Requiredfieldvalidator15" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Enter
administrator name</span>
</div>
<div class="col-md-4"> Email </div>
<div class="col-md-8">
<input name="txtadminemail" type="text" maxlength="25" size="30" id="txtadminemail" tabindex="12" class="TextBox">
<font color="red"><strong>*</strong>
<span controltovalidate="txtadminemail" errormessage="Enter administrator email" id="Requiredfieldvalidator16" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;visibility:hidden;">Enter administrator email</span><span controltovalidate="txtadminemail" errormessage="Invalid email " id="Regularexpressionvalidator4"
evaluationfunction="RegularExpressionValidatorEvaluateIsValid" validationexpression="\w+([-+.]\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*" style="color:Red;font-size:X-Small;width:72px;visibility:hidden;">Invalid email </span>
</font>
</div>
<div class="col-md-4">Phone No </div>
<div class="col-md-8">
<input name="txtadmintel" type="text" maxlength="25" size="30" id="txtadmintel" tabindex="12" class="TextBox">
<font color="red"><strong>*</strong></font>
<span controltovalidate="txtadmintel" errormessage="Enter administrator phone" id="Requiredfieldvalidator17" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Enter
administrator phone</span>
</div>
<div class="col-md-4"> How did you hear about DESWARE </div>
<div class="col-md-8">
<select name="lstquestion" id="lstquestion" class="TextBox dropdown">
<option value=" ">Please Select One</option>
<option value="Search engine or directory">Search engine or directory</option>
<option value="Link from other Web site">Link from other Web site</option>
<option value="Advertisement">Advertisement</option>
<option value="Magazine Article">Magazine Article</option>
<option value="Tradeshow">Tradeshow</option>
<option value="Other">Other</option>
</select>
<font color="red">*</font>
<span controltovalidate="lstquestion" errormessage="Please select one entry" id="RequiredFieldValidator10" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Please
select one entry</span>
</div>
<div class="Clear"></div>
<div class="col-md-4"> If "Other" please specify </div>
<div class="col-md-8">
<input name="txtquestion" type="text" maxlength="25" size="30" id="txtquestion" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtquestion" errormessage="You must specify this field" id="RequiredFieldValidator9" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">You
must specify this field</span>
<span controltovalidate="txtuser" errormessage="Username must be between 6-12 characters with no blank spaces" id="CustomValidator1" evaluationfunction="CustomValidatorEvaluateIsValid"
style="color:Red;font-size:X-Small;visibility:hidden;">Username must be between 6-12 characters with no blank spaces</span>
</div>
<div class="col-md-4"> Preferred Username </div>
<div class="col-md-8">
<input name="txtuser" type="text" maxlength="12" size="30" id="txtuser" tabindex="13" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtuser" errormessage="Enter Username" id="RequiredFieldValidator2" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;height:2px;width:84px;visibility:hidden;">Enter Username</span>
</div>
<div class="col-md-11">
<em>
<font color="blue" size="2">(Username must be between 6 - 12 characters with no blank spaces)</font>
</em>
</div>
<div class="col-md-11">
<hr style="WIDTH: 98.82%;border-color:Silver" align="left" noshade="" size="2">
<h3>2. PROFILE (Activity)</h3>
</div>
<div class="col-md-11">Please select the one response below which best describes your <strong>activity: </strong>
</div>
<div class="col-md-4"></div>
<div class="col-md-8">
<select name="lstActivity" id="lstActivity" tabindex="13" class="dropdown TextBox">
<option value=" ">Please Select One</option>
<option value="University/College">1. University/College</option>
<option value="Government">2.Government</option>
<option value="NGO">3. NGO</option>
<option value="Business/Industry">4.Business/Industry</option>
<option value=" Student">5. Student</option>
<option value="Not Applicable">6. Not Applicable</option>
<option value="other">7. Other</option>
</select>
</div>
<div class="col-md-4">If "Other" please specify: </div>
<div class="col-md-8">
<input name="txtactivtyOther" type="text" maxlength="25" size="30" id="txtactivtyOther" class="TextBox">
</div>
<div class="col-md-4">Primary Job Function </div>
<div class="col-md-8">
