-
Notifications
You must be signed in to change notification settings - Fork 17
/
register.html
executable file
·823 lines (758 loc) · 38.3 KB
/
register.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<meta name="description" content="">
<meta name="author" content="Vvveb">
<!-- base href="/app/public/themes/default/" -->
<link rel="icon" href="../../favicon.ico">
<title>Vvveb default theme</title>
<!-- Bootstrap core CSS -->
<link href="css/style.css" rel="stylesheet">
<!-- link href="css/bootstrap.css" rel="stylesheet"-->
<!-- link href="css/stylesheet.css" rel="stylesheet"-->
</head>
<body>
<div class="page-container">
<div id="top-nav" class="bg-light smaller-font-size text-muted">
<nav class="navbar-expand-md container px-3">
<button class="navbar-toggler navbar-toggler-right" type="button" data-toggle="collapse" data-target="#navbarsExampleDefault" aria-controls="navbarsExampleDefault" aria-expanded="false" aria-label="Toggle navigation">
<span class="navbar-toggler-icon"></span>
</button>
<div class="collapse navbar-collapse" id="navbarsExampleDefault">
<ul class="navbar-nav mr-auto">
<li class="nav-item active">
<a class="nav-link text-muted" href="#"><i class="la la-heart"></i> <span class="hidden-xs hidden-sm hidden-md">Wish List (0)</span></a>
</li>
<li class="nav-item">
<a class="nav-link text-muted" href="#"><i class="la la-shopping-cart"></i> <span class="hidden-xs hidden-sm hidden-md">Shopping Cart</span></a>
</li>
<li class="nav-item">
<a class="nav-link text-muted" href="#"><i class="la la-share"></i> <span class="hidden-xs hidden-sm hidden-md">Checkout</span></a>
</li>
</ul>
<ul class="navbar-nav float-right">
<li class="nav-item dropdown float-right">
<a class="nav-link dropdown-toggle text-muted" href="http://example.com" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"><i class="la la-dollar"></i> USD</a>
<div class="dropdown-menu" aria-labelledby="dropdown01">
<a class="dropdown-item" href="#">Action</a>
<a class="dropdown-item" href="#">Another action</a>
<a class="dropdown-item" href="#">Something else here</a>
</div>
</li>
<li class="nav-item dropdown float-right">
<a class="nav-link dropdown-toggle text-muted" href="http://example.com" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"><i class="la la-flag"></i> EN</a>
<div class="dropdown-menu" aria-labelledby="dropdown01">
<a class="dropdown-item" href="#">Action</a>
<a class="dropdown-item" href="#">Another action</a>
<a class="dropdown-item" href="#">Something else here</a>
</div>
</li>
</ul>
</div>
</nav>
</div>
<header class="container mt-5">
<div class="row">
<div class="col-md-3">
<a href="/" class="logo">
<!-- img src="img/logo.png"-->
<h1 class="text-dark"><i class="text-secondary la la-plug"></i><span>electr<span class="text-secondary">o.</span></span></h1>
<small class="text-dark">electronics shopping mall</small>
</a>
</div>
<div class="col-md-5">
<form class="">
<div class="input-group input-group-lg mb-3" id="search-box">
<input type="text" class="form-control default-font-size" placeholder="Search product" aria-label="Search product">
<select class="custom-select input-group-append form-control-lg no-border-x default-font-size">
<option selected="">All categories</option>
<option value="1">One</option>
<option value="2">Two</option>
<option value="3">Three</option>
</select>
<div class="input-group-append">
<button class="btn btn-primary" type="button"><i class="la la-search"></i></button>
</div>
</div>
</form>
</div>
<div class="col-md-4">
<div class="dropdown float-right" id="mini-cart">
<a class="btn btn-link dropdown-toggle bg-faded p-0 chevron-big" href="https://example.com" id="dropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
<i class="la la-shopping-cart d-inline-block" style="font-size:42px"><span class="cart-items">3</span></i>  <div class="d-inline-block text-dark"><span class="small d-block text-left">Your cart</span><span class="font-weight-bold">$3500.05</span></div>
