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Chaitanya

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May 15th, 2010
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  1. <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
  2. <html xmlns="http://www.w3.org/1999/xhtml">
  3. <head>
  4. <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
  5. <title>Employee Details</title>
  6. <link rel="stylesheet" type="text/css" href="view.css" media="all">
  7. <script type="text/javascript" src="view.js"></script>
  8. <script type="text/javascript" src="calendar.js"></script>
  9. </head>
  10. <body id="main_body" >
  11.    
  12.     <img id="top" src="top.png" alt="">
  13.     <div id="form_container">
  14.    
  15.         <h1><a>Employee Details</a></h1>
  16.         <form id="form_235323" class="appnitro"  method="post" action="employee.php">
  17.                     <div class="form_description">
  18.             <h2>Employee Details</h2>
  19.             <p>Enter Employee details below</p>
  20.         </div>                     
  21.             <ul >
  22.            
  23.                     <li id="li_1" >
  24.         <label class="description" for="element_1">Name </label>
  25.         <span>
  26.             <input id="element_1_1" name= "element_1_1" class="element text" maxlength="255" size="8" value=""/>
  27.             <label>First</label>
  28.         </span>
  29.         <span>
  30.             <input id="element_1_2" name= "element_1_2" class="element text" maxlength="255" size="14" value=""/>
  31.             <label>Last</label>
  32.         </span>
  33.         </li>       <li id="li_16" >
  34.         <label class="description" for="element_16">Department </label>
  35.         <div>
  36.         <select class="element select medium" id="element_16" name="element_16">
  37.             <option value="" selected="selected"></option>
  38.         <?php
  39.             include("control/db.class.php");
  40.             $mys = new db_class();
  41.             $mys->connect();
  42.             $mys->select_db();
  43.             $query="select * from department";
  44.             $result = $mys->select($query);
  45.             while($row = mysql_fetch_array($result))
  46.                 {
  47.                   echo "<option value=\"".$row['dept_id']."\">".$row['dept_name']."\n  ";
  48.                 }
  49.                 mysql_close();
  50.             ?>
  51.  
  52.         </select>
  53.         </div>
  54.         </li>       <li id="li_17" >
  55.         <label class="description" for="element_17">Team name </label>
  56.         <div>
  57.         <select class="element select medium" id="element_17" name="element_17">
  58.             <option value="" selected="selected"></option>
  59. <?php
  60.             include("control/db.class.php");
  61.             $my = new db_class();
  62.             $my->connect();
  63.             $my->select_db();
  64.             $query_1="select * from team";
  65.             $result_1 = $my->select($query_1);
  66.             while($row_1 = mysql_fetch_array($result_1))
  67.                 {
  68.                   echo "<option value=\"".$row['id']."\">".$row_1['team_name']."\n  ";
  69.                 }
  70.                 mysql_close();
  71.             ?>
  72.  
  73.         </select>
  74.         </div>
  75.         </li>       <li id="li_4" >
  76.         <label class="description" for="element_4">Joined Date </label>
  77.         <span>
  78.             <input id="element_4_1" name="element_4_1" class="element text" size="2" maxlength="2" value="" type="text"> /
  79.             <label for="element_4_1">MM</label>
  80.         </span>
  81.         <span>
  82.             <input id="element_4_2" name="element_4_2" class="element text" size="2" maxlength="2" value="" type="text"> /
  83.             <label for="element_4_2">DD</label>
  84.         </span>
  85.         <span>
  86.             <input id="element_4_3" name="element_4_3" class="element text" size="4" maxlength="4" value="" type="text">
  87.             <label for="element_4_3">YYYY</label>
  88.         </span>
  89.    
  90.         <span id="calendar_4">
  91.             <img id="cal_img_4" class="datepicker" src="calendar.gif" alt="Pick a date.">  
  92.         </span>
  93.         <script type="text/javascript">
  94.             Calendar.setup({
  95.             inputField   : "element_4_3",
  96.             baseField    : "element_4",
  97.             displayArea  : "calendar_4",
  98.             button       : "cal_img_4",
  99.             ifFormat     : "%B %e, %Y",
  100.             onSelect     : selectDate
  101.             });
  102.         </script>
  103.          
  104.         </li>       <li id="li_5" >
  105.         <label class="description" for="element_5">Job  Title </label>
  106.         <div>
  107.             <input id="element_5" name="element_5" class="element text medium" type="text" maxlength="255" value=""/>
  108.         </div>
  109.         </li>       <li id="li_6" >
  110.         <label class="description" for="element_6">Resigned date </label>
  111.         <span>
  112.             <input id="element_6_1" name="element_6_1" class="element text" size="2" maxlength="2" value="" type="text"> /
  113.             <label for="element_6_1">MM</label>
  114.         </span>
  115.         <span>
  116.             <input id="element_6_2" name="element_6_2" class="element text" size="2" maxlength="2" value="" type="text"> /
  117.             <label for="element_6_2">DD</label>
  118.         </span>
  119.         <span>
  120.             <input id="element_6_3" name="element_6_3" class="element text" size="4" maxlength="4" value="" type="text">
  121.             <label for="element_6_3">YYYY</label>
  122.         </span>
  123.    