<select name="txtProfession" id="txtProfession" tabindex="14" class="dropdown TextBox">
<option value=" ">Please Select One</option>
<option value="Research and Development">Research and Development</option>
<option value="Processing/Manufacturing">Processing/Manufacturing</option>
<option value="Process/Project Engineering">Process/Project Engineering</option>
<option value="Corporate Management">Corporate Management</option>
<option value="Student">Student</option>
<option value="other">Other</option>
<option value="None">None</option>
</select>
</div>
<div class="col-md-4">If "Other" please specify: </div>
<div class="col-md-8">
<input name="txtjob" type="text" maxlength="50" size="30" id="txtjob" class="TextBox">
</div>
<div class="col-md-10">From the list of subject categories below please select the ONE which best describes your area of work or study </div>
<div class="col-md-10 col-md-offset-2">
<select name="txtCategories" id="txtCategories" tabindex="15" class="dropdown TextBox">
<option value="Please Select One">Please Select One</option>
<option value="All Subjects">All Subjects</option>
<option value="Not Applicable(none)">Not Applicable(none)</option>
<option value="Overview of the Encyclopedia of Desalination and Water Resources">Overview of the Encyclopedia of Desalination and Water Resources</option>
<option value="History, Development and Demands">History, Development and Demands</option>
<option value="Physical, Chemical and Biological Properties of Water">Physical, Chemical and Biological Properties of Water</option>
<option value="Physical, Biological and Chemical Phenomina Affecting Desalination Plants">Physical, Biological and Chemical Phenomina Affecting Desalination Plants</option>
<option value="The Desalination Site and Civil Works">The Desalination Site and Civil Works</option>
<option value="Raw Water Pretreatment">Raw Water Pretreatment</option>
<option value="Common Fundamentals and Unit Operation in Thermal Desalination Plants">Common Fundamentals and Unit Operation in Thermal Desalination Plants</option>
<option value="Thermal Desalination Processes">Thermal Desalination Processes</option>
<option value="Membrane Processes">Membrane Processes</option>
<option value="Renewable Energy Systems and Desalination">Renewable Energy Systems and Desalination</option>
<option value="Ancilliary Equipment">Ancilliary Equipment</option>
<option value="Process Instrumentation , Control and Automation">Process Instrumentation , Control and Automation</option>
<option value="Post Treatment of Distillate and Permeat">Post Treatment of Distillate and Permeat</option>
<option value="Material Selection and Corrosion">Material Selection and Corrosion</option>
<option value="Plant Operation Maintenance and Management">Plant Operation Maintenance and Management</option>
<option value="Environmental Aspects">Environmental Aspects</option>
<option value="The Desalination Project ">The Desalination Project </option>
<option value="The World's Major Seawater Desalination Plants">The World's Major Seawater Desalination Plants</option>
<option value="Co-generation Planning and Operation">Co-generation Planning and Operation</option>
<option value="Sustainable Development, Water Resources and Desalination">Sustainable Development, Water Resources and Desalination</option>
<option value="Water Sciences and Technology Resources">Water Sciences and Technology Resources</option>
<option value="Basic Sciences">Basic Sciences</option>
<option value="Global Information and Data on Water Resources">Global Information and Data on Water Resources</option>
<option value="Other">Other</option>
</select>
</div>
<div class="col-md-11">
<hr style="WIDTH: 98.42%; border-color:Silver " align="left" size="2">
</div>
<div class="col-md-11">
<h3>3. PAYMENT<font color="red">*</font>
</h3>
</div>
<div class="col-md-4"> Select Plan </div>
<div class="col-md-8">
<table id="radsubsrates" style="font-size:Smaller;">
<tbody>
<tr>
<td><input id="radsubsrates_0" type="radio" name="radsubsrates" value="6M" checked="checked" tabindex="17"><label for="radsubsrates_0">Six Months Plan </label></td>
<td><input id="radsubsrates_1" type="radio" name="radsubsrates" value="3M" tabindex="17"><label for="radsubsrates_1">Three Months Plan</label></td>
</tr>
</tbody>
</table>
</div>
<div class="col-md-4"> Amount </div>
<div class="col-md-8"> </div>
<div class="col-md-4"> Mode Of Payment </div>
<div class="col-md-8">
<table id="ModePay" style="font-size:Smaller;">
<tbody>
<tr>