</a>
<div class="dropdown-menu dropdown-menu-right" aria-labelledby="dropdownMenuLink">
<table class="table table-sm table-striped">
<tbody><tr>
<td class="text-center"> <a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=40"><img src="http://opencart3100.givan.ro/image/cache/catalog/demo/iphone_1-47x47.jpg" alt="iPhone" title="iPhone" class="img-thumbnail"></a> </td>
<td class="text-left"><a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=40">iPhone</a>
</td>
<td class="text-right">x 1</td>
<td class="text-right">$123.20</td>
<td class="text-center"><button type="button" onclick="cart.remove('1');" data-toggle="tooltip" title="" class="btn btn-danger btn-sm" data-original-title="Remove"><i class="la la-times"></i></button></td>
</tr>
<tr>
<td class="text-center"> <a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=43"><img src="http://opencart3100.givan.ro/image/cache/catalog/demo/macbook_1-47x47.jpg" alt="MacBook" title="MacBook" class="img-thumbnail"></a> </td>
<td class="text-left"><a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=43">MacBook</a>
</td>
<td class="text-right">x 1</td>
<td class="text-right">$602.00</td>
<td class="text-center"><button type="button" onclick="cart.remove('2');" data-toggle="tooltip" title="" class="btn btn-danger btn-sm" data-original-title="Remove"><i class="la la-times"></i></button></td>
</tr>
<tr>
<td class="text-center"> <a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=30"><img src="http://opencart3100.givan.ro/image/cache/catalog/demo/canon_eos_5d_1-47x47.jpg" alt="Canon EOS 5D" title="Canon EOS 5D" class="img-thumbnail"></a> </td>
<td class="text-left"><a href="http://opencart3100.givan.ro/index.php?route=product/product&language=en-gb&product_id=30">Canon EOS 5D</a>
<br>
- <small>Select Red</small> </td>
<td class="text-right">x 1</td>
<td class="text-right">$98.00</td>
<td class="text-center"><button type="button" onclick="cart.remove('3');" data-toggle="tooltip" title="" class="btn btn-danger btn-sm" data-original-title="Remove"><i class="la la-times"></i></button></td>
</tr>
</tbody></table>
<div>
<table class="table table-sm table-bordered">
<tbody><tr>
<td class="text-right"><strong>Sub-Total</strong></td>
<td class="text-right">$681.00</td>
</tr>
<tr>
<td class="text-right"><strong>Eco Tax (-2.00)</strong></td>
<td class="text-right">$6.00</td>
</tr>
<tr>
<td class="text-right"><strong>VAT (20%)</strong></td>
<td class="text-right">$136.20</td>
</tr>
<tr>
<td class="text-right"><strong>Total</strong></td>
<td class="text-right">$823.20</td>
</tr>
</tbody></table>
<p class="text-right"><a href="http://opencart3100.givan.ro/index.php?route=checkout/cart&language=en-gb"><strong><i class="la la-shopping-cart"></i> View Cart</strong></a> <a href="http://opencart3100.givan.ro/index.php?route=checkout/checkout&language=en-gb"><strong><i class="la la-share"></i> Checkout</strong></a></p>
</div>
</div>
</div>
<div class="dropdown float-right" id="mini-user">
<a class="btn btn-link dropdown-toggle bg-faded p-0 chevron-big" href="https://example.com" id="dropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
<i class="la la-user d-inline-block" style="font-size:42px"></i>  <div class="d-inline-block text-dark"><span class="small d-block text-left">My account</span><span class="font-weight-bold">Login/Register</span></div>
</a>
<div class="dropdown-menu" aria-labelledby="dropdownMenuLink">
<a class="dropdown-item" href="#">Action</a>
<a class="dropdown-item" href="#">Another action</a>
<a class="dropdown-item" href="#">Something else here</a>
</div>
</div>
</div>
</div>
<nav class="navbar navbar-light bg-white rounded navbar-expand-md mt-4">
<button class="navbar-toggler navbar-toggler-right" type="button" data-toggle="collapse" data-target="#containerNavbar" aria-controls="containerNavbar" aria-expanded="false" aria-label="Toggle navigation">
