
<!---
Page Name: SubmitUserRegInfo.asp
Brief Description: Form gathers information submitted by a customer
during registration
Orignal Programmer: ASP Script Abhijit.Revankar
HTML: Immanuel Ravindra
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Immanuel Ravindra
Last change date: 08/04/2003
Change Description: As per instructions from Bruce to sort Department drop-down alphabetically and show the option that says "Choose Department" stored procedure ecs2sp_get_Department - modified to sort as per the description column.
-------------------------------------------------------------------------------------------------------------------------------------
Last change date: 2/10/06
Last Changed by :Abhijit Revankar
Change Description: Change to accomodate new field - How did you hear about us
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Immanuel Ravindra
Last change date: 09/08/2006
Change Description: Setting tabindex for the form fields. Wrote new javascript function to set focus to the e-mail column on form
                    load.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Bruce Thorner
Last change date: 10/11/2006
Change Description: Changes the size of the back button from 43 x 43 to 90 x 30.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Bruce Thorner
Last change date: 10/17/2006
Change Description: Add code to check for query string and test characters in query string to insure no cross-site injection
                    attempts.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Immanuel Ravindra
Last change date: 10/18/2006
Change Description: Add Server.URLEncode to the hidden variable value contract to avoid cross-site injection attempts.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by : B. Thorner and I. Sogunro
Last change date: 10/23/06 - Added vbscript checks on query strings to prevent cross-site scripting
                             to replace javascript checker.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Jyothi Nagaraj
Last change date: 10/24/2007
Change Description: Added label for How did you hear about us Select box to fix the INPUT requires explicit label violation
					Added id for the Enter Other Option input box and a label to fix the above violation
					Changed doctype declaration from 4.0 to 4.01 to fix 508 violations - 11/07/2007
					Added TH tag to tables to fix WCAG 5.1 violation - 11/20/2007
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Immanuel Ravindra
Last change date: 04/15/2008
Change Description: Add ASP code to display error on top of page if the e-mail address used for customer registration is not a valid            
                    federal government domain like .gov or .mil.
-------------------------------------------------------------------------------------------------------------------------------------
Last Changed by :Immanuel Ravindra
Last change date: 04/15/2008
Change Description: Add code to check for query string and test characters in query string to insure no cross-site injection
                    attempts for all the querystring variables passed back to this page when validation fails for e-mail address.
-------------------------------------------------------------------------------------------------------------------------------------
--->

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<HTML>
<HEAD>
<!--- these JScriptFiles are included to validate user input and format phone number.--->
<script language="javascript">
//Script Abhijit.Revankar
//Details of change: Jyothi Nagaraj 10/24/07 - Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation
//Details of change: Immanuel Ravindra 12/09/08 - Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation
function get_color(color_num) 
{ 
var now_color=color_num; 

var my_color= new Array(5) 
my_color[0]="black"; 
my_color[1]="black"; 
my_color[2]="black"; 
my_color[3]="#99cc99"; 
my_color[4]="ghostwhite"; 


document.bgColor=my_color[now_color]; 
} 
</SCRIPT> 
<noscript>Your browser does not support JavaScript!</noscript>
<script language="JavaScript1.2">

function changeto(highlightcolor){
source=event.srcElement
if (source.tagName=="TR"||source.tagName=="TABLE")
return
while(source.tagName!="TR")
source=source.parentElement
if (source.style.backgroundColor!=highlightcolor&&source.id!="ignore")
source.style.backgroundColor=highlightcolor
}

function changeback(originalcolor){
if (event.fromElement.contains(event.toElement)||source.contains(event.toElement)||source.id=="ignore")
return
if (event.toElement!=source)
source.style.backgroundColor=originalcolor
}
</script>
<noscript>Your browser does not support JavaScript!</noscript>
<SCRIPT LANGUAGE = "JavaScript">
//Author: Bruce Thorner
//Last Changed By:  Bruce Thorner
//Last Change Date: 10/12/06

//Last changed date: 10/24/07
//Last changed by:   Jyothi Nagaraj
//Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation

//Last changed date: 11/03/2008
//Last changed by:   Rekha Vijayan
//Details: Added missing single quotes in line - var spec = '-= /.,$@_?';

//Function validateText1 tests that the value passes is of nonzero length and does not have characters
//  included that could be used for a SQL injection attack or cross-site scripting attack

function validateText1(s)
{

//Test that the string contains characters

    if (s.length <= 0)
    {
        return false;
    }
    
    
    return false;
}

// Text Field Validation Functions
// copyright Stephen Chapman, 26th Dec 2004
// you may copy this function but please keep the copyright notice with it
// Special characters added by B. Thorner.  This list can be modified as needed.

var numb = '0123456789';
var lwr = 'abcdefghijklmnopqrstuvwxyz';
var upr = 'ABCDEFGHIJKLMNOPQRSTUVWXYZ';
var spec = '-= /.,$@_?';

function isValid(parm,val) {
  if (parm == "") return true;
  for (i=0; i<parm.length; i++) {
    if (val.indexOf(parm.charAt(i),0) == -1) return false;
  }
  return true;
}

// The following functions have self explanitory names.  Use these functions for validating input fields.

function isNum(parm) {return isValid(parm,numb);}
function isLower(parm) {return isValid(parm,lwr);}
function isUpper(parm) {return isValid(parm,upr);}
function isAlpha(parm) {return isValid(parm,lwr+upr);}
function isAlphanum(parm) {return isValid(parm,lwr+upr+numb+spec);}
function isDecimal(parm) {return isValid(parm,numb+'.');}
</script>
<noscript>Your browser does not support JavaScript!</noscript>

<SCRIPT LANGUAGE="JavaScript">
//Script Abhijit.Revankar
//Last modification: Jyothi Nagaraj
//Modified Date: 06/05/2007
//Description: Modified the validateDate function to add validation to check for numbers in the date field
//fixed the bug found in parseInt function by adding the radix parameter to the parseInt funtion. 
//The bug is when the user types 08 or 09 the date is returned as invalid though it is a valid date. 
//Please refer this article for more details - https://webarchive.library.unt.edu/eot2008/20090130212241/http://www.go4expert.com/forums/showthread.php?t=857 

//Last changed date: 10/24/07
//Last changed by:   Jyothi Nagaraj
//Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation

<!-- Stealth Mode On
function validateInput(frm, mask){

   //Count the number of form elements
   var FrmLen = frm.elements.length;
 