  124.         <span id="calendar_6">
  125.             <img id="cal_img_6" class="datepicker" src="calendar.gif" alt="Pick a date.">  
  126.         </span>
  127.         <script type="text/javascript">
  128.             Calendar.setup({
  129.             inputField   : "element_6_3",
  130.             baseField    : "element_6",
  131.             displayArea  : "calendar_6",
  132.             button       : "cal_img_6",
  133.             ifFormat     : "%B %e, %Y",
  134.             onSelect     : selectDate
  135.             });
  136.         </script>
  137.          
  138.         </li>       <li id="li_7" >
  139.         <label class="description" for="element_7">Reason for resigning </label>
  140.         <div>
  141.             <textarea id="element_7" name="element_7" class="element textarea medium"></textarea>
  142.         </div>
  143.         </li>       <li id="li_18" >
  144.         <label class="description" for="element_18">Documents submitted </label>
  145.         <span>
  146.             <input id="element_18_1" name="element_18" class="element radio" type="radio" value="1" />
  147. <label class="choice" for="element_18_1">Yes</label>
  148. <input id="element_18_2" name="element_18" class="element radio" type="radio" value="2" />
  149. <label class="choice" for="element_18_2">No</label>
  150.  
  151.         </span>
  152.         </li>       <li id="li_8" >
  153.         <label class="description" for="element_8">Birthday </label>
  154.         <span>
  155.             <input id="element_8_1" name="element_8_1" class="element text" size="2" maxlength="2" value="" type="text"> /
  156.             <label for="element_8_1">MM</label>
  157.         </span>
  158.         <span>
  159.             <input id="element_8_2" name="element_8_2" class="element text" size="2" maxlength="2" value="" type="text"> /
  160.             <label for="element_8_2">DD</label>
  161.         </span>
  162.         <span>
  163.             <input id="element_8_3" name="element_8_3" class="element text" size="4" maxlength="4" value="" type="text">
  164.             <label for="element_8_3">YYYY</label>
  165.         </span>
  166.    
  167.         <span id="calendar_8">
  168.             <img id="cal_img_8" class="datepicker" src="calendar.gif" alt="Pick a date.">  
  169.         </span>
  170.         <script type="text/javascript">
  171.             Calendar.setup({
  172.             inputField   : "element_8_3",
  173.             baseField    : "element_8",
  174.             displayArea  : "calendar_8",
  175.             button       : "cal_img_8",
  176.             ifFormat     : "%B %e, %Y",
  177.             onSelect     : selectDate
  178.             });
  179.         </script>
  180.          
  181.         </li>       <li id="li_9" >
  182.         <label class="description" for="element_9">Nationality </label>
  183.         <div>
  184.             <input id="element_9" name="element_9" class="element text medium" type="text" maxlength="255" value=""/>
  185.         </div>
  186.         </li>       <li id="li_19" >
  187.         <label class="description" for="element_19">Gender </label>
  188.         <span>
  189.             <input id="element_19_1" name="element_19" class="element radio" type="radio" value="1" />
  190. <label class="choice" for="element_19_1">Male</label>
  191. <input id="element_19_2" name="element_19" class="element radio" type="radio" value="2" />
  192. <label class="choice" for="element_19_2">Female</label>
  193.  
  194.         </span>
  195.         </li>       <li id="li_20" >
  196.         <label class="description" for="element_20">Martial status </label>
  197.         <span>
  198.             <input id="element_20_1" name="element_20" class="element radio" type="radio" value="1" />
  199. <label class="choice" for="element_20_1">Single</label>
  200. <input id="element_20_2" name="element_20" class="element radio" type="radio" value="2" />
  201. <label class="choice" for="element_20_2">Married</label>
  202. <input id="element_20_3" name="element_20" class="element radio" type="radio" value="3" />
  203. <label class="choice" for="element_20_3">Widow/Widower</label>
  204.  