<span class="navbar-toggler-icon"></span>
</button>
<div class="collapse navbar-collapse" id="containerNavbar">
<ul class="navbar-nav mr-auto">
<li class="nav-item dropdown categories-dropdown">
<a class="nav-link dropdown-toggle" href="http://example.com" id="dropdown04" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"><i class="la la-bars"></i> Categories <i class="la la-angle-down float-right"></i></a>
<div class="dropdown-menu" aria-labelledby="dropdown04">
<a class="dropdown-item" href="#"><i class="la la-desktop"></i> Desktops</a>
<a class="dropdown-item" href="#">Another action</a>
<a class="dropdown-item" href="#">Something else here</a>
</div>
</li>
<li class="nav-item active">
<a class="nav-link" href="#">Home <span class="sr-only">(current)</span></a>
</li>
<li class="nav-item dropdown dropdown--canvas dropdown--canvas--left dropdown--canvas--sm">
<a class="nav-link dropdown-toggle" data-toggle="dropdown" href="#" role="button" aria-haspopup="true" aria-expanded="false">
Store Location
</a>
<div class="dropdown-menu">
Hello!
</div>
</li>
<li class="nav-item">
<a class="nav-link" href="#">Delivery Services</a>
</li>
<li class="nav-item">
<a class="nav-link" href="#">Blog</a>
</li>
<li class="nav-item">
<a class="nav-link" href="#">Support</a>
</li>
<li class="nav-item dropdown">
<a class="nav-link dropdown-toggle" href="http://example.com" id="dropdown04" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">About Us</a>
<div class="dropdown-menu" aria-labelledby="dropdown04">
<a class="dropdown-item" href="#">FAQ</a>
<a class="dropdown-item" href="#">Our Story</a>
<a class="dropdown-item" href="#">Something else here</a>
</div>
</li>
<li class="nav-item">
<a class="nav-link" href="#">Contact Us</a>
</li>
</ul>
</div>
</nav>
</header>
<div class="content">
<div class="container">
<div class="thickline"></div>
</div>
<nav class="breadcrumb container">
<a class="breadcrumb-item" href="#">Home</a>
<a class="breadcrumb-item" href="#">Laptops</a>
<a class="breadcrumb-item" href="#">Slim laptops</a>
<span class="breadcrumb-item active">Sony Vaio</span>
</nav>
<div class="container">
<div class="row">
<div class="col-12">
<form action="https://demo.opencart.com/index.php?route=account/register" method="post" enctype="multipart/form-data" class="form-horizontal">
<fieldset id="account">
<legend>Your Personal Details</legend>
<div class="form-group row required" style="display: none;">
<label class="col-sm-2 control-label">Customer Group</label>
<div class="col-sm-10">
<div class="radio">
<label>
<input name="customer_group_id" value="1" checked="checked" type="radio">
Default</label>
</div>
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-firstname">First Name</label>
<div class="col-sm-10">
<input name="firstname" value="" placeholder="First Name" id="input-firstname" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-lastname">Last Name</label>
<div class="col-sm-10">
<input name="lastname" value="" placeholder="Last Name" id="input-lastname" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-email">E-Mail</label>
<div class="col-sm-10">
<input name="email" value="" placeholder="E-Mail" id="input-email" class="form-control" type="email">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-telephone">Telephone</label>
<div class="col-sm-10">
<input name="telephone" value="" placeholder="Telephone" id="input-telephone" class="form-control" type="tel">
</div>
</div>
<div class="form-group row">
<label class="col-sm-2 control-label" for="input-fax">Fax</label>
<div class="col-sm-10">
<input name="fax" value="" placeholder="Fax" id="input-fax" class="form-control" type="text">
</div>
</div>
</fieldset>
<fieldset id="address">
<legend>Your Address</legend>
<div class="form-group row">