   //Get the validation mask string
   var maskarr = mask;
   
   //Loop through all the form elements
   for (var i = 0; i < FrmLen; i++)
   {
      //obtain the validation mask character
      maskarr = mask.substring(i,i+1)
      //Initialize local variables
      
      var valalpha = 1;
      var valdate = 1;
      var valtext = 1;
      var valnum = 1;
      var valtelenum = 1;
      var valemail = 1;
      var valfname = 1;

   //Test field based on validation mask character
   
   if (maskarr == "a")
   {
      valalpha = validateAlphaNumeric(frm.elements[i].value);
   }
   if (maskarr == "d")
   {
      valdate = validateDate(frm.elements[i].value);
   }
   if (maskarr == "t")
   {
      valtext = validateText(frm.elements[i].value);
   }
   if (maskarr == "n")
   {
      valnum = validateNum(frm.elements[i].value);
   }
   if (maskarr == "p")
   {
      valtelenum = validateTeleNum(frm.elements[i].value);
   }
   if (maskarr == "e")
   {
      valemail = validateEmail(frm.elements[i].value);
   }
   
   //If the validation fails prompt the user with an error message
   if (! valalpha)
      {
         alert ("A required text field is either blank or contains one or more restricted characters.  Please try again");
         putFocus(frm.elements[i]);
         return false;
   }
   if (! valdate)
   {
      alert("The date you have entered is invalid");
      putFocus(frm.elements[i]);
      return false;
   }
   if (! valtext)
   {
      alert("The details you have entered are incomplete");
      putFocus(frm.elements[i]);
      return false;
   }
   if (! valnum)
   {
      alert("Please enter a valid number");
      putFocus(frm.elements[i]);
      return false;
   }
   if (! valtelenum)
   {
      alert("Please enter a valid telephone or extension number");
      putFocus(frm.elements[i]);
      return false;
   }
   if (! valemail)
   {
      alert("The Email address you have entered is invalid");
      putFocus(frm.elements[i]);
      return false;
   }
      
   }
   return true;
}

//Validate an alphanumeric string
function validateAlphaNumeric (textField) {

   var status;
   
   //test for non zero length

   if (textField.length < 1) {
      return false;
   }
   
   status = isAlphanum(textField);

   if (!status) {
      return false;
   }
   return true
}

//Date validation function
function validateDate(s)
{
   //Test for a string on non-zero length
   if (s.length > 0)
   {
      //Create an array to split the date into (mm/dd/yy)
      strarr = new Array ()

      //Use own split function as JScript does not include JavaScripts split function
      own_split(strarr, s, "/");

      //3 array elements means month, day and year
      if (strarr.length == 3)
      {
         //Test the value of each element falls in an acceptable range
         for (var i = 0; i < strarr.length; i++){
           var valTest = validateNum(strarr[i]);
           if (! valTest){
              return false;
           }
         }
         
         if ((strarr[0] < 0) || (strarr[0] >12)){
            return false;
         }
         if ((strarr[1] < 0) || (strarr[1] >31)){
            return false;
         }
         //Check for valid 2 digit year
         if (strarr[2].length == 2) {
            if (isNaN(strarr[2])){
                 return false;
            }
            else {
               if ((strarr[2] <= 0) || (strarr[2] >99)){ 
                 return false;
               }
            }
         }
         else {
            //Check for valid 4 digit year
            if (strarr[2].length == 4) {
               if (isNaN(strarr[2])){
                  return false;
               }
               else {
                  if ((strarr[2] <= 0) || (strarr[2] >9999)){  
                     return false;
                  }
               }
            }
            else {
               return false; // Any other number for length of year fails
            }
         }
         return true // Date OK if it passes all tests
      }
      return false;  // Any other number for strarr fails
   }
   return false;  // If string is zero length then fail
}


//Text validation function
function validateText(s)
{
   //test for a string
   if (s.length > 0)
   {
      return true;
   }
   return false;
}

//Number validation function
function validateNum(s)
{
   //Test to see if the value converts to a number

   num = new Number(s);
   //alert (num.valueOf());
   if (num.valueOf() > 0)
   {
      return true;
   }
   return false;
}

//Telephone Number validation function
function validateTeleNum(s)
{
   //Test for a string
   if (s.length > 0)
   {
      for (i = 0;  i < s.length;  i++)
      {
            ch = s.charAt(i);
         if(! own_instring(ch))
         {
         return false;
         }
      }
      return true;
   }
   return false;
}

//E-Mail address validation function
function validateEmail(s)
{
   //First test to see if this is a valid alphanumeric string

   if (validateAlphaNumeric (s)) {
   // Return false if e-mail field does not contain a '@' and '.' .
      if (s.indexOf ('@',0) == -1 || s.indexOf ('.',0) == -1) {
         return false;
      }
      return true;
   }
   return false;
}

//In string function to test for valid substring, accomodates JavaScripts lack of VBScripts InStr() function
function own_instring(c)
{
   var checkOK = "0123456789-+-. ()\t\r\n\f";
   var ret  = false;

      for (j = 0;  j < checkOK.length;  j++)
      {
               if (c != checkOK.charAt(j))
         {
         continue;
         }
         else
         {
         ret = true;
         break;
         }
      }
   return ret;
}

//String split function to accomodate JScripts lack of JavaScripts split function
function own_split(arr, str, delim)
{
   //Initialise local variables
   var pos = 0;
   var num = 0;
   var start = 0;
   
   //Loop while there are characters in the string
   while (pos < str.length)
   {
      //Loop while there are delimiters in the string
      while((str.substring (pos, pos+1) != delim) && (pos < str.length))
      {
      pos++;
      }
      //Add the new characters to the output array
      arr[num] = str.substring(start,pos);
      num++;
      start = pos+1;
      pos++;
   }
}

function putFocus(elementStr)
   {
   elementStr.value="";
   elementStr.focus();
   }
   
//-->
</SCRIPT>
<noscript>Your browser does not support JavaScript!</noscript>


<SCRIPT LANGUAGE="JavaScript">

/*
Script Abhijit.Revankar
This function returns everything after the first instance of the search string in the expression
*/ 