  205.         </span>
  206.         </li>       <li id="li_10" >
  207.         <label class="description" for="element_10">Mobile number </label>
  208.         <div>
  209.             <input id="element_10" name="element_10" class="element text medium" type="text" maxlength="255" value=""/>
  210.         </div>
  211.         </li>       <li id="li_11" >
  212.         <label class="description" for="element_11">Home Phone </label>
  213.         <div>
  214.             <input id="element_11" name="element_11" class="element text medium" type="text" maxlength="255" value=""/>
  215.         </div>
  216.         </li>       <li id="li_12" >
  217.         <label class="description" for="element_12">Work Email </label>
  218.         <div>
  219.             <input id="element_12" name="element_12" class="element text medium" type="text" maxlength="255" value=""/>
  220.         </div>
  221.         </li>       <li id="li_13" >
  222.         <label class="description" for="element_13">Personal Email </label>
  223.         <div>
  224.             <input id="element_13" name="element_13" class="element text medium" type="text" maxlength="255" value=""/>
  225.         </div>
  226.         </li>       <li id="li_14" >
  227.         <label class="description" for="element_14">Present Address </label>
  228.        
  229.         <div>
  230.             <input id="element_14_1" name="element_14_1" class="element text large" value="" type="text">
  231.             <label for="element_14_1">Street Address</label>
  232.         </div>
  233.    
  234.         <div>
  235.             <input id="element_14_2" name="element_14_2" class="element text large" value="" type="text">
  236.             <label for="element_14_2">Address Line 2</label>
  237.         </div>
  238.    
  239.         <div class="left">
  240.             <input id="element_14_3" name="element_14_3" class="element text medium" value="" type="text">
  241.             <label for="element_14_3">City</label>
  242.         </div>
  243.    
  244.         <div class="right">
  245.             <input id="element_14_4" name="element_14_4" class="element text medium" value="" type="text">
  246.             <label for="element_14_4">State / Province / Region</label>
  247.         </div>
  248.    
  249.         <div class="left">
  250.             <input id="element_14_5" name="element_14_5" class="element text medium" maxlength="15" value="" type="text">
  251.             <label for="element_14_5">Postal / Zip Code</label>
  252.         </div>
  253.    
  254.         <div class="right">
  255.             <select class="element select medium" id="element_14_6" name="element_14_6">
  256.             <option value="" selected="selected"></option>
  257. <option value="Afghanistan" >Afghanistan</option>
  258. <option value="Albania" >Albania</option>
  259. <option value="Algeria" >Algeria</option>
  260. <option value="Andorra" >Andorra</option>
  261. <option value="Antigua and Barbuda" >Antigua and Barbuda</option>
  262. <option value="Argentina" >Argentina</option>
  263. <option value="Armenia" >Armenia</option>
  264. <option value="Australia" >Australia</option>
  265. <option value="Austria" >Austria</option>
  266. <option value="Azerbaijan" >Azerbaijan</option>
  267. <option value="Bahamas" >Bahamas</option>
  268. <option value="Bahrain" >Bahrain</option>
  269. <option value="Bangladesh" >Bangladesh</option>
  270. <option value="Barbados" >Barbados</option>
  271. <option value="Belarus" >Belarus</option>
  272. <option value="Belgium" >Belgium</option>
  273. <option value="Belize" >Belize</option>
  274. <option value="Benin" >Benin</option>
  275. <option value="Bhutan" >Bhutan</option>
  276. <option value="Bolivia" >Bolivia</option>
  277. <option value="Bosnia and Herzegovina" >Bosnia and Herzegovina</option>
  278. <option value="Botswana" >Botswana</option>
  279. <option value="Brazil" >Brazil</option>
  280. <option value="Brunei" >Brunei</option>
  281. <option value="Bulgaria" >Bulgaria</option>
  282. <option value="Burkina Faso" >Burkina Faso</option>
  283. <option value="Burundi" >Burundi</option>
  284. <option value="Cambodia" >Cambodia</option>
  285. <option value="Cameroon" >Cameroon</option>
  286. <option value="Canada" >Canada</option>
  287. <option value="Cape Verde" >Cape Verde</option>
  288. <option value="Central African Republic" >Central African Republic</option>
  289. <option value="Chad" >Chad</option>
  290. <option value="Chile" >Chile</option>
  291. <option value="China" >China</option>
  292. <option value="Colombia" >Colombia</option>
  293. <option value="Comoros" >Comoros</option>
  294. <option value="Congo" >Congo</option>
  295. <option value="Costa Rica" >Costa Rica</option>