<label class="col-sm-2 control-label" for="input-company">Company</label>
<div class="col-sm-10">
<input name="company" value="" placeholder="Company" id="input-company" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-address-1">Address 1</label>
<div class="col-sm-10">
<input name="address_1" value="" placeholder="Address 1" id="input-address-1" class="form-control" type="text">
</div>
</div>
<div class="form-group row">
<label class="col-sm-2 control-label" for="input-address-2">Address 2</label>
<div class="col-sm-10">
<input name="address_2" value="" placeholder="Address 2" id="input-address-2" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-city">City</label>
<div class="col-sm-10">
<input name="city" value="" placeholder="City" id="input-city" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-postcode">Post Code</label>
<div class="col-sm-10">
<input name="postcode" value="" placeholder="Post Code" id="input-postcode" class="form-control" type="text">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-country">Country</label>
<div class="col-sm-10">
<select name="country_id" id="input-country" class="form-control custom-select">
<option value=""> --- Please Select --- </option>
<option value="244">Aaland Islands</option>
<option value="1">Afghanistan</option>
<option value="2">Albania</option>
<option value="3">Algeria</option>
<option value="4">American Samoa</option>
<option value="5">Andorra</option>
<option value="6">Angola</option>
<option value="7">Anguilla</option>
<option value="8">Antarctica</option>
<option value="9">Antigua and Barbuda</option>
<option value="10">Argentina</option>
<option value="11">Armenia</option>
<option value="12">Aruba</option>
<option value="252">Ascension Island (British)</option>
<option value="13">Australia</option>
<option value="14">Austria</option>
<option value="15">Azerbaijan</option>
<option value="16">Bahamas</option>
<option value="17">Bahrain</option>
<option value="18">Bangladesh</option>
<option value="19">Barbados</option>
<option value="20">Belarus</option>
<option value="21">Belgium</option>
<option value="22">Belize</option>
<option value="23">Benin</option>
<option value="24">Bermuda</option>
<option value="25">Bhutan</option>
<option value="26">Bolivia</option>
<option value="245">Bonaire, Sint Eustatius and Saba</option>
<option value="27">Bosnia and Herzegovina</option>
<option value="28">Botswana</option>
<option value="29">Bouvet Island</option>
<option value="30">Brazil</option>
<option value="31">British Indian Ocean Territory</option>
<option value="32">Brunei Darussalam</option>
<option value="33">Bulgaria</option>
<option value="34">Burkina Faso</option>
<option value="35">Burundi</option>
<option value="36">Cambodia</option>
<option value="37">Cameroon</option>
<option value="38">Canada</option>
<option value="251">Canary Islands</option>
<option value="39">Cape Verde</option>
<option value="40">Cayman Islands</option>
<option value="41">Central African Republic</option>
<option value="42">Chad</option>
<option value="43">Chile</option>
<option value="44">China</option>
<option value="45">Christmas Island</option>
<option value="46">Cocos (Keeling) Islands</option>
<option value="47">Colombia</option>
<option value="48">Comoros</option>
<option value="49">Congo</option>
<option value="50">Cook Islands</option>
<option value="51">Costa Rica</option>
<option value="52">Cote D'Ivoire</option>
<option value="53">Croatia</option>
<option value="54">Cuba</option>
<option value="246">Curacao</option>
<option value="55">Cyprus</option>
<option value="56">Czech Republic</option>
<option value="237">Democratic Republic of Congo</option>
<option value="57">Denmark</option>
<option value="58">Djibouti</option>
<option value="59">Dominica</option>
<option value="60">Dominican Republic</option>
<option value="61">East Timor</option>