/*
Last changed date: 10/29/07
Last changed by:   Jyothi Nagaraj
Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation (I had to add the NOSCRIPT tag to this function as this was getting called in replaceall.js in the IW2 folder)
*/

function getallafterfirst(expr,searchstr){
	foundoffset = expr.indexOf(searchstr)
	if (foundoffset == -1){
		return ""
	}
	else{
		return expr.substring(foundoffset+searchstr.length,expr.length)
	}
}

</SCRIPT>
<NOSCRIPT>Your browser does not support JavaScript!</NOSCRIPT><SCRIPT LANGUAGE="JavaScript">

/*
Script Abhijit.Revankar
This function returns everything after the first instance of the search string in the expression
*/ 

/*
Last changed date: 10/29/07
Last changed by:   Jyothi Nagaraj
Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation (I had to add the NOSCRIPT tag to this function as this was getting called in replaceall.js in the IW2 folder)
*/

function getallbeforefirst(expr,searchstr){
	foundoffset = expr.indexOf(searchstr)
	if(foundoffset == -1){
		return expr.substring(0,expr.length)
	}
	else{
		return expr.substring(0,foundoffset)
	}
}
</SCRIPT>
<NOSCRIPT>Your browser does not support JavaScript!</NOSCRIPT>
<SCRIPT LANGUAGE="JavaScript">
/*
Last changed date: 10/24/07
Last changed by:   Jyothi Nagaraj
Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation
*/
 /*
This function replaces all instances of one string with another in the expression
MUST INCLUDE: getallbeforefirst.js, getallafterfirst.js
*/ 

/*
Last changed date: 02/20/2008
Last changed by:   Immanuel
Details: The .js files which were called using (script src="") was replaced with the include file to 
         fix the Javascript error message appearing in the browser's status bar.
*/

function replaceall(expr,removestring,replacestring){
	foundoffset = expr.indexOf(removestring)
	var retstring=expr
	while (foundoffset != -1){
		var front = getallbeforefirst(expr,removestring)
		var end = getallafterfirst(expr,removestring)
		expr=front + replacestring + end
		foundoffset = expr.indexOf(removestring)
	}
	return expr
}
</script>
<noscript>Your browser does not support JavaScript!</noscript><SCRIPT LANGUAGE = "JavaScript">
// Author Abhijit.Revankar

//function checkstate(){
//if (document.UserReg.state.value == "Please select one") {            
//      alert("Please select a city.");           
//      document.UserReg.state.focus();            
//      return false            
//   }
//}

/*
Last changed date: 10/24/07
Last changed by:   Jyothi Nagaraj
Details: Added NOSCRIPT tag after SCRIPT tag to fix the NOSCRIPT tag violation
*/
function checkpassword(form){
if ((form.passwd.value != form.confpasswd.value) && (form.confpasswd.value != "")){
   alert("Password Not Confirmed")
   form.confpasswd.value  = ""   
   form.confpasswd.focus();   
}
}

function validateName(Field) 
{
   //  true if string contains all valid character

   var isCharValid= true;
   var validString = Field.value;

   // Loop through each of the characters in the string

   for  (i=0 ; i < validString.length ; i++) 
   {
      // check if character is valid
      if (validateCharacter(validString.charAt(i)) == false) {
         isCharValid = false;
         i = validString.length;
      }
   }
   
   //if string contains non-valid characters display alert box

   if (isCharValid == false) {
      alert("The name contains invalid character. It only accepts alphabets.");
      Field.focus();
      Field.value = ""
      
      //Select would allow the user to keep going without change     
      //Field.select();    
   }
}  

function check4nihEmp(){
   if(document.forms[0].NihEmp.checked){
      for(i=1;i<document.forms[0].Department.length;i++){
         if(document.forms[0].Department.options[i].value=="NATIONAL INSTITUTES OF HEALTH/DHHS"){
            selectthis=i
         }
      }
      document.forms[0].Department.selectedIndex=selectthis
   }
}

function phoneformat(phonenumber){
   phonenumber=replaceall(phonenumber,"(","")
   phonenumber=replaceall(phonenumber,")","")
   phonenumber=replaceall(phonenumber,".","")
   phonenumber=replaceall(phonenumber,"-","")
   phonenumber=replaceall(phonenumber,"#","")
   phonenumber=replaceall(phonenumber,"*","")
   if(isNaN(phonenumber)){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.UserReg.phone.focus();
         }
   else if(phonenumber.length!=10){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.UserReg.phone.focus();
      }
   else{
      retstring=phonenumber.substr(0,3)+"-"+phonenumber.substr(3,3)+"-"+phonenumber.substr(6,4)
   }
   return retstring
   
}

function faxformat(faxnumber){
   phonenumber=replaceall(faxnumber,"(","")
   phonenumber=replaceall(faxnumber,")","")
   phonenumber=replaceall(faxnumber,".","")
   phonenumber=replaceall(faxnumber,"-","")
   phonenumber=replaceall(faxnumber,"#","")
   phonenumber=replaceall(faxnumber,"*","")
   if(isNaN(faxnumber)){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.UserReg.fax.focus();
         }
   else if(phonenumber.length!=10){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.UserReg.fax.focus();
      }
   else{
      retstring=faxnumber.substr(0,3)+"-"+faxnumber.substr(3,3)+"-"+faxnumber.substr(6,4)
   }
   return retstring
   
}

function validZip(inZip) {       
      if (inZip.length !=5) {          
         alert("Should be five digits.")
         document.UserReg.zip.value  = "" 
         document.UserReg.zip.focus();    
         }  
}  

function validatelastname(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.UserReg.lastname.value  = ""
            document.UserReg.lastname.focus(); 
}
function validatechar(character,message) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || ( character >= '0' && character <= '9'))
      return 1;
       else
         alert("message")
         return 2;
}

function validatecharord(character,message) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || ( character >= '0'))
      return 1;
       else
         //alert("message")
         return 2;
}

function validatenum(character,field) {
   //Return true if valid
      if (( character >= '0' && character <= '9')
         || (character == '-'))
          return true;
       else
          alert("Invalid number.")
           field.value = 0.00
         document.UserReg.totorder.value = 0.00
}

function validatemiddlename(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.UserReg.middlename.value  = ""
            document.UserReg.middlename.focus(); 
}
function validatefirstname(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.UserReg.firstname.value  = ""
            document.UserReg.firstname.focus(); 
}

