<% t1 = Request.Form ("T1") t2 = Request.Form ("T2") t5 = Request.Form ("T5") t6 = Request.Form ("T6") t7 = Request.Form ("T7") t8 = Request.Form ("T8") t9 = Request.Form ("T9") t10 = Request.Form ("T10") t11 = Request.Form ("T11") t12 = Request.Form ("T12") t13 = Request.Form ("T13") t14 = Request.Form ("T14") %>  

 

 

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 About your PANASYSTEM.COM account
In order To Purchase any item you need to register
 Your account allows you to personalize PANASYSTEM.COM to meet your needs and shopping. In addition to tracking your recent order . Creating an account is easy, free and there's no obligation of any kind. The address you provide shortens your checkout process. Your information is safe with us and your privacy is protected.

Remember, fields marked with * are required.
 

*Your e-mail :

<% if t1="" then yuuu="yourname@email.com" else yuuu = t1 %>   (As User name)

*Re-enter e-mail :
Password :

We send to you a auto generated password and you may change it later easily.
       
*First name :

*Last name:

To avoid delays with your order, make sure this is the address where your credit card statement is sent.

 Make sure your shipping address matches with your credit card Billing address

If you pay By paypal, Your shipping Address has to match with your paypal address.
*Street address : 250 CHAR
*City/Town :

*State/Province :

 Only for USA.
*Zip/Postal code :

*Country :
*Phone :
<% if t10="" then yuuu="" else yuuu = t10 %>(Note: You will only be called for order-related issues.)

Fax :
<% if t11="" then yuuu="" else yuuu = t11 %>
     
     
Type the 8 characters you see in the picture:  

<% lo = 1 up =15 randomize timer fty=Int((up - lo + 1) * Rnd + lo) %>


I Agree.