<option value="62">Ecuador</option>
<option value="63">Egypt</option>
<option value="64">El Salvador</option>
<option value="65">Equatorial Guinea</option>
<option value="66">Eritrea</option>
<option value="67">Estonia</option>
<option value="68">Ethiopia</option>
<option value="69">Falkland Islands (Malvinas)</option>
<option value="70">Faroe Islands</option>
<option value="71">Fiji</option>
<option value="72">Finland</option>
<option value="74">France, Metropolitan</option>
<option value="75">French Guiana</option>
<option value="76">French Polynesia</option>
<option value="77">French Southern Territories</option>
<option value="126">FYROM</option>
<option value="78">Gabon</option>
<option value="79">Gambia</option>
<option value="80">Georgia</option>
<option value="81">Germany</option>
<option value="82">Ghana</option>
<option value="83">Gibraltar</option>
<option value="84">Greece</option>
<option value="85">Greenland</option>
<option value="86">Grenada</option>
<option value="87">Guadeloupe</option>
<option value="88">Guam</option>
<option value="89">Guatemala</option>
<option value="256">Guernsey</option>
<option value="90">Guinea</option>
<option value="91">Guinea-Bissau</option>
<option value="92">Guyana</option>
<option value="93">Haiti</option>
<option value="94">Heard and Mc Donald Islands</option>
<option value="95">Honduras</option>
<option value="96">Hong Kong</option>
<option value="97">Hungary</option>
<option value="98">Iceland</option>
<option value="99">India</option>
<option value="100">Indonesia</option>
<option value="101">Iran (Islamic Republic of)</option>
<option value="102">Iraq</option>
<option value="103">Ireland</option>
<option value="254">Isle of Man</option>
<option value="104">Israel</option>
<option value="105">Italy</option>
<option value="106">Jamaica</option>
<option value="107">Japan</option>
<option value="257">Jersey</option>
<option value="108">Jordan</option>
<option value="109">Kazakhstan</option>
<option value="110">Kenya</option>
<option value="111">Kiribati</option>
<option value="113">Korea, Republic of</option>
<option value="253">Kosovo, Republic of</option>
<option value="114">Kuwait</option>
<option value="115">Kyrgyzstan</option>
<option value="116">Lao People's Democratic Republic</option>
<option value="117">Latvia</option>
<option value="118">Lebanon</option>
<option value="119">Lesotho</option>
<option value="120">Liberia</option>
<option value="121">Libyan Arab Jamahiriya</option>
<option value="122">Liechtenstein</option>
<option value="123">Lithuania</option>
<option value="124">Luxembourg</option>
<option value="125">Macau</option>
<option value="127">Madagascar</option>
<option value="128">Malawi</option>
<option value="129">Malaysia</option>
<option value="130">Maldives</option>
<option value="131">Mali</option>
<option value="132">Malta</option>
<option value="133">Marshall Islands</option>
<option value="134">Martinique</option>
<option value="135">Mauritania</option>
<option value="136">Mauritius</option>
<option value="137">Mayotte</option>
<option value="138">Mexico</option>
<option value="139">Micronesia, Federated States of</option>
<option value="140">Moldova, Republic of</option>
<option value="141">Monaco</option>
<option value="142">Mongolia</option>
<option value="242">Montenegro</option>
<option value="143">Montserrat</option>
<option value="144">Morocco</option>
<option value="145">Mozambique</option>
<option value="146">Myanmar</option>
<option value="147">Namibia</option>
<option value="148">Nauru</option>
<option value="149">Nepal</option>
<option value="150">Netherlands</option>
<option value="151">Netherlands Antilles</option>
<option value="152">New Caledonia</option>
<option value="153">New Zealand</option>
<option value="154">Nicaragua</option>
<option value="155">Niger</option>
<option value="156">Nigeria</option>
<option value="157">Niue</option>