<td><input id="ModePay_0" type="radio" name="ModePay" value="CreditCard" checked="checked" tabindex="16"><label for="ModePay_0">CreditCard </label></td>
<td><input id="ModePay_1" type="radio" name="ModePay" value="BankDraft" onclick="javascript:setTimeout('__doPostBack(\'ModePay$1\',\'\')', 0)" language="javascript" tabindex="16"><label for="ModePay_1">BankDraft</label></td>
</tr>
</tbody>
</table>
</div>
<div class="col-md-4"> Credit Card Type </div>
<div class="col-md-8">
<table id="paytype" style="font-size:Smaller;">
<tbody>
<tr>
<td><input id="paytype_0" type="radio" name="paytype" value="Visa" checked="checked" tabindex="17"><label for="paytype_0">Visa </label></td>
<td><input id="paytype_1" type="radio" name="paytype" value="MasterCard" tabindex="17"><label for="paytype_1">MasterCard </label></td>
<td><input id="paytype_2" type="radio" name="paytype" value="AmericanExpress" tabindex="17"><label for="paytype_2">AmericanExpress</label></td>
</tr>
</tbody>
</table>
</div>
<div class="col-md-4"> Cardholder Name </div>
<div class="col-md-8">
<input name="txtcardholdername" type="text" maxlength="75" size="30" id="txtcardholdername" tabindex="24" class="TextBox">
<font color="red">* </font>
<span controltovalidate="txtcardholdername" errormessage="Enter cardholder name" id="reqcardholder" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Enter
cardholder name</span>
</div>
<div class="col-md-11">
<font color="navy" size="2">* You must type creditcard number without blank spaces or hyphens</font>
</div>
<div class="col-md-4"> Credit Card No </div>
<div class="col-md-8">
<input name="txtcreditcard" type="text" maxlength="20" id="txtcreditcard" tabindex="18" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtcreditcard" errormessage="Enter Credit Card no" id="RequiredFieldValidator1" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;height:12px;visibility:hidden;">Enter Credit Card no</span><span controltovalidate="txtcreditcard" errormessage=" Invalid Credit Card No" id="CustomValidator2"
evaluationfunction="CustomValidatorEvaluateIsValid" style="color:Red;font-size:X-Small;visibility:hidden;"> Invalid Credit Card No</span>
</div>
<div class="col-md-4"> Card Identification No </div>
<div class="col-md-8">
<input name="txtsecuritycode" type="text" maxlength="5" size="5" id="txtsecuritycode" tabindex="18" class="TextBox" style="height:25px;width:69px;"> <em>
<font size="2">(For information on card identification number, click <a onclick="javascript:window.open('CardIdNo.aspx','_blank','height=475,width=450,toolbar=no');">
<u><font color="#6666ff">here</font></u></a>)</font>
</em>
</div>
<div class="col-md-4"> Expiry Month </div>
<div class="col-md-8">
<select name="lstexpmonth" id="lstexpmonth" tabindex="19" class="TextBox dropdown" style="width:154px;">
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
<font color="red">*</font>
</div>
<div class="col-md-4"> Expiry Year </div>
<div class="col-md-8">
<select name="lstexpyear" id="lstexpyear" tabindex="20" class="TextBox dropdown" style="width:155px;">
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
<option value="2035">2035</option>
<option value="2036">2036</option>
<option value="2037">2037</option>
<option value="2038">2038</option>
<option value="2039">2039</option>
<option value="2040">2040</option>
</select>
<font color="red">*</font>
</div>
<div class="col-md-4"> Draft No </div>
<div class="col-md-8">
<input name="txtdd" type="text" maxlength="20" id="txtdd" disabled="disabled" tabindex="17" class="aspNetDisabled TextBox" style="background-color:Silver;">
<font color="red">*</font>
<span controltovalidate="txtdd" errormessage="Enter Draft No " enabled="False" id="ReqDraft" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;height:5px;width:140px;visibility:hidden;">Enter Draft No </span>
</div>
<div class="col-md-4"> IssueBank </div>
<div class="col-md-8">
<input name="txtbank" type="text" maxlength="100" id="txtbank" disabled="disabled" tabindex="19" class="aspNetDisabled TextBox" style="background-color:Silver;">
<font color="red">*</font>
</div>
<div class="col-md-4"> IssueDate(mm/dd/yyyy) </div>
<div class="col-md-8">
<input name="txtissuedate" type="text" value="mm/dd/yyyy" id="txtissuedate" disabled="disabled" tabindex="18" class="aspNetDisabled TextBox" style="background-color:Silver;">
<font color="red">*</font>