  296. <option value="Côte d'Ivoire" >Côte d'Ivoire</option>
  297. <option value="Croatia" >Croatia</option>
  298. <option value="Cuba" >Cuba</option>
  299. <option value="Cyprus" >Cyprus</option>
  300. <option value="Czech Republic" >Czech Republic</option>
  301. <option value="Denmark" >Denmark</option>
  302. <option value="Djibouti" >Djibouti</option>
  303. <option value="Dominica" >Dominica</option>
  304. <option value="Dominican Republic" >Dominican Republic</option>
  305. <option value="East Timor" >East Timor</option>
  306. <option value="Ecuador" >Ecuador</option>
  307. <option value="Egypt" >Egypt</option>
  308. <option value="El Salvador" >El Salvador</option>
  309. <option value="Equatorial Guinea" >Equatorial Guinea</option>
  310. <option value="Eritrea" >Eritrea</option>
  311. <option value="Estonia" >Estonia</option>
  312. <option value="Ethiopia" >Ethiopia</option>
  313. <option value="Fiji" >Fiji</option>
  314. <option value="Finland" >Finland</option>
  315. <option value="France" >France</option>
  316. <option value="Gabon" >Gabon</option>
  317. <option value="Gambia" >Gambia</option>
  318. <option value="Georgia" >Georgia</option>
  319. <option value="Germany" >Germany</option>
  320. <option value="Ghana" >Ghana</option>
  321. <option value="Greece" >Greece</option>
  322. <option value="Grenada" >Grenada</option>
  323. <option value="Guatemala" >Guatemala</option>
  324. <option value="Guinea" >Guinea</option>
  325. <option value="Guinea-Bissau" >Guinea-Bissau</option>
  326. <option value="Guyana" >Guyana</option>
  327. <option value="Haiti" >Haiti</option>
  328. <option value="Honduras" >Honduras</option>
  329. <option value="Hong Kong" >Hong Kong</option>
  330. <option value="Hungary" >Hungary</option>
  331. <option value="Iceland" >Iceland</option>
  332. <option value="India" >India</option>
  333. <option value="Indonesia" >Indonesia</option>
  334. <option value="Iran" >Iran</option>
  335. <option value="Iraq" >Iraq</option>
  336. <option value="Ireland" >Ireland</option>
  337. <option value="Israel" >Israel</option>
  338. <option value="Italy" >Italy</option>
  339. <option value="Jamaica" >Jamaica</option>
  340. <option value="Japan" >Japan</option>
  341. <option value="Jordan" >Jordan</option>
  342. <option value="Kazakhstan" >Kazakhstan</option>
  343. <option value="Kenya" >Kenya</option>
  344. <option value="Kiribati" >Kiribati</option>
  345. <option value="North Korea" >North Korea</option>
  346. <option value="South Korea" >South Korea</option>
  347. <option value="Kuwait" >Kuwait</option>
  348. <option value="Kyrgyzstan" >Kyrgyzstan</option>
  349. <option value="Laos" >Laos</option>
  350. <option value="Latvia" >Latvia</option>
  351. <option value="Lebanon" >Lebanon</option>
  352. <option value="Lesotho" >Lesotho</option>
  353. <option value="Liberia" >Liberia</option>
  354. <option value="Libya" >Libya</option>
  355. <option value="Liechtenstein" >Liechtenstein</option>
  356. <option value="Lithuania" >Lithuania</option>
  357. <option value="Luxembourg" >Luxembourg</option>
  358. <option value="Macedonia" >Macedonia</option>
  359. <option value="Madagascar" >Madagascar</option>
  360. <option value="Malawi" >Malawi</option>
  361. <option value="Malaysia" >Malaysia</option>
  362. <option value="Maldives" >Maldives</option>
  363. <option value="Mali" >Mali</option>
  364. <option value="Malta" >Malta</option>
  365. <option value="Marshall Islands" >Marshall Islands</option>
  366. <option value="Mauritania" >Mauritania</option>
  367. <option value="Mauritius" >Mauritius</option>
  368. <option value="Mexico" >Mexico</option>
  369. <option value="Micronesia" >Micronesia</option>
  370. <option value="Moldova" >Moldova</option>
  371. <option value="Monaco" >Monaco</option>
  372. <option value="Mongolia" >Mongolia</option>
  373. <option value="Montenegro" >Montenegro</option>
  374. <option value="Morocco" >Morocco</option>
  375. <option value="Mozambique" >Mozambique</option>
  376. <option value="Myanmar" >Myanmar</option>
  377. <option value="Namibia" >Namibia</option>
  378. <option value="Nauru" >Nauru</option>
  379. <option value="Nepal" >Nepal</option>
  380. <option value="Netherlands" >Netherlands</option>
  381. <option value="New Zealand" >New Zealand</option>
  382. <option value="Nicaragua" >Nicaragua</option>
  383. <option value="Niger" >Niger</option>
  384. <option value="Nigeria" >Nigeria</option>
  385. <option value="Norway" >Norway</option>
  386. <option value="Oman" >Oman</option>
  387. <option value="Pakistan" >Pakistan</option>
  388. <option value="Palau" >Palau</option>
  389. <option value="Panama" >Panama</option>