<option value="158">Norfolk Island</option>
<option value="112">North Korea</option>
<option value="159">Northern Mariana Islands</option>
<option value="160">Norway</option>
<option value="161">Oman</option>
<option value="162">Pakistan</option>
<option value="163">Palau</option>
<option value="247">Palestinian Territory, Occupied</option>
<option value="164">Panama</option>
<option value="165">Papua New Guinea</option>
<option value="166">Paraguay</option>
<option value="167">Peru</option>
<option value="168">Philippines</option>
<option value="169">Pitcairn</option>
<option value="170">Poland</option>
<option value="171">Portugal</option>
<option value="172">Puerto Rico</option>
<option value="173">Qatar</option>
<option value="174">Reunion</option>
<option value="175">Romania</option>
<option value="176">Russian Federation</option>
<option value="177">Rwanda</option>
<option value="178">Saint Kitts and Nevis</option>
<option value="179">Saint Lucia</option>
<option value="180">Saint Vincent and the Grenadines</option>
<option value="181">Samoa</option>
<option value="182">San Marino</option>
<option value="183">Sao Tome and Principe</option>
<option value="184">Saudi Arabia</option>
<option value="185">Senegal</option>
<option value="243">Serbia</option>
<option value="186">Seychelles</option>
<option value="187">Sierra Leone</option>
<option value="188">Singapore</option>
<option value="189">Slovak Republic</option>
<option value="190">Slovenia</option>
<option value="191">Solomon Islands</option>
<option value="192">Somalia</option>
<option value="193">South Africa</option>
<option value="194">South Georgia & South Sandwich Islands</option>
<option value="248">South Sudan</option>
<option value="195">Spain</option>
<option value="196">Sri Lanka</option>
<option value="249">St. Barthelemy</option>
<option value="197">St. Helena</option>
<option value="250">St. Martin (French part)</option>
<option value="198">St. Pierre and Miquelon</option>
<option value="199">Sudan</option>
<option value="200">Suriname</option>
<option value="201">Svalbard and Jan Mayen Islands</option>
<option value="202">Swaziland</option>
<option value="203">Sweden</option>
<option value="204">Switzerland</option>
<option value="205">Syrian Arab Republic</option>
<option value="206">Taiwan</option>
<option value="207">Tajikistan</option>
<option value="208">Tanzania, United Republic of</option>
<option value="209">Thailand</option>
<option value="210">Togo</option>
<option value="211">Tokelau</option>
<option value="212">Tonga</option>
<option value="213">Trinidad and Tobago</option>
<option value="255">Tristan da Cunha</option>
<option value="214">Tunisia</option>
<option value="215">Turkey</option>
<option value="216">Turkmenistan</option>
<option value="217">Turks and Caicos Islands</option>
<option value="218">Tuvalu</option>
<option value="219">Uganda</option>
<option value="220">Ukraine</option>
<option value="221">United Arab Emirates</option>
<option value="222" selected="selected">United Kingdom</option>
<option value="223">United States</option>
<option value="224">United States Minor Outlying Islands</option>
<option value="225">Uruguay</option>
<option value="226">Uzbekistan</option>
<option value="227">Vanuatu</option>
<option value="228">Vatican City State (Holy See)</option>
<option value="229">Venezuela</option>
<option value="230">Viet Nam</option>
<option value="231">Virgin Islands (British)</option>
<option value="232">Virgin Islands (U.S.)</option>
<option value="233">Wallis and Futuna Islands</option>
<option value="234">Western Sahara</option>
<option value="235">Yemen</option>
<option value="238">Zambia</option>
<option value="239">Zimbabwe</option>
</select>
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-zone">Region / State</label>
<div class="col-sm-10">
