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<title>6to Coloquio Uruguayo de Matémática-Registro</title>
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<div class="sidebar">
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<div id="content">
<h1>Registrarse</h1>
<form id="registerform" action="register.php" method="post">
<div class="form_settings">
<p class="inline-input">
<span>Nombre</span>
<!--bel for="nombre" class="control-label">Nombre</label>-->
<input placeholder="Juan" name="nombre" type="text" class="form-control" id="nombre" required>
<label for="apellido" class="control-label">Apellido</label>
<input name="apellido" placeholder="Rodriguez" type="text" class="form-control" id="apellido" required>
</p>
<p class="inline-input">
<span>Documento:</span>
<select class="small" name="doctype" required id="doctype">
<option>Tipo:</option>
<option>C.I</option>
<option>PSP</option>
</select>
<label for="docnro" class="control-label">Nro.</label>
<input placeholder="Seleccione Tipo.. " type="text" id="txtdocnro" name="docnro" required>
</p>
<p>
<span>Dirección:</span>
<input name="dir" placeholder="18 de Julio 1544" type="text" name="dir" required>
</p>
<p class="inline-input">
<span>Pais: </span>
<!--<label for="pais" class="control-label">Pais</label>-->
<input placeholder="Uruguay" type="text" class="form-control" name="pais" required>
<label for="estado" class="control-label">Ciudad</label>
<input placeholder="Montevideo" type="text" name="ciudad" required>
</p>
<p><span>Teléfono:</span><input placeholder="099 123 456" class="contact" type="text" name="tel" required /></p>
<p><span>Email:</span><input placeholder="mail@example.com" class="contact" type="email" name="email" value="" required/></p>
<p><span>Profesión:</span><input placeholder="Profesor" class="contact" type="text" name="profesion" required/></p>
<p>
<span style="width:150px;">Precisa financiación?</span>
<label>Si</label><input type="radio" name="financiacion" value="si" id="sifinan"/>
<label>No</label><input type="radio" checked="True" name="financiacion" value="no" id="nofinan"/>
</p>
<br/>
<p id="detallefinan">
<span>Detalle, con estimación de costo:</span>
<textarea class="contact textarea" type="text" rows="8" cols="50" name="detallefinan"></textarea>
</p>
<p style="padding-top: 15px"><span> </span><input class="submit" type="submit" name="contact_submitted" value="submit" /></p>
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<div id="statusmsg" class="alert alert-success">
<strong>Success!</strong> Indicates a successful or positive action.
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