Changes for page X1000 - Contact Registration Form
Last modified by SuperUwe Trueggelmann on 2025-04-18
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Page properties (1 modified, 0 added, 0 removed)
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... ... @@ -212,7 +212,22 @@ 212 212 <input type="text" id="companypostcode" name="companypostcode" placeholder="Enter the Postal Code part of your company's registered business address" size="10"> 213 213 </select> 214 214 </td> 215 - </tr> <tr> 215 + </tr> 216 + <tr> 217 + <td align="left" class="style1">Registered Business Address - Province or State:</td> 218 + <td class="style1"> 219 + <input type="text" id="companyprovince" name="companyprovince" placeholder="Enter the Province or State part of your company's registered business address, leave empty if n/a" size="100"> 220 + </select> 221 + </td> 222 + </tr> 223 + <tr> 224 + <td align="left" class="style1">Registered Business Address - Country:</td> 225 + <td class="style1"> 226 + <input type="text" id="companycountry" name="companycountry" placeholder="Enter the Country part of your company's registered business address" size="50"> 227 + </select> 228 + </td> 229 + </tr> 230 + <tr> 216 216 <td align="left" class="style1">Title:</td> 217 217 <td class="style1"> 218 218 <input type="text" id="title" name="title" placeholder="Enter your title (Ms, Mr, Dr, etc)" size="30">