<select name="zone_id" id="input-zone" class="form-control custom-select">
<option value=""> --- Please Select --- </option>
<option value="3513">Aberdeen</option>
<option value="3514">Aberdeenshire</option>
<option value="3515">Anglesey</option>
<option value="3516">Angus</option>
<option value="3517">Argyll and Bute</option>
<option value="3518">Bedfordshire</option>
<option value="3519">Berkshire</option>
<option value="3520">Blaenau Gwent</option>
<option value="3521">Bridgend</option>
<option value="3522">Bristol</option>
<option value="3523">Buckinghamshire</option>
<option value="3524">Caerphilly</option>
<option value="3525">Cambridgeshire</option>
<option value="3526">Cardiff</option>
<option value="3527">Carmarthenshire</option>
<option value="3528">Ceredigion</option>
<option value="3529">Cheshire</option>
<option value="3530">Clackmannanshire</option>
<option value="3531">Conwy</option>
<option value="3532">Cornwall</option>
<option value="3949">County Antrim</option>
<option value="3950">County Armagh</option>
<option value="3951">County Down</option>
<option value="3952">County Fermanagh</option>
<option value="3953">County Londonderry</option>
<option value="3954">County Tyrone</option>
<option value="3955">Cumbria</option>
<option value="3533">Denbighshire</option>
<option value="3534">Derbyshire</option>
<option value="3535">Devon</option>
<option value="3536">Dorset</option>
<option value="3537">Dumfries and Galloway</option>
<option value="3538">Dundee</option>
<option value="3539">Durham</option>
<option value="3540">East Ayrshire</option>
<option value="3541">East Dunbartonshire</option>
<option value="3542">East Lothian</option>
<option value="3543">East Renfrewshire</option>
<option value="3544">East Riding of Yorkshire</option>
<option value="3545">East Sussex</option>
<option value="3546">Edinburgh</option>
<option value="3547">Essex</option>
<option value="3548">Falkirk</option>
<option value="3549">Fife</option>
<option value="3550">Flintshire</option>
<option value="3551">Glasgow</option>
<option value="3552">Gloucestershire</option>
<option value="3553">Greater London</option>
<option value="3554">Greater Manchester</option>
<option value="3555">Gwynedd</option>
<option value="3556">Hampshire</option>
<option value="3557">Herefordshire</option>
<option value="3558">Hertfordshire</option>
<option value="3559">Highlands</option>
<option value="3560">Inverclyde</option>
<option value="3561">Isle of Wight</option>
<option value="3562">Kent</option>
<option value="3563">Lancashire</option>
<option value="3564">Leicestershire</option>
<option value="3565">Lincolnshire</option>
<option value="3566">Merseyside</option>
<option value="3567">Merthyr Tydfil</option>
<option value="3568">Midlothian</option>
<option value="3569">Monmouthshire</option>
<option value="3570">Moray</option>
<option value="3571">Neath Port Talbot</option>
<option value="3572">Newport</option>
<option value="3573">Norfolk</option>
<option value="3574">North Ayrshire</option>
<option value="3575">North Lanarkshire</option>
<option value="3576">North Yorkshire</option>
<option value="3577">Northamptonshire</option>
<option value="3578">Northumberland</option>
<option value="3579">Nottinghamshire</option>
<option value="3580">Orkney Islands</option>
<option value="3581">Oxfordshire</option>
<option value="3582">Pembrokeshire</option>
<option value="3583">Perth and Kinross</option>
<option value="3584">Powys</option>
<option value="3585">Renfrewshire</option>
<option value="3586">Rhondda Cynon Taff</option>
<option value="3587">Rutland</option>
<option value="3588">Scottish Borders</option>
<option value="3589">Shetland Islands</option>
<option value="3590">Shropshire</option>
<option value="3591">Somerset</option>
<option value="3592">South Ayrshire</option>
<option value="3593">South Lanarkshire</option>
<option value="3594">South Yorkshire</option>
