<?php
$page_title = "New Agent Registration";
include_once('template/base_head.php');
?>
			<!-- サイドバー -->
			<aside id="colLeft">
				<h1><a href=""><img src="../img/logo.png" alt="iWallet"></a></h1>
				<div class="aside-heading">
					&nbsp;
				</div>
				&nbsp;
			</aside>
			<!-- /サイドバー -->
			<!-- メインカラム -->
			<div id="colMain">
				<div class="mainIn">
<?php include_once('template/base_nav.php'); ?>
					<article>
						<div class="article-heading">
							<h2><?php echo $page_title; ?></h2>
						</div>
						<?php $this -> echoMessage(); ?>
						<form id="acForm" action="" method="post">
							<p class="calign mb20">Please enter the account number you want to add.<br></p>
							<p class="calign">
								Account Number：
								<input type="text" name="user_account" value="<?php $this -> echoUserAccount(); ?>" class="px150">&nbsp;
								<input type="button" id="btnNext" value="Next" class="btn bg-grad px80 hi25">
							</p>
							<input type="hidden" value="" id="type" name="type" />

							<!-- Language Transition Data (Anton) 04/22/2016 -->
							<input class="lang-trans-data" type="hidden" id="lang_data_action" value="/agent"/>
							<input class="lang-trans-data" type="hidden" id="lang_data_type" value="action"/>
							<input class="lang-trans-data" type="hidden" id="lang_data_form" value="#acForm"/>
							<!-- /Language Transition Data -->
						</form>
					</article>
				</div>
			</div>
			<!-- /メインカラム -->
		</div>
<?php include_once('template/base_foot.php'); ?>
	</div>
	<script src="../js/agent.js"></script>
</body>
</html>