function validateExt(character) {
   //Return true if valid
      if (( character >= '0' && character <= '9')
            || (character == '-'))
          return true;
       else
          alert("Invalid number.")
         document.UserReg.ext.value  = ""
            document.UserReg.ext.focus();   
}
function validateIntNumber(character) {
   //Return true if valid
      if (( character >= '0' && character <= '9')
            || (character == '-'))
          return true;
       else
          alert("Invalid number.")
         document.UserReg.Intphone.value  = ""
            document.UserReg.Intphone.focus();  
}

function validatenihlastname(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.AddNihUser.LastName.value  = ""
            document.AddNihUser.LastName.focus(); 
}


function validatenihmiddlename(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.AddNihUser.mname.value  = ""
            document.AddNihUser.mname.focus(); 
}
function validatenihfirstname(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.AddNihUser.FirstName.value  = ""
            document.AddNihUser.FirstName.focus(); 
}
function validatenihdepartment(character) {
   //Return true if valid
      if (( character >= 'a' && character <= 'zz')
         || ( character >='A' && character <='Zz')
         || (character == ''))
          return true;
       else
         alert("The Name contains invalid character.")
         document.AddNihUser.department.value  = ""
            document.AddNihUser.department.focus(); 
}

function nihphoneformat(phonenumber){
   phonenumber=replaceall(phonenumber,"(","")
   phonenumber=replaceall(phonenumber,")","")
   phonenumber=replaceall(phonenumber,".","")
   phonenumber=replaceall(phonenumber,"-","")
   phonenumber=replaceall(phonenumber,"#","")
   phonenumber=replaceall(phonenumber,"*","")
   if(isNaN(phonenumber)){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.AddNihUser.phone.focus();
         }
   else if(phonenumber.length!=10){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.AddNihUser.phone.focus();
      }
   else{
      retstring=phonenumber.substr(0,3)+"-"+phonenumber.substr(3,3)+"-"+phonenumber.substr(6,4)
   }
   return retstring
   
}

function nihfaxformat(faxnumber){
   phonenumber=replaceall(faxnumber,"(","")
   phonenumber=replaceall(faxnumber,")","")
   phonenumber=replaceall(faxnumber,".","")
   phonenumber=replaceall(faxnumber,"-","")
   phonenumber=replaceall(faxnumber,"#","")
   phonenumber=replaceall(faxnumber,"*","")
   if(isNaN(faxnumber)){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.AddNihUser.fax.focus();
         }
   else if(phonenumber.length!=10){
      alert("Please use the format ###-###-#### when entering a telephone or fax number.")
      retstring=""
      document.AddNihUser.fax.focus();
      }
   else{
      retstring=faxnumber.substr(0,3)+"-"+faxnumber.substr(3,3)+"-"+faxnumber.substr(6,4)
   }
   return retstring
   
}

function nihvalidateExt(character) {
   //Return true if valid
      if (( character >= '0' && character <= '9')
            || (character == '-'))
          return true;
       else
          alert("Invalid number.")
         document.AddNihUser.ext.value  = ""
            document.AddNihUser.ext.focus();   
}
</script>
<noscript>Your browser does not support JavaScript!</noscript>
<script language="JavaScript">

/*function showMe(id) { // This gets executed when the user clicks on the checkbox
var obj = document.getElementById(objectId);
if (obj.style.visibility=="hidden") { // if it is checked, make it visible, if not, hide it
obj.style.visibility = "visible";
} else {
obj.style.visibility =="hidden";
}
}*/

// function switchDiv()
//  this function takes the id of a div
//  and calls the other functions required
//  to show that div
//
function switchDiv(div_id)
{
  var style_sheet = getStyleObject(div_id);
  if (style_sheet)
  {
    hideAll();
    changeObjectVisibility(div_id,"visible");
  }
  else
  {
    alert("sorry, this only works in browsers that do Dynamic HTML");
  }
}

function validateTextInput (textField) {

   var status;
   status = isAlphanum(textField);

   if (!status) {
      return false;
   }
   return true;
}

// function hideAll()
//  hides a bunch of divs
//
function hideAll()
{
   changeObjectVisibility("div2","hidden");
   (UserReg.aboutotr.value="Enter Other option here.");
}

// function getStyleObject(string) -> returns style object
//  given a string containing the id of an object
//  the function returns the stylesheet of that object
//  or false if it can't find a stylesheet.  Handles
//  cross-browser compatibility issues.
//
function getStyleObject(objectId) {
  // checkW3C DOM, then MSIE 4, then NN 4.
  //
  if(document.getElementById && document.getElementById(objectId)) {
   return document.getElementById(objectId).style;
   }
   else if (document.all && document.all(objectId)) {
   return document.all(objectId).style;
   }
   else if (document.layers && document.layers[objectId]) {
   return document.layers[objectId];
   } else {
   return false;
   }
}

function changeObjectVisibility(objectId, newVisibility) {
    // first get a reference to the cross-browser style object
    // and make sure the object exists
    var styleObject = getStyleObject(objectId);
    if(styleObject) {
   styleObject.visibility = newVisibility;
   return true;
    } else {
   // we couldn't find the object, so we can't change its visibility
   return false;
    }
}
//-->
function clr(){
if (UserReg.aboutotr.value=="Enter Other option here."){
UserReg.aboutotr.value=""
//alert("t"+UserReg.aboutus.value);
//alert("t"+UserReg.aboutotr.value);
}
}

function ale(pt){
document.forms['UserReg'].aboutus.options[6].value=pt;
//alert("y"+UserReg.aboutus.value);
//alert("y"+UserReg.aboutotr.value);
}

function chksry(form){
var subval = 0;
if (validateInput(UserReg, 'uetutpuuuuutttuttnt')) {
if ((UserReg.aboutus.value == "Other") && ((UserReg.aboutotr.value=='')|| (UserReg.aboutotr.value=="Enter Other option here."))){
alert("Please enter other option in the highlighted field.");
subval=1;
return false;
}
//NetS
if ((UserReg.aboutus.value == '') && ((UserReg.aboutotr.value=='')|| (UserReg.aboutotr.value=="Enter Other option here."))){
alert("Please enter other option in the highlighted field.");
subval=1;
return false;
}
if (UserReg.aboutus.value == "CO"){
alert("Please select 'How you heard about us?'.");
subval=1;
return false;
}
if (UserReg.Department.value == "Choose Department..."){
alert("Please select department.");
subval=1;
return false;
}
if (UserReg.state.value == "Choose State..."){
alert("Please select state.");
subval=1;
return false;
}
if (subval==0){
form.submit();
}
}
}