  390. <option value="Papua New Guinea" >Papua New Guinea</option>
  391. <option value="Paraguay" >Paraguay</option>
  392. <option value="Peru" >Peru</option>
  393. <option value="Philippines" >Philippines</option>
  394. <option value="Poland" >Poland</option>
  395. <option value="Portugal" >Portugal</option>
  396. <option value="Puerto Rico" >Puerto Rico</option>
  397. <option value="Qatar" >Qatar</option>
  398. <option value="Romania" >Romania</option>
  399. <option value="Russia" >Russia</option>
  400. <option value="Rwanda" >Rwanda</option>
  401. <option value="Saint Kitts and Nevis" >Saint Kitts and Nevis</option>
  402. <option value="Saint Lucia" >Saint Lucia</option>
  403. <option value="Saint Vincent and the Grenadines" >Saint Vincent and the Grenadines</option>
  404. <option value="Samoa" >Samoa</option>
  405. <option value="San Marino" >San Marino</option>
  406. <option value="Sao Tome and Principe" >Sao Tome and Principe</option>
  407. <option value="Saudi Arabia" >Saudi Arabia</option>
  408. <option value="Senegal" >Senegal</option>
  409. <option value="Serbia and Montenegro" >Serbia and Montenegro</option>
  410. <option value="Seychelles" >Seychelles</option>
  411. <option value="Sierra Leone" >Sierra Leone</option>
  412. <option value="Singapore" >Singapore</option>
  413. <option value="Slovakia" >Slovakia</option>
  414. <option value="Slovenia" >Slovenia</option>
  415. <option value="Solomon Islands" >Solomon Islands</option>
  416. <option value="Somalia" >Somalia</option>
  417. <option value="South Africa" >South Africa</option>
  418. <option value="Spain" >Spain</option>
  419. <option value="Sri Lanka" >Sri Lanka</option>
  420. <option value="Sudan" >Sudan</option>
  421. <option value="Suriname" >Suriname</option>
  422. <option value="Swaziland" >Swaziland</option>
  423. <option value="Sweden" >Sweden</option>
  424. <option value="Switzerland" >Switzerland</option>
  425. <option value="Syria" >Syria</option>
  426. <option value="Taiwan" >Taiwan</option>
  427. <option value="Tajikistan" >Tajikistan</option>
  428. <option value="Tanzania" >Tanzania</option>
  429. <option value="Thailand" >Thailand</option>
  430. <option value="Togo" >Togo</option>
  431. <option value="Tonga" >Tonga</option>
  432. <option value="Trinidad and Tobago" >Trinidad and Tobago</option>
  433. <option value="Tunisia" >Tunisia</option>
  434. <option value="Turkey" >Turkey</option>
  435. <option value="Turkmenistan" >Turkmenistan</option>
  436. <option value="Tuvalu" >Tuvalu</option>
  437. <option value="Uganda" >Uganda</option>
  438. <option value="Ukraine" >Ukraine</option>
  439. <option value="United Arab Emirates" >United Arab Emirates</option>
  440. <option value="United Kingdom" >United Kingdom</option>
  441. <option value="United States" >United States</option>
  442. <option value="Uruguay" >Uruguay</option>
  443. <option value="Uzbekistan" >Uzbekistan</option>
  444. <option value="Vanuatu" >Vanuatu</option>
  445. <option value="Vatican City" >Vatican City</option>
  446. <option value="Venezuela" >Venezuela</option>
  447. <option value="Vietnam" >Vietnam</option>
  448. <option value="Yemen" >Yemen</option>
  449. <option value="Zambia" >Zambia</option>
  450. <option value="Zimbabwe" >Zimbabwe</option>
  451.    
  452.             </select>
  453.         <label for="element_14_6">Country</label>
  454.     </div>
  455.         </li>       <li id="li_15" >
  456.         <label class="description" for="element_15">Permanent Address </label>
  457.        
  458.         <div>
  459.             <input id="element_15_1" name="element_15_1" class="element text large" value="" type="text">
  460.             <label for="element_15_1">Street Address</label>
  461.         </div>
  462.    
  463.         <div>
  464.             <input id="element_15_2" name="element_15_2" class="element text large" value="" type="text">
  465.             <label for="element_15_2">Address Line 2</label>
  466.         </div>
  467.    
  468.         <div class="left">
  469.             <input id="element_15_3" name="element_15_3" class="element text medium" value="" type="text">
  470.             <label for="element_15_3">City</label>
  471.         </div>
  472.    
  473.         <div class="right">
  474.             <input id="element_15_4" name="element_15_4" class="element text medium" value="" type="text">
  475.             <label for="element_15_4">State / Province / Region</label>
  476.         </div>
  477.    
  478.         <div class="left">
  479.             <input id="element_15_5" name="element_15_5" class="element text medium" maxlength="15" value="" type="text">
  480.             <label for="element_15_5">Postal / Zip Code</label>
  481.         </div>
  482.    