<span errormessage="Invalid Date- Draft must not be earlier or later than six months" enabled="False" id="CustomValidator4" evaluationfunction="CustomValidatorEvaluateIsValid" style="font-size:X-Small;visibility:hidden;">Invalid Date- Draft
must not be earlier or later than six months</span>
</div>
<div class="col-md-11">
<hr style="WIDTH: 98.42%; border-color:Silver " align="left" size="2">
<h3>Institution IP Addresses and/or Ranges </h3>
</div>
<div class="col-md-4"> Domain Name<font size="2"> (e.g.www.mydomain.edu)</font>
</div>
<div class="col-md-8">
<input name="txtdomain" type="text" size="30" id="txtdomain" tabindex="30" class="TextBox">
<font color="red">*</font>
<span controltovalidate="txtdomain" errormessage="Enter domain" id="RequiredFieldValidator6" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Enter
domain</span><span controltovalidate="txtdomain" errormessage="Invalid domain format" id="RegularExpressionValidator2" evaluationfunction="RegularExpressionValidatorEvaluateIsValid" validationexpression="\w+([-.]\w+)*\.\w+([-.]\w+)*"
style="color:Red;font-size:X-Small;visibility:hidden;">Invalid domain format</span>
</div>
<div class="col-md-11"><i>
For Institutional subscribers require an IP Address, please print
out the attached <a href="des_ip_reg.pdf">PDF</a> version, fill the
information and return to the address stated at the end of the page </i>
</div>
<div class="col-md-11 col-md-offset-1" style="padding:2px;border:dotted 1px grey;">
<div class="col-md-11"> Examples of valid IP Addresses </div>
<div class="col-md-3"> Single Station : </div>
<div class="col-md-8">
<input class="input_ip" disabled="" readonly="" type="text" size="1" value="192">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="40 ">. <input class="input_ip" disabled="" readonly="" type="text" size="1"
value="158">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="10">
</div>
<div class="col-md-3"> Class B Networks : </div>
<div class="col-md-8">
<input class="input_ip" disabled="" readonly="" type="text" size="1" value="128">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="58">. <input class="input_ip" disabled="" readonly="" type="text" size="1"
value="*">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="*">
</div>
<div class="col-md-3"> Class C Networks : </div>
<div class="col-md-8">
<input class="input_ip" disabled="" readonly="" type="text" size="1" value="210">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="45">. <input class="input_ip" disabled="" readonly="" type="text" size="1"
value="198">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="*">
</div>
<div class="col-md-3">IP Range : </div>
<div class="col-md-8">
<input class="input_ip" disabled="" readonly="" type="text" size="1" value="192">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="58">. <input class="input_ip" disabled="" readonly="" type="text" size="1"
value="150">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="*"> - <input class="input_ip" disabled="" readonly="" type="text" size="1" value="192">. <input class="input_ip" disabled="" readonly=""
type="text" size="1" value="58">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="152">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="*"> or <input class="input_ip" disabled=""
readonly="" type="text" size="1" value="192">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="58">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="150">. <input class="input_ip"
disabled="" readonly="" type="text" size="1" value="10"> - <input class="input_ip" disabled="" readonly="" type="text" size="1" value="192">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="58">. <input
class="input_ip" disabled="" readonly="" type="text" size="1" value="150">. <input class="input_ip" disabled="" readonly="" type="text" size="1" value="30">
</div>
</div>
<div class="col-md-11"> To enter Range address click on the checkbox to enable the second IP address box </div>
<div class="col-md-11"> 1. <input name="txtIP11" type="text" maxlength="3" id="txtIP11" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP12" type="text" maxlength="3" id="txtIP12" tabindex="22" class="TextBox textbox_ip">. <input
name="txtIP13" type="text" maxlength="3" id="txtIP13" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP14" type="text" maxlength="3" id="txtIP14" tabindex="22" class="TextBox textbox_ip"> <span
style="font-size:Smaller;height:20px;width:38px;"><input id="chkIP1" type="checkbox" name="chkIP1" onclick="javascript:setTimeout('__doPostBack(\'chkIP1\',\'\')', 0)" language="javascript"><label