function LTrim(str)
{
        var whitespace = new String(" \t\n\r ");
        var s = new String(str);
        if (whitespace.indexOf(s.charAt(0)) != -1) {
            var j=0, i = s.length;
            while (j < i && whitespace.indexOf(s.charAt(j)) != -1)
                j++;
            s = s.substring(j, i);
        }
        return s;
}

function RTrim(str)
{
         var whitespace = new String(" \t\n\r ");
         var s = new String(str);
        if (whitespace.indexOf(s.charAt(s.length-1)) != -1) {
             var i = s.length - 1;
             while (i >= 0 && whitespace.indexOf(s.charAt(i)) != -1)
                i--;
            s = s.substring(0, i+1);
        }
        return s;
}
</SCRIPT>
<noscript>Your browser does not support JavaScript!</noscript>
<script language="JavaScript">
// Set focus to selected field
function setFocus() {
   document.UserReg.email.focus();
}
</script>
<noscript>Your browser does not support JavaScript!</noscript>

<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=ISO-8859-1">
<META NAME="Generator" CONTENT="">
<TITLE>Federal Customers Instant Registration</TITLE>
<link href="nitaac1.css" rel="stylesheet" type="text/css">
</HEAD>
<!--
Last Modified By: Jyothi Nagaraj
Modified Date:	  11/20/2007
Details:		  Added TH tag to fix WCAG 5.1 violation

-->
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<html>
<head>
	<title>Federal Customers Instant Registration</title>
</head>
<body>


<script type="text/javascript">
  var wmNotice = "UNT Web Archive - External links, forms, and search boxes may not function within this collection. Url: https://nitaac.nih.gov/SubmitUserRegInfo.asp?ConType=ECS3 time: 21:22:41 Jan 30, 2009";
  var wmHideNotice = "hide";
  var contextRoot = "https://webarchive.library.unt.edu/eot2008/";
</script>
<script type="text/javascript" src="https://webarchive.library.unt.edu/eot2008/js/disclaim.js"></script>


<table width="100%" border="0" cellspacing="0" cellpadding="0" align="center">
<tr><th></th></tr>
<tr>
	<td width="20%" align="left"><img src="Images/img.topgraphic.gif" width=275 height=40 border=0 alt="National Institute of Health Information Technology Acquisition and Assessment Center" title="National Institute of Health Information Technology Acquisition and Assessment Center"></td>
	<td width="21%" align="left" valign="bottom" bgcolor="#003366">&nbsp;&nbsp;&nbsp;&nbsp;<font color="white" size="2"><b></b></font></td>
	<td width="33%" bgcolor="#003366">&nbsp;</td>
	<td bgcolor="#003366" align="center" width="20%"><font face="verdana" color="white" size="-2"><b>&nbsp;Friday, January 30, 2009</b></font><br><font face="verdana" color="white" size="-2"><b>Customer Registration</b></font><!--- &nbsp;<font face="verdana" color="white" size="-2"> ---></td>
</tr>
</table>
</body>
</html>

<BODY TEXT="#000000"  LINK="#000066" VLINK="#006699" ALINK="#0066FF" TOPMARGIN=0 LEFTMARGIN=1 MARGINWIDTH=0 MARGINHEIGHT=0 onLoad="hideAll();setFocus()">
<div id="overDiv" style="position:absolute; visibility:hidden; z-index:1000;"></div>
<form name="UserReg" action="ScriptSubmitUserRegInfo.asp" method="post" onSubmit="alert();return validateInput(UserReg, 'uetutpuuuuutttuttnt');"><br>

<!-- Test the character content of the string passed in the URL to insure no cross-site injections --->
<input type=hidden name="contract" value=ECS3>

<script language="JavaScript">

// Test the URL field

if (!validateTextInput (UserReg.contract.value)) {
   var MYMESSAGE = "The query string  contains one or more restricted characters.  Please contact the Webmaster.";
   location.href = "main_delay.asp?DELAY_MESSAGE=" + MYMESSAGE + "&REDIRECT_URL=ecs3home.asp"
}
</script>
<noscript>Your browser does not support JavaScript!</noscript>
<table border="1" cellpadding="0" cellspacing="0" width="85%" align="center" class="whitetext1">
<tr>
<th align="left" class="unnamed7" colspan="2">Note: All Fields marked (*) are Mandatory.</th>
</tr>
<tr>
   <td align="center" class="unnamed5" colspan="2">Federal Customer Instant Registration Form</td>
</tr>


<tr>
<td>
<table width="100%" border="0" cellpadding="0" cellspacing="0" align="center">
   <tr><th>&nbsp;</th></tr>
   <tr>
      <td align="right" nowrap class="whitetext1"><label for="usrname">*E-mail(UserName):</label><br>(eg. customer@od.nih.gov)</td>
      <td align="left"><input type="Text" id="usrname" name="email" size="32" maxlength="50" tabindex="1" class="textboxfld" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="lname">*Last Name</label>:</td>
      <td class="whitetext1"><input class="textboxfld" id="lname" type="Text" name="lastname" size="21" tabindex="2" onChange="validatelastname(document.UserReg.lastname.value)" value="">&nbsp;<label for="mname">M.I.</label>&nbsp;<input class="textboxfld" id="mname" type="Text" name="middlename" size="5" maxlength="1" tabindex="3" onChange="validatemiddlename(document.UserReg.middlename.value)" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="fname">*First Name:</label></td>
      <td><input type="Text" class="textboxfld" id="fname" name="firstname" size="32" tabindex="4" onChange="validatefirstname(document.UserReg.firstname.value)" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="phone">*Phone:</label></td>
      <td class="whitetext1"><input  class="textboxfld" id="phone" type="Text" name="phone" size="18" tabindex="5" value="" onChange="this.value=phoneformat(this.value)">&nbsp;<label for="ext">Ext:</label>&nbsp;&nbsp;<input type="Text" class="textboxfld" id="ext" name="ext" size="8" tabindex="6" onChange="validateExt(document.UserReg.ext.value)" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="fax">Fax:</label></td>
      <td><input type="Text" name="fax" class="textboxfld" id="fax" size="18" tabindex="7" onChange="this.value=faxformat(this.value)" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="intphone">International Phone:</label></td>
      <td><input type="Text" class="textboxfld" name="Intphone" id="intphone" size="18" tabindex="8" onChange="validateIntNumber(document.UserReg.Intphone.value)" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="nihempl">Are you NIH Employee:</label></td>
      <td><input type="checkbox" id="nihempl" name="NihEmp" value="Y" tabindex="9" onClick="check4nihEmp()" onKeyPress="check4nihEmp()" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="contoff">Are you Contracting Officer:</label></td>
      <td><input type="checkbox" id="contoff" name="ConOfficer" value="Y" tabindex="10" value=""></td>
   </tr>
   <!--- <tr><td>&nbsp;</td></tr> --->
</table>
</td>
<td>
<table border="0" cellpadding="0" cellspacing="0" align="center" width="100%">
   <tr><th>&nbsp;</th></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="agency">*Company/Agency:</label></td>
      <td><input type="Text" class="textboxfld" id="agency" name="company" maxlength="95" size="32" tabindex="12" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="offi">*Office:</label></td>
      <td align="left"><input type="Text" class="textboxfld" id="offi" name="office" size="32" tabindex="13" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="add1">*Address1:</label></td>
      <td align="left"><input type="Text" class="textboxfld" id="add1" name="address1" size="32" tabindex="14" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="add2">Address2:</label></td>
      <td align="left"><input type="Text" class="textboxfld" id="add2" name="address2" size="32" tabindex="15" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   <tr>
      <td align="right" class="whitetext1"><label for="city">*City:</label></td>
      <td align="left"><input type="Text" class="textboxfld" id="city" name="city" size="20" tabindex="16" value=""></td>
   </tr>
   <tr><td>&nbsp;</td></tr>
   </tr>

