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<title>6to Coloquio Uruguayo de Matémática</title>
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<div id="content" class="col-xs-12 col-sm-8">
<h1>Registrarse</h1>
<form id="registerform" action="register.php" method="post" class="form-horizontal">
<div class="form-group">
<label class="control-label col-sm-2" for="txtnombre">Nombre:</label>
<div class="col-sm-8">
<input id="txtnombre" class="form-control" name="nombre"
placeholder="Juan" type="text" pattern="^[a-zA-Z][a-zA-Z\s\-.'`áéíóú]*[a-zA-Z]$" required>
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<label class="control-label col-sm-2" for="txtapellido">Apellido:</label>
<div class="col-sm-8">
<input id="txtapellido" class="form-control" name="apellido"
placeholder="Perez" type="text" pattern="^[a-zA-Z][a-zA-Z\s\-.'`áéíóú]*[a-zA-Z]$" required>
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</div>
<!-- Selector de Documento mas nro-->
<div class="form-group row">
<label class="col-sm-2 control-label" for="txtdocnro">Documento:</label>
<div class="col-sm-8">
<div class="input-group">
<div class="input-group-btn">
<button id="btntipodoc" type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">Tipo <span class="caret"></span></button>
<ul id="tipodoc" class="dropdown-menu">
<li><a href="#">C.I.</a></li>
<li><a href="#">Otro</a></li>
<input id="txttipodoc" name="doctype" type="hidden">
</ul>
</div><!-- /btn-group -->
<input id="txtdocnro" name="docnro" class="form-control"
placeholder="Seleccione Tipo de Documento..." type="text" required>
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</div>
<div class="form-group row">
<label class="col-sm-2 control-label" for="txtdir">Pais:</label>
<div class="col-sm-2">
<button id="btnpais" type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">Pais <span class="caret"></span></button>
<ul id="lstpais" class="dropdown-menu">
<li><a href="#">Uruguay</a></li>
<li><a href="#">Alemania</a></li>
<li><a href="#">Austria</a></li>
<li><a href="#">Argentina</a></li>
<li><a href="#">Bolivia</a></li>
<li><a href="#">Brasil</a></li>
<li><a href="#">Canadá</a></li>
<li><a href="#">Chile</a></li>
<li><a href="#">Colombia</a></li>
<li><a href="#">Ecuador</a></li>
<li><a href="#">España</a></li>
<li><a href="#">Estados Unidos</a></li>
<li><a href="#">Francia</a></li>
<li><a href="#">Inglaterra</a></li>
<li><a href="#">Italia</a></li>
<li><a href="#">México</a></li>
<li><a href="#">Paraguay</a></li>
<li><a href="#">Perú</a></li>
<li><a href="#">Suiza</a></li>
<li><a href="#">Venezuela</a></li>
<li><a href="#">Otro</a></li>
</ul>
<input id="txtpais" name="pais" type="hidden">
</div>
<label class="col-sm-2 control-label" for="txtciudad">Ciudad:</label>
<div class="col-sm-4">
<input id="txtciudad" name="ciudad" class="form-control"
placeholder="Montevideo" type="text" required>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-2" for="txtdir">Direccion:</label>
<div class="col-sm-8">
<input id="txtdir" class="form-control" name="dir"
placeholder="18 de Julio 1432 apto 302" type="text" required>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-2" for="txtel">Telefono:</label>
<div class="col-sm-8">
<input id="txttel" class="form-control" name="tel"
placeholder="099123456" type="text" required>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-2" for="txtmail">Email:</label>
<div class="col-sm-8">
<input id="txtmail" class="form-control" name="email"
placeholder="mail@example.com" type="email" required>
</div>
</div>
<div class="form-group">
<label class="control-label col-sm-2" for="txtprof">Profesión:</label>
<div class="col-sm-8">
<input id="txtprof" class="form-control" name="profesion"
placeholder="Profesor, Docente o Estudiante, etc" type="text" pattern="[a-zA-Z]*" required>
</div>
</div>
<div class="form-group row">
<label class="col-sm-2 control-label" for="txttrabaja">Trabaja en:</label>
<div class="col-sm-8">
<button id="btntraba" type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">Pais <span class="caret"></span></button>
<ul id="lsttrabaja" class="dropdown-menu">
<li><a href="#">Primaria</a></li>
<li><a href="#">Secundaria</a></li>
<li><a href="#">Universidad</a></li>
<li><a href="#">UTU</a></li>
<li><a href="#">UTEC</a></li>
<li><a href="#">IPA/CERP</a></li>
<li><a href="#">Sector Privado</a></li>
<li><a href="#">Sector Público</a></li>
</ul>
<input id="txttrabaja" name="trabaja" type="hidden">
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<label class="control-label col-sm-2" for="rdfinan">Financiación?</label>
<div class="col-sm-8">
<label class="radio-inline"><input id="sifinan" type="radio" name="financiacion" value="si">Sí</label>
<label class="radio-inline"><input id="nofinan" type="radio" checked="true" name="financiacion" value="no">No</label>
</div>
</div>
<div id="detallefinan" class="form-group">
<label class="control-label col-sm-2" for="detallefinan">Detalle estimación de costo:</label>
<div class="col-sm-8">
<textarea class="form-control" name="detallefinan" row="10" style="height:200px;">
</textarea>
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<button type="submit" class="btn btn-primary">Registrar</button>
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<strong>Success!</strong> Indicates a successful or positive action.
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