for="chkIP1"> To</label></span> <input name="txtIP15" type="text" maxlength="3" id="txtIP15" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input
name="txtIP16" type="text" maxlength="3" id="txtIP16" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP17" type="text" maxlength="3" id="txtIP17"
disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP18" type="text" maxlength="3" id="txtIP18" disabled="disabled" tabindex="22"
class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">
<font color="red">* <span controltovalidate="txtIP14" errormessage="IP requires 4 parts" id="RequiredFieldValidator12" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:X-Small;visibility:hidden;">IP requires 4 parts</span><span controltovalidate="txtIP13" errormessage="Incomplete IP" id="RequiredFieldValidator11" evaluationfunction="RequiredFieldValidatorEvaluateIsValid"
initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Incomplete IP</span><span controltovalidate="txtIP12" errormessage="Enter IP" id="RequiredFieldValidator14" evaluationfunction="RequiredFieldValidatorEvaluateIsValid"
initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">Enter IP</span><span controltovalidate="txtIP11" errormessage="IP required" id="RequiredFieldValidator13" evaluationfunction="RequiredFieldValidatorEvaluateIsValid"
initialvalue="" style="color:Red;font-size:X-Small;visibility:hidden;">IP required</span></font>
</div>
<div class="col-md-11"> 2. <input name="txtIP21" type="text" maxlength="3" id="txtIP21" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP22" type="text" maxlength="3" id="txtIP22" tabindex="22" class="TextBox textbox_ip">. <input
name="txtIP23" type="text" maxlength="3" id="txtIP23" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP24" type="text" maxlength="3" id="txtIP24" tabindex="22" class="TextBox textbox_ip"> <span
style="font-size:Smaller;height:20px;width:38px;"><input id="chkIP2" type="checkbox" name="chkIP2" onclick="javascript:setTimeout('__doPostBack(\'chkIP2\',\'\')', 0)" language="javascript"><label
for="chkIP2"> To</label></span> <input name="txtIP25" type="text" maxlength="3" id="txtIP25" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input
name="txtIP26" type="text" maxlength="3" id="txtIP26" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP27" type="text" maxlength="3" id="txtIP27"
disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP28" type="text" maxlength="3" id="txtIP28" disabled="disabled" tabindex="22"
class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;"> </div>
<div class="col-md-11">3. <input name="txtIP31" type="text" maxlength="3" id="txtIP31" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP32" type="text" maxlength="3" id="txtIP32" tabindex="22" class="TextBox textbox_ip">. <input
name="txtIP33" type="text" maxlength="3" id="txtIP33" tabindex="22" class="TextBox textbox_ip">. <input name="txtIP34" type="text" maxlength="3" id="txtIP34" tabindex="22" class="TextBox textbox_ip"> <span
style="font-size:Smaller;height:20px;width:38px;"><input id="chkIP3" type="checkbox" name="chkIP3" onclick="javascript:setTimeout('__doPostBack(\'chkIP3\',\'\')', 0)" language="javascript"><label
for="chkIP3"> To</label></span> <input name="txtIP35" type="text" maxlength="3" id="txtIP35" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input
name="txtIP36" type="text" maxlength="3" id="txtIP36" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP37" type="text" maxlength="3" id="txtIP37"
disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;">. <input name="txtIP38" type="text" maxlength="3" id="txtIP38" disabled="disabled" tabindex="22"
class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;"> </div>
<div class="col-md-11"> Does your institution have a Firewall Server? </div>
<div class="col-md-11">
<p><input id="radfirewallno" type="radio" name="radproxy" value="radfirewallno" checked="checked"><label for="radfirewallno">No</label><br>
<input id="radfirewallyes" type="radio" name="radproxy" value="radfirewallyes" onclick="javascript:setTimeout('__doPostBack(\'radfirewallyes\',\'\')', 0)" language="javascript"><label for="radfirewallyes">Yes</label> <em>
<font size="2">If yes, enter the IP address of the Firewall Server</font> </em>
<input name="txtPro11" type="text" maxlength="3" id="txtPro11" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;height:23px;width:29px;">. <input name="txtPro12" type="text"