   <!--- Assign the recordset values to the select box. --->
   <tr>
      <td align="right" class="whitetext1"><label for="state">*State:</label></td>
      <td align="left"><select name="state" id="state" class="selectlist1" tabindex="17">
      <option selected>Choose State...</option>
      
      <Option value="AA(Armed Forces Americas)"
        >
                AA(Armed Forces Americas)
      <Option value="AE(Armed Forces Europe)"
        >
                AE(Armed Forces Europe)
      <Option value="Alabama"
        >
                Alabama
      <Option value="Alaska"
        >
                Alaska
      <Option value="AP(Armed Forces Pacific)"
        >
                AP(Armed Forces Pacific)
      <Option value="Arizona"
        >
                Arizona
      <Option value="Arkansas"
        >
                Arkansas
      <Option value="California"
        >
                California
      <Option value="Colorado"
        >
                Colorado
      <Option value="Connecticut"
        >
                Connecticut
      <Option value="Delaware"
        >
                Delaware
      <Option value="District of Columbia"
        >
                District of Columbia
      <Option value="Florida"
        >
                Florida
      <Option value="Georgia"
        >
                Georgia
      <Option value="Guam"
        >
                Guam
      <Option value="Hawaii"
        >
                Hawaii
      <Option value="Idaho"
        >
                Idaho
      <Option value="Illinois"
        >
                Illinois
      <Option value="Indiana"
        >
                Indiana
      <Option value="Iowa"
        >
                Iowa
      <Option value="Kansas"
        >
                Kansas
      <Option value="Kentucky"
        >
                Kentucky
      <Option value="Louisiana"
        >
                Louisiana
      <Option value="Maine"
        >
                Maine
      <Option value="Maryland"
        >
                Maryland
      <Option value="Massachusetts"
        >
                Massachusetts
      <Option value="Michigan"
        >
                Michigan
      <Option value="Minnesota"
        >
                Minnesota
      <Option value="Mississippi"
        >
                Mississippi
      <Option value="Missouri"
        >
                Missouri
      <Option value="Montana"
        >
                Montana
      <Option value="Nebraska"
        >
                Nebraska
      <Option value="Nevada"
        >
                Nevada
      <Option value="New Hampshire"
        >
                New Hampshire
      <Option value="New Jersey"
        >
                New Jersey
      <Option value="New Mexico"
        >
                New Mexico
      <Option value="New York"
        >
                New York
      <Option value="North Carolina"
        >
                North Carolina
      <Option value="North Dakota"
        >
                North Dakota
      <Option value="Ohio"
        >
                Ohio
      <Option value="Oklahoma"
        >
                Oklahoma
      <Option value="Oregon"
        >
                Oregon
      <Option value="Pennsylvania"
        >
                Pennsylvania
      <Option value="Puerto Rico"
        >
                Puerto Rico
      <Option value="Rhode Island"
        >
                Rhode Island
      <Option value="South Carolina"
        >
                South Carolina
      <Option value="South Dakota"
        >
                South Dakota
      <Option value="Tennessee"
        >
                Tennessee
      <Option value="Texas"
        >
                Texas
      <Option value="Utah"
        >
                Utah
      <Option value="Vermont"
        >
                Vermont
      <Option value="Virginia"
        >
                Virginia
      <Option value="Washington"
        >
                Washington
      <Option value="West Virginia"
        >
                West Virginia
      <Option value="Wisconsin"
        >
                Wisconsin
      <Option value="Wyoming"
        >
                Wyoming
      </select></td>
      
   </tr>
   <tr><td>&nbsp;</td>
   <tr>
      <td align="right" class="whitetext1"><label for="zip">*Zip:</label></td>
      <td align="left"><input type="Text" class="textboxfld" id="zip" name="zip" size="5" tabindex="18" maxlength="5" value=""></td>
   </tr>

   <tr>
      <td>&nbsp;</td>
   </tr>
   <tr>
      <td align="right" class="whitetext1"><label for="dept">*Department:</label></td>
      <td><select STYLE="WIDTH:350PX" id="dept" name="Department" class="selectlist1" tabindex="19">
      <option selected>Choose Department...</option>
      
