<?php 
	session_start();
	ob_start();
	
	include_once('include/functions.php');
	include_once('include/formular.php');
	

	
	db_connect();
	

 include("includes/templates/header.tpl.php"); 

	?>	
<form action="pApply.php" method="post">
<table width="100%" border="0">
	<tr>
		<td align="right">
			<img src="img/SealEuroRec.gif">
		</td>
	</tr>
<table cellpadding="1" cellspacing="2" width="70%" border="0" align="center">
	<tr>
		<td align="center" colspan=2>
			<h1>Formular &Icirc;nscriere</h1>
		</td>
	</tr>
	
	<tr>
		<td height="10px" colspan="2">
		</td>
	</tr>
	<tr>
		<td colspan="2" class="footer"> 
			Pentru a putea primi cheia de &icirc;nregistrare pentru formularul de votare, v&#259; rug&#259;m s&#259; completa&#539;i c&acirc;mpurile de mai jos. &nbsp; 
		</td>
	</tr>
	<tr>
		<td height="10px" colspan="2">
		</td>
	</tr>
	<tr>
		<td colspan="2" class="warning"> 
<?php
	echo $mesaj = empty($_GET['var']) ? "" : "Va rugam introduceti date in toate campurile";
?>
		</td>
	</tr>
	<tr>
		<td height="10px" colspan="2">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Nume:
		</td>
		<td >
			<input type="text" name="nume" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Prenume:
		</td>
		<td >
			<input type="text" name="prenume" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Institu&#355;ia de provenien&#355;&#259;:
		</td>
		<td >
			<input type="text" name="institutia" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Ora&#351;:
		</td>
		<td >
			<input type="text" name="oras" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Telefon:
		</td>
		<td >
			<input type="text" name="telefon" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			E-mail:
		</td>
		<td >
			<input type="text" name="email" size="30">
		</td>
	</tr>
	<tr>
		<td width="50%" align="left" class="formLeft">
			Introduce-&#539;i codul de verificare afi&#537;at:
		</td>
		<td class="formRight">
			<input type="text" name="verificareIn" size="18">
			<?php
				$verificare=rand();
			?>
			<input type="hidden" name="verificareRand" value="<?= $verificare; ?>">
			<?= $verificare; ?>
			
		</td>
	</tr>
	<tr>
		<td height="10px">
		</td>
	</tr>
	<tr>
		<td colspan="2" align="center">
			<input type="submit" value="&Icirc;nregistrare">
		</td>
	</tr>
<tr>
		<td colspan="2" class="footer"> 
			<br></br>

			V&#259; mul&#539;umin ca a&#539;i completat formularul de &icirc;nregistrare. &nbsp;
			
			<br>V&#259; rug&#259;m s&#259; verifica&#539;i la adresa de e-mail introdus&#259; de dumneavoastr&#259;  in formularul de mai sus, cheia de &icirc;nregistrare &icirc;mpreuna cu linkul de acces la formularul cu criterii &quot;EuroRec Seal Level 2 &quot;. <!-- aici poti pune text -->
		</td>
	</tr>
	

</table>
</table>
</form>
	
<?php include("includes/templates/footer.tpl.php"); ?>