  483.         <div class="right">
  484.             <select class="element select medium" id="element_15_6" name="element_15_6">
  485.             <option value="" selected="selected"></option>
  486. <option value="Afghanistan" >Afghanistan</option>
  487. <option value="Albania" >Albania</option>
  488. <option value="Algeria" >Algeria</option>
  489. <option value="Andorra" >Andorra</option>
  490. <option value="Antigua and Barbuda" >Antigua and Barbuda</option>
  491. <option value="Argentina" >Argentina</option>
  492. <option value="Armenia" >Armenia</option>
  493. <option value="Australia" >Australia</option>
  494. <option value="Austria" >Austria</option>
  495. <option value="Azerbaijan" >Azerbaijan</option>
  496. <option value="Bahamas" >Bahamas</option>
  497. <option value="Bahrain" >Bahrain</option>
  498. <option value="Bangladesh" >Bangladesh</option>
  499. <option value="Barbados" >Barbados</option>
  500. <option value="Belarus" >Belarus</option>
  501. <option value="Belgium" >Belgium</option>
  502. <option value="Belize" >Belize</option>
  503. <option value="Benin" >Benin</option>
  504. <option value="Bhutan" >Bhutan</option>
  505. <option value="Bolivia" >Bolivia</option>
  506. <option value="Bosnia and Herzegovina" >Bosnia and Herzegovina</option>
  507. <option value="Botswana" >Botswana</option>
  508. <option value="Brazil" >Brazil</option>
  509. <option value="Brunei" >Brunei</option>
  510. <option value="Bulgaria" >Bulgaria</option>
  511. <option value="Burkina Faso" >Burkina Faso</option>
  512. <option value="Burundi" >Burundi</option>
  513. <option value="Cambodia" >Cambodia</option>
  514. <option value="Cameroon" >Cameroon</option>
  515. <option value="Canada" >Canada</option>
  516. <option value="Cape Verde" >Cape Verde</option>
  517. <option value="Central African Republic" >Central African Republic</option>
  518. <option value="Chad" >Chad</option>
  519. <option value="Chile" >Chile</option>
  520. <option value="China" >China</option>
  521. <option value="Colombia" >Colombia</option>
  522. <option value="Comoros" >Comoros</option>
  523. <option value="Congo" >Congo</option>
  524. <option value="Costa Rica" >Costa Rica</option>
  525. <option value="Côte d'Ivoire" >Côte d'Ivoire</option>
  526. <option value="Croatia" >Croatia</option>
  527. <option value="Cuba" >Cuba</option>
  528. <option value="Cyprus" >Cyprus</option>
  529. <option value="Czech Republic" >Czech Republic</option>
  530. <option value="Denmark" >Denmark</option>
  531. <option value="Djibouti" >Djibouti</option>
  532. <option value="Dominica" >Dominica</option>
  533. <option value="Dominican Republic" >Dominican Republic</option>
  534. <option value="East Timor" >East Timor</option>
  535. <option value="Ecuador" >Ecuador</option>
  536. <option value="Egypt" >Egypt</option>
  537. <option value="El Salvador" >El Salvador</option>
  538. <option value="Equatorial Guinea" >Equatorial Guinea</option>
  539. <option value="Eritrea" >Eritrea</option>
  540. <option value="Estonia" >Estonia</option>
  541. <option value="Ethiopia" >Ethiopia</option>
  542. <option value="Fiji" >Fiji</option>
  543. <option value="Finland" >Finland</option>
  544. <option value="France" >France</option>
  545. <option value="Gabon" >Gabon</option>
  546. <option value="Gambia" >Gambia</option>
  547. <option value="Georgia" >Georgia</option>
  548. <option value="Germany" >Germany</option>
  549. <option value="Ghana" >Ghana</option>
  550. <option value="Greece" >Greece</option>
  551. <option value="Grenada" >Grenada</option>
  552. <option value="Guatemala" >Guatemala</option>
  553. <option value="Guinea" >Guinea</option>
  554. <option value="Guinea-Bissau" >Guinea-Bissau</option>
  555. <option value="Guyana" >Guyana</option>
  556. <option value="Haiti" >Haiti</option>
  557. <option value="Honduras" >Honduras</option>
  558. <option value="Hong Kong" >Hong Kong</option>
  559. <option value="Hungary" >Hungary</option>
  560. <option value="Iceland" >Iceland</option>
  561. <option value="India" >India</option>
  562. <option value="Indonesia" >Indonesia</option>
  563. <option value="Iran" >Iran</option>
  564. <option value="Iraq" >Iraq</option>
  565. <option value="Ireland" >Ireland</option>
  566. <option value="Israel" >Israel</option>
  567. <option value="Italy" >Italy</option>
  568. <option value="Jamaica" >Jamaica</option>
  569. <option value="Japan" >Japan</option>
  570. <option value="Jordan" >Jordan</option>
  571. <option value="Kazakhstan" >Kazakhstan</option>
