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{if ($warning ne "") } |
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<p align="center" ><font color="#ff0000" size="+1">{$warning}</font></p> |
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{/if} |
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|
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<form method="post" action="{$self}"> |
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<input type="hidden" name="p" value="obrazac"> |
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<p> |
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{input type="radio" name="zanimanje" value="faramacevt"} Farmacevt |
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{input type="radio" name="zanimanje" value="zdravnik"} Zdravnik |
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{input type="radio" name="zanimanje" value="veterinar"} Veterinar |
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<br> |
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{input type="radio" name="zanimanje" value="drugo"} Drugo |
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{input name="drugo_zanimanje" size="53"} |
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</p> |
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<table width="99%" border="0" bgcolor="#FFFFFF" cellpadding="0" cellspacing="0"> |
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<tr> |
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<td>{rinput name=login desc="Uporabni¹ko ime"}</td> |
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<td>{input name=login desc="Uporabni¹ko ime" size=40}</td> |
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</tr><tr> |
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<td>{rinput name=geslo desc=Geslo}</td> |
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<td>{input name="geslo" size="40"}</td> |
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</tr><tr> |
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<td>{rinput name="sender" desc="Ime in priimek"}</td> |
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<td>{input name="sender" size="40"}</td> |
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</tr><tr> |
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<td>Naslov<br>(ulica in hi¹na ¹tevilka)</td> |
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<td>{input name="ulica" size="40"}</td> |
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</tr><tr> |
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<td>po¹tna ¹tevilka</td> |
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<td>{input name="posta" size="40"}</td> |
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</tr><tr> |
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<td>kraj</td> |
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<td>{input name="kraj" size="40"}</td> |
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</tr><tr> |
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<td>telefonska ¹tevilka</td> |
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<td>{input name="tel" size="40"}</td> |
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</tr><tr> |
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<td>{rinput name="reply" desc="el. po¹ta"}</td> |
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<td>{input name="reply" size="40" type=email}</td> |
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</tr> |
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</table> |
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<hr> |
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<p><b>Podatki o zaposlitvi</b></p> |
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<table width="99%" border="0" cellpadding="0" cellspacing="0"> |
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<tr> |
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<td>{rinput name="org" desc="Delovna organizacija"}</td> |
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<td>{input name="org" size="40"}</td> |
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</tr><tr> |
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<td>telefon</td> |
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<td>{input name="orgtel" size="40"}</td> |
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</tr><tr> |
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<td>faks</td> |
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<td>{input name="orgfax" size="40"}</td> |
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</tr><tr> |
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<td>el. po¹ta</td> |
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<td>{input name="orgemail" size="40"}</td> |
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</tr> |
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</table> |
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|
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<hr> |
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<div align="center">Specializacija<br> |
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{textarea name="specializacija" cols="60" rows="5"} |
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</div> |
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|
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<hr> |
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<div align="center">Strokovno podroèje |
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{textarea name="podrocje" cols="60" rows="5"} |
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</div> |
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|
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<hr> |
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<div align="left"> |
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Za pridobitev gesla je nujno izpolniti oznaèene vrstice. |
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<input type="submit" name="submit" value="Po¹lji"> |
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<input type="reset" name="Reset" value="Zbri¹i"> |
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</div> |
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|
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</form> |