<option value="3595">Staffordshire</option>
<option value="3596">Stirling</option>
<option value="3597">Suffolk</option>
<option value="3598">Surrey</option>
<option value="3599">Swansea</option>
<option value="3600">Torfaen</option>
<option value="3601">Tyne and Wear</option>
<option value="3602">Vale of Glamorgan</option>
<option value="3603">Warwickshire</option>
<option value="3604">West Dunbartonshire</option>
<option value="3605">West Lothian</option>
<option value="3606">West Midlands</option>
<option value="3607">West Sussex</option>
<option value="3608">West Yorkshire</option>
<option value="3609">Western Isles</option>
<option value="3610">Wiltshire</option>
<option value="3611">Worcestershire</option>
<option value="3612">Wrexham</option>
</select>
</div>
</div>
</fieldset>
<fieldset>
<legend>Your Password</legend>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-password">Password</label>
<div class="col-sm-10">
<input name="password" value="" placeholder="Password" id="input-password" class="form-control" type="password">
</div>
</div>
<div class="form-group row required">
<label class="col-sm-2 control-label" for="input-confirm">Password Confirm</label>
<div class="col-sm-10">
<input name="confirm" value="" placeholder="Password Confirm" id="input-confirm" class="form-control" type="password">
</div>
</div>
</fieldset>
<fieldset>
<legend>Newsletter</legend>
<div class="form-group row">
<label class="col-sm-2 control-label">Subscribe</label>
<div class="col-sm-10">
<label class="radio-inline">
<input name="newsletter" value="1" type="radio">
Yes</label>
<label class="radio-inline">
<input name="newsletter" value="0" checked="checked" type="radio">
No</label>
</div>
</div>
</fieldset>
<div class="buttons">
<div class="pull-right">I have read and agree to the <a href="https://demo.opencart.com/index.php?route=information/information/agree&information_id=3" class="agree"><b>Privacy Policy</b></a> <input name="agree" value="1" type="checkbox">
<input value="Continue" class="btn btn-primary" type="submit">
</div>
</div>
</form>
</div>
</div>
</div>
</div>
<footer class="bg-faded text-muted py-5 mt-5">
<div class="container">
<div class="row">
<div class="col-sm-3">
<h5>Information</h5>
<ul class="list-unstyled">
<li><a href="#">About Us</a></li>
<li><a href="#">Delivery Information</a></li>
<li><a href="#">Privacy Policy</a></li>
<li><a href="#">Terms & Conditions</a></li>
</ul>
</div>
<div class="col-sm-3">
<h5>Customer Service</h5>
<ul class="list-unstyled">
<li><a href="#">Contact Us</a></li>
<li><a href="#">Returns</a></li>
<li><a href="#">Site Map</a></li>
</ul>
</div>
<div class="col-sm-3">
<h5>Extras</h5>
<ul class="list-unstyled">
<li><a href="#">Brands</a></li>
<li><a href="#">Gift Certificates</a></li>
<li><a href="#">Affiliate</a></li>
<li><a href="#">Specials</a></li>
</ul>
</div>
<div class="col-sm-3">
<h5>My Account</h5>
<ul class="list-unstyled">
<li><a href="#">My Account</a></li>
<li><a href="#">Order History</a></li>
<li><a href="#">Wish List</a></li>
<li><a href="#">Newsletter</a></li>
</ul>
</div>
</div>
<p class="float-right">
<a href="#">Back to top</a>
</p>
</div>
</footer>
</div>
<!-- Bootstrap core JavaScript
================================================== -->
<!-- Placed at the end of the document so the pages load faster -->
<!-- script src="https://code.jquery.com/jquery-3.1.1.slim.min.js" integrity="sha384-A7FZj7v+d/sdmMqp/nOQwliLvUsJfDHW+k9Omg/a/EheAdgtzNs3hpfag6Ed950n" crossorigin="anonymous"></script -->
<script src="js/jquery.min.js"></script>
<!-- script src="https://cdnjs.cloudflare.com/ajax/libs/tether/1.4.0/js/tether.min.js" integrity="sha384-DztdAPBWPRXSA/3eYEEUWrWCy7G5KFbe8fFjk5JAIxUYHKkDx6Qin1DkWx51bBrb" crossorigin="anonymous"></script -->
<script src="js/popper.min.js"></script>
<script src="js/bootstrap.min.js"></script>
</body>
</html>