<html>
<head>
<meta http-equiv="Content-Language" content="en-us">
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<title><? echo $l_title_report; ?> III/V</title>
<LINK REL=StyleSheet HREF="css/wizzard.css" TYPE="text/css" MEDIA=screen>
</head>
<body class="main" >
<form action="wiz_start.php" method="POST" target="_self">
<input type="hidden" name="lstDepartment" value="<? echo $lstDepartment ?>">
<input type="hidden" name="lstRequest" value="<? echo $lstRequest; ?>">
<br><br>
<table align="center" width="90%" >
<tr>
<td colspan="5" height="19" align="center"> <h1><? echo $l_titel_wizzard2, $lstDepartment;?></h1></td>
</tr>
<tr>
<td width="7%"><? echo "$l_firstname";?> </td>
<td width="18%"> <input class="input" type="text" name="txtUserFirstName" size="20" >
</td>
<td colspan="3">
<div class="errortxt"><?php if ($add_d_err[1]==1){echo "$l_verifyfirstname"; }?>
</div>
</td>
</tr>
<tr>
<td><? echo "$l_lastname";?> </td>
<td><input class="input" type="text" name="txtUserLastName" size="20"></td>
<td colspan="3"> <div class="errortxt"><?php if ($add_d_err[2]==1){echo "$l_verifylastname"; }?>
</div>
</td>
</tr>
<tr>
<td><? echo $l_telephonenumberextension;?></td>
<td><input class="input" type="text" name="txtUserTelephone" size="20"></td>
<td width="24%"> </td>
<td width="5%"><?echo $l_location?></td>
<td width="46%"><input class="input" type=text size=20 name="txtLocation"></td>
</tr>
<tr>
<td><? echo $l_emailaddress;?></td>
<td><input class="input" type="text" name="txtUserEmail" size="20"></td>
<td colspan="3"><div class="errortxt"><?php if ($add_d_err[3]==1){echo "$l_verifyemail"; }?>
</div>
</td>
</tr>
<tr>
<td><? echo $l_computerid;?></td>
<td colspan="2"><input class="input" type="text" name="txtComputerid" size="20"></td>
<td><? echo $l_num_personal;?></td>
<td><input class="input" type="text" name="txtStaffid" size="20"></td>
</tr>
<tr>
<td><? echo $l_area;?></td>
<td><input class="input" type="text" name="txtArea" size="20"></td>
<td> </td>
<td><?echo $l_dateopened;?></td>
<td><? echo $readable_date," ", $readable_time;?></td>
</tr>
<tr>
<td colspan="5"> <center>
<input class="input" type="Submit" name="cmdNext03" value="<? echo $l_next; ?>">
</center></td>
</tr>
<tr>
<td colspan ="5"><center>
<a href="javascript:history.back()"><?echo $l_back;?></a></center></td>
</tr>
</table>
</form>
</body>
</html>