       <OPTION VALUE="ADMINISTRATION FOR CHILDREN AND FAMILIES/DHHS"
        >
                ADMINISTRATION FOR CHILDREN AND FAMILIES/DHHS
       <OPTION VALUE="ADMINISTRATION ON AGING/DHHS"
        >
                ADMINISTRATION ON AGING/DHHS
       <OPTION VALUE="AGENCY FOR HEALTH CARE POLICY AND RESEARCH/DHHS"
        >
                AGENCY FOR HEALTH CARE POLICY AND RESEARCH/DHHS
       <OPTION VALUE="AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY/DHHS"
        >
                AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY/DHHS
       <OPTION VALUE="CENTERS FOR DISEASE CONTROL/DHHS"
        >
                CENTERS FOR DISEASE CONTROL/DHHS
       <OPTION VALUE="CENTERS FOR MEDICARE AND MEDICAID SERVICES"
        >
                CENTERS FOR MEDICARE AND MEDICAID SERVICES
       <OPTION VALUE="CENTRAL INTELLIGENCE AGENCY"
        >
                CENTRAL INTELLIGENCE AGENCY
       <OPTION VALUE="COMMODITY FUTURES TRADING COMMISSION"
        >
                COMMODITY FUTURES TRADING COMMISSION
       <OPTION VALUE="CORPORATION FOR NATIONAL SERVICE"
        >
                CORPORATION FOR NATIONAL SERVICE
       <OPTION VALUE="DEPARMENT OF AGRICULTURE"
        >
                DEPARMENT OF AGRICULTURE
       <OPTION VALUE="DEPARTMENT OF COMMERCE"
        >
                DEPARTMENT OF COMMERCE
       <OPTION VALUE="DEPARTMENT OF EDUCATION"
        >
                DEPARTMENT OF EDUCATION
       <OPTION VALUE="DEPARTMENT OF ENERGY"
        >
                DEPARTMENT OF ENERGY
       <OPTION VALUE="DEPARTMENT OF HOMELAND SECURITY"
        >
                DEPARTMENT OF HOMELAND SECURITY
       <OPTION VALUE="DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT"
        >
                DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
       <OPTION VALUE="DEPARTMENT OF JUSTICE"
        >
                DEPARTMENT OF JUSTICE
       <OPTION VALUE="DEPARTMENT OF LABOR"
        >
                DEPARTMENT OF LABOR
       <OPTION VALUE="DEPARTMENT OF STATE"
        >
                DEPARTMENT OF STATE
       <OPTION VALUE="DEPARTMENT OF THE INTERIOR"
        >
                DEPARTMENT OF THE INTERIOR
       <OPTION VALUE="DEPARTMENT OF TRANSPORTATION"
        >
                DEPARTMENT OF TRANSPORTATION
       <OPTION VALUE="DEPARTMENT OF TREASURY"
        >
                DEPARTMENT OF TREASURY
       <OPTION VALUE="DEPARTMENT OF VETERANS AFFAIRS"
        >
                DEPARTMENT OF VETERANS AFFAIRS
       <OPTION VALUE="DISTRICT OF COLUMBIA"
        >
                DISTRICT OF COLUMBIA
       <OPTION VALUE="ENVIRONMENTAL PROTECTION AGENCY"
        >
                ENVIRONMENTAL PROTECTION AGENCY
       <OPTION VALUE="EQUAL EMPLOYMENT OPPORTUNITY COMMISSION"
        >
                EQUAL EMPLOYMENT OPPORTUNITY COMMISSION
       <OPTION VALUE="FEDERAL BUREAU of INVESTIGATION"
        >
                FEDERAL BUREAU of INVESTIGATION
       <OPTION VALUE="FEDERAL COMMUNICATIONS COMMISSION"
        >
                FEDERAL COMMUNICATIONS COMMISSION
       <OPTION VALUE="FEDERAL DEPOSIT INSURANCE CORPORTATION"
        >
                FEDERAL DEPOSIT INSURANCE CORPORTATION
       <OPTION VALUE="FEDERAL ELECTION COMMISSION"
        >
                FEDERAL ELECTION COMMISSION
       <OPTION VALUE="FEDERAL EMERGENCY MANAGEMENT AGENCY"
        >
                FEDERAL EMERGENCY MANAGEMENT AGENCY
       <OPTION VALUE="FEDERAL HIGHWAY ADMINISTRATION"
        >
                FEDERAL HIGHWAY ADMINISTRATION
       <OPTION VALUE="FEDERAL JUDICIAL CENTER"
        >
                FEDERAL JUDICIAL CENTER
       <OPTION VALUE="FEDERAL MARITIME COMMISSION"
        >
                FEDERAL MARITIME COMMISSION
       <OPTION VALUE="FEDERAL RESERVE SYSTEM"
        >
                FEDERAL RESERVE SYSTEM
       <OPTION VALUE="FEDERAL TRADE COMMISSION"
        >
                FEDERAL TRADE COMMISSION
       <OPTION VALUE="FOOD AND DRUG ADMINISTRATION/DHHS"
        >
                FOOD AND DRUG ADMINISTRATION/DHHS
       <OPTION VALUE="GENERAL SERVICES ADMINISTRATION"
        >
                GENERAL SERVICES ADMINISTRATION
       <OPTION VALUE="GOVERNMENT ACCOUNTING OFFICE"
        >
                GOVERNMENT ACCOUNTING OFFICE
       <OPTION VALUE="GOVERNMENT PRINTING OFFICE"
        >
                GOVERNMENT PRINTING OFFICE
       <OPTION VALUE="HEALTH CARE FINANCING ADMINISTRATION/DHHS"
        >
                HEALTH CARE FINANCING ADMINISTRATION/DHHS
       <OPTION VALUE="HEALTH RESOURCES AND SERVICES ADMINISTRATION/DHHS"
        >
                HEALTH RESOURCES AND SERVICES ADMINISTRATION/DHHS
       <OPTION VALUE="INDIAN HEALTH SERVICE/DHHS"
        >
                INDIAN HEALTH SERVICE/DHHS
       <OPTION VALUE="INTERNAL REVENUE SERVICE"
        >
                INTERNAL REVENUE SERVICE
       <OPTION VALUE="LIBRARY OF CONGRESS"
        >
                LIBRARY OF CONGRESS
       <OPTION VALUE="NATIONAL AERONAUTICS AND SPACE ADMINISTRATION"
        >
                NATIONAL AERONAUTICS AND SPACE ADMINISTRATION
       <OPTION VALUE="NATIONAL ARCHIVES AND RECORDS ADMINISTRATION"
        >
                NATIONAL ARCHIVES AND RECORDS ADMINISTRATION
       <OPTION VALUE="NATIONAL CREDIT UNION ADMINISTRATION"
        >
                NATIONAL CREDIT UNION ADMINISTRATION
       <OPTION VALUE="NATIONAL IMAGERY AND MAPPING AGENCY/DEPARTMENT OF DEFENSE"
        >
                NATIONAL IMAGERY AND MAPPING AGENCY/DEPARTMENT OF DEFENSE
       <OPTION VALUE="NATIONAL INSTITUTES OF HEALTH/DHHS"
        >
                NATIONAL INSTITUTES OF HEALTH/DHHS
       <OPTION VALUE="NATIONAL SCIENCE FOUNDATION"
        >
                NATIONAL SCIENCE FOUNDATION
       <OPTION VALUE="NATIONAL SECURITY AGENCY"
        >
                NATIONAL SECURITY AGENCY
       <OPTION VALUE="NUCLEAR REGULATORY COMMISSION"
        >
                NUCLEAR REGULATORY COMMISSION
       <OPTION VALUE="OFFICE OF MANAGEMENT AND BUDGET"
        >
                OFFICE OF MANAGEMENT AND BUDGET
       <OPTION VALUE="OFFICE OF PERSONNEL MANAGEMENT"
        >
                OFFICE OF PERSONNEL MANAGEMENT
       <OPTION VALUE="OFFICE OF THE SECRETARY/DHHS"
        >
                OFFICE OF THE SECRETARY/DHHS
       <OPTION VALUE="OTHER FEDERAL OFFICES"
        >
                OTHER FEDERAL OFFICES
       <OPTION VALUE="OTHER/DEPARTMENT OF DEFENSE"
        >
                OTHER/DEPARTMENT OF DEFENSE
       <OPTION VALUE="OTHERS/DHHS"
        >
                OTHERS/DHHS
       <OPTION VALUE="PENSION BENEFIT GUARANTRY CORPORATION"
        >
                PENSION BENEFIT GUARANTRY CORPORATION
       <OPTION VALUE="PROGRAM SUPPORT CENTER/DHHS"
        >
                PROGRAM SUPPORT CENTER/DHHS
       <OPTION VALUE="SECURITIES AND EXCHANGE COMMISSION"
        >
                SECURITIES AND EXCHANGE COMMISSION
       <OPTION VALUE="SMALL BUSINESS ADMINISTRATION"
        >
                SMALL BUSINESS ADMINISTRATION
       <OPTION VALUE="SMITHSONIAN INSTITUTION"
        >
                SMITHSONIAN INSTITUTION
       <OPTION VALUE="SOCIAL SECURITY ADMINISTRATION"
        >
                SOCIAL SECURITY ADMINISTRATION
       <OPTION VALUE="SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION/DHHS"
        >
                SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION/DHHS
       <OPTION VALUE="THE WHITE HOUSE OFFICE"
        >
                THE WHITE HOUSE OFFICE
       <OPTION VALUE="U.S.AIR FORCE/DEPARTMENT OF DEFENSE"
        >
                U.S.AIR FORCE/DEPARTMENT OF DEFENSE
       <OPTION VALUE="U.S.ARMY/DEPARTMENT OF DEFENSE"
        >
                U.S.ARMY/DEPARTMENT OF DEFENSE
       <OPTION VALUE="U.S.HOLOCAUST MUSEUM"
        >
                U.S.HOLOCAUST MUSEUM
       <OPTION VALUE="U.S.HOUSE OF REPRESENTATIVES"
        >
                U.S.HOUSE OF REPRESENTATIVES
       <OPTION VALUE="U.S.MARINES/DEPARTMENT OF DEFENSE"
        >
                U.S.MARINES/DEPARTMENT OF DEFENSE
       <OPTION VALUE="U.S.NAVY/DEPARTMENT OF DEFENSE"
        >
                U.S.NAVY/DEPARTMENT OF DEFENSE
       <OPTION VALUE="U.S.SENATE"
        >
                U.S.SENATE
       <OPTION VALUE="UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT"
        >
                UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
       <OPTION VALUE="UNITED STATES COURTS"
        >
                UNITED STATES COURTS
       <OPTION VALUE="UNITED STATES INFORMATION AGENCY"
        >
                UNITED STATES INFORMATION AGENCY
       <OPTION VALUE="UNITED STATES POSTAL SERVICE"
        >
                UNITED STATES POSTAL SERVICE
       <OPTION VALUE="UNITED STATES SENTENCING COMMISSION"
        >
                UNITED STATES SENTENCING COMMISSION
      </select></td>
      
