- <TD ALIGN="right" VALIGN="center"><% mt('Address') |h %></TD>
- <TD><INPUT TYPE="text" NAME="address" SIZE=54></TD>
- </TR>
-
- <TR>
- <TD ALIGN="right" VALIGN="center"><% mt('County') |h %></TD>
- <TD>
- <& /elements/select-county.html,
- disable_empty => 0,
- empty_label => '(all)',
- &>
- </TD>
- </TR>
-
-
- <TR>
- <TD ALIGN="right" VALIGN="center"><% mt('State') |h %></TD>
- <TD>
- <& /elements/select-state.html,
- disable_empty => 0,
- empty_label => '(all)',
- &>
- </TD>
- </TR>
-
- <TR>
- <TD ALIGN="right" VALIGN="center"><% mt('Zip') |h %></TD>
- <TD><INPUT TYPE="text" NAME="zip" SIZE=12></TD>
- </TR>
-
- <TR>
- <TD ALIGN="right" VALIGN="center"><% mt('Country') |h %></TD>
- <TD>
- <& /elements/select-country.html,
- disable_empty => 0,
- state_disable_empty => 0,
- state_empty_label => '(all)',
- &>
- </TD>
- </TR>
-
- <TR>
- <TD ALIGN="right" VALIGN="center"><% mt('Signup date') |h %></TD>