  572. <option value="Kenya" >Kenya</option>
  573. <option value="Kiribati" >Kiribati</option>
  574. <option value="North Korea" >North Korea</option>
  575. <option value="South Korea" >South Korea</option>
  576. <option value="Kuwait" >Kuwait</option>
  577. <option value="Kyrgyzstan" >Kyrgyzstan</option>
  578. <option value="Laos" >Laos</option>
  579. <option value="Latvia" >Latvia</option>
  580. <option value="Lebanon" >Lebanon</option>
  581. <option value="Lesotho" >Lesotho</option>
  582. <option value="Liberia" >Liberia</option>
  583. <option value="Libya" >Libya</option>
  584. <option value="Liechtenstein" >Liechtenstein</option>
  585. <option value="Lithuania" >Lithuania</option>
  586. <option value="Luxembourg" >Luxembourg</option>
  587. <option value="Macedonia" >Macedonia</option>
  588. <option value="Madagascar" >Madagascar</option>
  589. <option value="Malawi" >Malawi</option>
  590. <option value="Malaysia" >Malaysia</option>
  591. <option value="Maldives" >Maldives</option>
  592. <option value="Mali" >Mali</option>
  593. <option value="Malta" >Malta</option>
  594. <option value="Marshall Islands" >Marshall Islands</option>
  595. <option value="Mauritania" >Mauritania</option>
  596. <option value="Mauritius" >Mauritius</option>
  597. <option value="Mexico" >Mexico</option>
  598. <option value="Micronesia" >Micronesia</option>
  599. <option value="Moldova" >Moldova</option>
  600. <option value="Monaco" >Monaco</option>
  601. <option value="Mongolia" >Mongolia</option>
  602. <option value="Montenegro" >Montenegro</option>
  603. <option value="Morocco" >Morocco</option>
  604. <option value="Mozambique" >Mozambique</option>
  605. <option value="Myanmar" >Myanmar</option>
  606. <option value="Namibia" >Namibia</option>
  607. <option value="Nauru" >Nauru</option>
  608. <option value="Nepal" >Nepal</option>
  609. <option value="Netherlands" >Netherlands</option>
  610. <option value="New Zealand" >New Zealand</option>
  611. <option value="Nicaragua" >Nicaragua</option>
  612. <option value="Niger" >Niger</option>
  613. <option value="Nigeria" >Nigeria</option>
  614. <option value="Norway" >Norway</option>
  615. <option value="Oman" >Oman</option>
  616. <option value="Pakistan" >Pakistan</option>
  617. <option value="Palau" >Palau</option>
  618. <option value="Panama" >Panama</option>
  619. <option value="Papua New Guinea" >Papua New Guinea</option>
  620. <option value="Paraguay" >Paraguay</option>
  621. <option value="Peru" >Peru</option>
  622. <option value="Philippines" >Philippines</option>
  623. <option value="Poland" >Poland</option>
  624. <option value="Portugal" >Portugal</option>
  625. <option value="Puerto Rico" >Puerto Rico</option>
  626. <option value="Qatar" >Qatar</option>
  627. <option value="Romania" >Romania</option>
  628. <option value="Russia" >Russia</option>
  629. <option value="Rwanda" >Rwanda</option>
  630. <option value="Saint Kitts and Nevis" >Saint Kitts and Nevis</option>
  631. <option value="Saint Lucia" >Saint Lucia</option>
  632. <option value="Saint Vincent and the Grenadines" >Saint Vincent and the Grenadines</option>
  633. <option value="Samoa" >Samoa</option>
  634. <option value="San Marino" >San Marino</option>
  635. <option value="Sao Tome and Principe" >Sao Tome and Principe</option>
  636. <option value="Saudi Arabia" >Saudi Arabia</option>
  637. <option value="Senegal" >Senegal</option>
  638. <option value="Serbia and Montenegro" >Serbia and Montenegro</option>
  639. <option value="Seychelles" >Seychelles</option>
  640. <option value="Sierra Leone" >Sierra Leone</option>
  641. <option value="Singapore" >Singapore</option>
  642. <option value="Slovakia" >Slovakia</option>
  643. <option value="Slovenia" >Slovenia</option>
  644. <option value="Solomon Islands" >Solomon Islands</option>
  645. <option value="Somalia" >Somalia</option>
  646. <option value="South Africa" >South Africa</option>
  647. <option value="Spain" >Spain</option>
  648. <option value="Sri Lanka" >Sri Lanka</option>
  649. <option value="Sudan" >Sudan</option>
  650. <option value="Suriname" >Suriname</option>
  651. <option value="Swaziland" >Swaziland</option>
  652. <option value="Sweden" >Sweden</option>
  653. <option value="Switzerland" >Switzerland</option>
  654. <option value="Syria" >Syria</option>
  655. <option value="Taiwan" >Taiwan</option>
  656. <option value="Tajikistan" >Tajikistan</option>
  657. <option value="Tanzania" >Tanzania</option>
  658. <option value="Thailand" >Thailand</option>