   </tr>
</table>
</td>
</tr>
<tr>

<table border="1" cellpadding="0" cols="3" cellspacing="0" align="center" width="85%" class="whitetext1">
   <tr><th></th></tr>
   <tr>
   <td width="24%"><label for="aus">*How did you hear about NITAAC?</label></td>
   <td width="21%">
      <select STYLE="WIDTH:178PX" id="aus" name="aboutus" class="selectlist1" tabindex="11" onchange="{if(this.value=='Other'){switchDiv('div2')}  else{hideAll()}};">
      <option value="CO" selected>Choose one</option>
      <option value="Contractor website">Contractor website</option>
      <option value="NITAAC marketing team">NITAAC marketing team</option>
      <option value="IT publication">IT publication</option>
      <option value="Trade show">Trade show</option>
      <option value="NITAAC staff">NITAAC staff</option>
      <option value="Other"><label for="aboutotr">Other</label></option>
   </td>
   <td align="center">
      <div id="div2" STYLE="display: block">
         <input type="Text" maxlength="100" value="Enter Other option here." class="temptext" id="aboutotr" name="aboutotr" STYLE="WIDTH:450PX" onchange="this.value = RTrim(LTrim(this.value));ale(this.value);" onclick="clr();" onKeyPress="clr();">
      </div>
   </td>
   </tr>
</table>

</tr>
</table>

<br>
<table width="85%" border="0" align="center">
   <tr>
      <th align="center" class="unnamed9" valign="bottom" width="97%"><label for="btnuser">Click button only once</label></th>
      <td>&nbsp;</td>
   <tr>
      <td align="center" width="97%"><input type="button" id="btnuser" class="buttonfld" Value="Register New User" name="user" tabindex="20" onclick="chksry(this.form);" onKeyPress="chksry(this.form);"></td>
      <td align="right" width="3%"><a href="prelogin.asp?ConType=ECS3"><img src="Images/backblue.jpg" width=90 height=30 border=0 alt="Back to Previous Page" title="Back to Previous Page"></a></td>
   </tr>
</table>

</form>
</body>
</html>


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