<!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>Design 3</title>
</head>
<style>
.outter{
border:3px #E0F0E8 solid;
background-color:#F5FAF9;
}
.note{
font-family:tahoma;
font-size:12px;
color:#333333;
border:1px #55917A dashed;
}
.input{
font-family:Verdana, Arial, Helvetica, sans-serif;
font-weight:normal;
font-size:12px;
border:1px #A7BEB7 solid;
}
.text{
font-family:tahoma;
font-size:11px;
color:#617E78;
}
.formHeading{
font-family:Arial, Helvetica, sans-serif;
font-size:18px;
color:#55917A;
}
</style>
<body>
<table width="550px" class="outter">
<tr>
<td>
<table class="text" border="0" cellpadding="4" cellspacing="3" width="100%">
<tr height="40px">
<td colspan="2" class="formHeading">Register - Create Account</td>
</tr>
<tr>
<td colspan="2" class="note" bgcolor="#E0F0E8">Field marked with <span style="color:#FF0000">*</span> are compulsory fields
</td>
</tr>
<tr height="10px">
<td colspan="2"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8" width="32%"><span style="color:#FF0000">*</span>Your Name</td>
<td width="68%"><input size="35" maxlength="50" class="input" type="text"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8"><span style="color:#FF0000">*</span>E-Mail ID</td>
<td><input size="50" maxlength="50" class="input" type="text"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8">Alternate E-Mail ID</td>
<td><input size="50" maxlength="50" class="input" type="text"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8">Your Phone</td>
<td>
<span>
<small>Country Code - City Code - Phone Number</small>
</span><br>
<input size="6" class="input" type="text"> -
<input size="4" class="input" type="text"> -
<input size="23" class="input" type="text">
</td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8">Mobile Phone </td>
<td><input size="35" class="input" type="text"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8"><span style="color:#FF0000">*</span>Your Postal Address</td>
<td><textarea cols="37" rows="3" class="input"></textarea></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8"><span style="color:#FF0000">*</span>Country </td>
<td>
<select class="input">
<option value="x" selected="selected">
------------- Select One --------------
</option>
</select>
</td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8"><span style="color:#FF0000">*</span>Password</td>
<td><input size="25" class="input" type="password"></td>
</tr>
<tr>
<td align="right" bgcolor="#E0F0E8"><span style="color:#FF0000">*</span>Re - Enter Password</td>
<td><input size="25" class="input" type="password"></td>
</tr>
<tr>
<td></td>
<td><input value="1" type="checkbox"> <b>I accept the <a href="#">Terms of Use</a></b></td>
</tr>
<tr>
<td></td>
<td height="30">
<input value="Continue >>" class="btnbg" type="submit">
<input value="Reset" class="btnbg" type="reset">
</td>
</tr>
</table>
</td>
</tr>
</table>
</body>
</html>