  659. <option value="Togo" >Togo</option>
  660. <option value="Tonga" >Tonga</option>
  661. <option value="Trinidad and Tobago" >Trinidad and Tobago</option>
  662. <option value="Tunisia" >Tunisia</option>
  663. <option value="Turkey" >Turkey</option>
  664. <option value="Turkmenistan" >Turkmenistan</option>
  665. <option value="Tuvalu" >Tuvalu</option>
  666. <option value="Uganda" >Uganda</option>
  667. <option value="Ukraine" >Ukraine</option>
  668. <option value="United Arab Emirates" >United Arab Emirates</option>
  669. <option value="United Kingdom" >United Kingdom</option>
  670. <option value="United States" >United States</option>
  671. <option value="Uruguay" >Uruguay</option>
  672. <option value="Uzbekistan" >Uzbekistan</option>
  673. <option value="Vanuatu" >Vanuatu</option>
  674. <option value="Vatican City" >Vatican City</option>
  675. <option value="Venezuela" >Venezuela</option>
  676. <option value="Vietnam" >Vietnam</option>
  677. <option value="Yemen" >Yemen</option>
  678. <option value="Zambia" >Zambia</option>
  679. <option value="Zimbabwe" >Zimbabwe</option>
  680.    
  681.             </select>
  682.         <label for="element_15_6">Country</label>
  683.     </div>
  684.         </li>       <li id="li_21" >
  685.         <label class="description" for="element_21">Employee Location </label>
  686.         <div>
  687.         <select class="element select medium" id="element_21" name="element_21">
  688.             <option value="" selected="selected"></option>
  689. <option value="1" >First option</option>
  690. <option value="2" >Second option</option>
  691. <option value="3" >Third option</option>
  692.  
  693.         </select>
  694.         </div>
  695.         </li>       <li id="li_22" >
  696.         <label class="description" for="element_22">Employee Status </label>
  697.         <div>
  698.         <select class="element select medium" id="element_22" name="element_22">
  699.             <option value="" selected="selected"></option>
  700. <option value="1" >First option</option>
  701. <option value="2" >Second option</option>
  702. <option value="3" >Third option</option>
  703.  
  704.         </select>
  705.         </div>
  706.         </li>  
  707.         <li id="li_23_1" >
  708.         <label class="description" for="element_23">Employee Id</label>
  709.         <div>
  710.             <input id="element_23_1" name="element_23_1" class="element text medium" type="text" maxlength="255" value=""/>
  711.         </div>
  712.         </li>   <li id="li_23" >
  713.         <label class="description" for="element_23">Password </label>
  714.         <div>
  715.             <input id="element_23" name="element_23" class="element text medium" type="password" maxlength="255" value=""/>
  716.         </div>
  717.         </li>
  718.         <li id="li_25" >
  719.         <label class="description" for="element_25">Confirm Password </label>
  720.         <div>
  721.             <input id="element_25" name="element_25" class="element text medium" type="password" maxlength="255" value=""/>
  722.         </div>
  723.         </li>       <li id="li_24" >
  724.         <label class="description" for="element_24">Secret Question </label>
  725.         <div>
  726.             <input id="element_24" name="element_24" class="element text medium" type="text" maxlength="255" value=""/>
  727.         </div>
  728.         </li>       <li id="li_26" >
  729.         <label class="description" for="element_26">User type </label>
  730.         <div>
  731.         <select class="element select medium" id="element_26" name="element_26">
  732.             <option value="" selected="selected"></option>
  733. <option value="1" >First option</option>
  734. <option value="2" >Second option</option>
  735. <option value="3" >Third option</option>
  736.  
  737.         </select>
  738.         </div>
  739.         </li>      
  740.            
  741.                     <li class="buttons">
  742.                 <input type="hidden" name="form_id" value="235323" />
  743.                
  744.                 <input id="saveForm" class="button_text" type="submit" name="submit" value="Submit" />
  745.         </li>
  746.             </ul>
  747.         </form>
  748.         <div id="footer">
  749.             </div>
  750.     </div>
  751.     <img id="bottom" src="bottom.png" alt="">
  752.     </body>
  753. </html>
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