maxlength="3" id="txtPro12" disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;height:23px;width:29px;">. <input name="txtPro13" type="text" maxlength="3" id="txtPro13"
disabled="disabled" tabindex="22" class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;height:23px;width:29px;">. <input name="txtPro14" type="text" maxlength="3" id="txtPro14" disabled="disabled" tabindex="22"
class="aspNetDisabled TextBox textbox_ip" style="background-color:Silver;height:23px;width:29px;">
</p>
</div>
<div class="col-md-11">
<input id="chkagreement" type="checkbox" name="chkagreement" checked="checked" tabindex="21"><label for="chkagreement"> I have read the <a href="Agreement_Insti.aspx" target="_blank">License Agreement</a> and accept to its
terms</label>
</div>
<div class="col-md-11"> Thank you for your order </div>
<div class="col-md-11"> For your convenience, subscription will be automatically renewed until you request cancellation. [For cancellation, send an email to <img class="img-responsive display-inline" src="images/email.png" alt="EOLSS Contact">]
</div>
<div class="col-md-11">
<strong>Alternatively:</strong>
</div>
<div class="col-md-11"> A downloadable Registration Form in <a href="DesInstiRegister.pdf">
PDF</a> or <a href="DesInstiRegister.doc">Word</a> is available. </div>
<div class="col-md-11"> Please Fax/Mail the form to UNESCO-EOLSS Joint Committee Secretariat<br> UNESCO-Encyclopedia of Life Support Systems (EOLSS)<br> E-mail: <img class="img-responsive display-inline" src="images/email.png"
alt="EOLSS Contact"> / <img class="img-responsive display-inline" src="images/email3.png" alt="EOLSS Contact">
<p></p>
</div>
<div class="col-md-11"> By Mail - Bank drafts payable to UNESCO-Encyclopedia of Life Support Systems (EOLSS) </div>
<div class="col-md-11"> Drafts must be in EUROS/UKP/UK$. International money orders are also accepted. </div>
<div class="col-md-11"> Email - Direct your order and credit card details to: <img class="img-responsive display-inline" src="images/email.png" alt="EOLSS Contact">
</div>
<div class="col-md-11">
<strong>Please read the following carefully:</strong>
</div>
<div class="col-md-11"> I understand that completion of this form is a binding agreement and I offer my personal e-mail address in lieu of a signature: </div>
<div class="col-md-11">
<span id="lblmsg" style="color:#C00000;font-weight:bold;height:19px;width:80%;"></span>
</div>
<div class="col-md-11">
<span id="Label61" style="color:#C00000;font-weight:bold;height:3px;width:80%;"></span>
</div>
<div class="col-md-4">
</div>
<div class="col-md-8">
<img alt="Captcha" height="50" src="JpegImage.aspx" width="200">
</div>
<div class="col-md-4"> Enter the Code Shown above </div>
<div class="col-md-8">
<input name="CodeNumberTextBox" type="text" id="CodeNumberTextBox" class="TextBox" style="width:100px;"> <font color="red">* </font>
<span controltovalidate="CodeNumberTextBox" errormessage="Enter verification code" id="Requiredfieldvalidator7" evaluationfunction="RequiredFieldValidatorEvaluateIsValid" initialvalue=""
style="color:Red;font-size:Smaller;width:136px;visibility:hidden;">Enter verification code</span>
</div>
<div class="col-md-11">
<em>
<font size="2">(Note: If you cannot read the numbers in the above image, reload the page to generate a new one.)</font>
</em>
</div>
<div class="col-md-2">
</div>
<div class="col-md-8">
<input type="submit" name="btnSubmit" value="Submit" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("btnSubmit", "", true, "", "", false, false))" language="javascript"
id="btnSubmit" tabindex="22" class="btn btn-default" style="font-weight:bold;">
<input type="submit" name="btnCancel" value="Cancel" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("btnCancel", "", true, "", "", false, false))" language="javascript"
id="btnCancel" tabindex="23" class="btn btn-default" style="font-weight:bold;">
<div showmessagebox="True" id="Validationsummary2" style="color:Red;width:80%;display:none;">
</div>
</div>
<div class="col-md-11"> OR Print and Fax with your signature. </div>
<div class="col-md-11">
<p>
<strong>NOTE:</strong> Please use an active email address when registering to EOLSS. An activation email will be sent to the email address associated with your account to provide you access to the service. <font color="red"> Please also
ensure that any email spam filters are properly configured to ensure that you recieve the activation email from EOLSS.</font>
</p>
</div>
</div>
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