
<td>
<TABLE align=center>

		<tr>
			<td> Login Id </td>
			<td><b>%s<b></td>
			<td>New Password </td>	
			<td><input type=password name=NewPassword maxlength=15 tabindex=2 %s></td>
		</tr>	

		<tr>			
			<td colspan=2>
				<input type=checkbox name=RO %s %s > Read Only <br>
				<input type=checkbox name=Active %s %s > Active <input type=checkbox name=Deleted %s %s > Deleted <br>
				<input type=checkbox name=Notify %s %s > Receive Alerts <br>
					Alert Messages: 
				<input type=radio name=NotifyMode value=none %s %s> None 
                                <input type=radio name=NotifyMode value=email %s %s> Email 
			</td>
			<td>Retype Password </td>	
			<td>
                                 <input type=password name=RePassword maxlength=15 %s>
			</td>	
		</tr>

		<tr>
			<td>
				First Name
			</td> 
			<td>
				<input type=text name=Firstname maxlength=15 value= "%s" %s tabindex=4>
			</td>
			<td>
				Last Name
			</td> 
			<td>
				<input type=text name=Lastname maxlength=15 value= "%s" %s tabindex=5>
			</td>
		</tr>
		<tr>
			<td>
				Street1
			</td> 
			<td>
				<input type=text name=Street1 maxlength=50 value= "%s" %s tabindex=6>
			</td>
			<td>
				Street2
			</td> 
			<td>
				<input type=text name=Street2 maxlength=50 value= "%s" %s tabindex=7>
			</td>
		</tr>	
		<tr>
			<td>
				City
			</td> 
			<td>
				<input type=text name=City maxlength=30 value="%s" %s>
			</td>
			<td>
				State
			</td> 
			<td>
				<input type=text name=State maxlength=2 size=4 value="%s" %s tabindex=9>
			</td>
		</tr>	
		<tr>
			<td>
				ZIP
			</td> 
			<td>
				<input type=text name=Zip maxlength=10 size=12 value="%s" %s tabindex=10>
			</td>
			<td>
				Country
			</td> 
			<td>
				<input type=text name=Country maxlength=15 value="%s" %s tabindex=11>
			</td>
		</tr>	
		<tr>
			<td>
				Home Phone
			</td> 
			<td>
				<input type=text name=Homephone maxlength=15 value="%s" %s tabindex=12>
			</td>
			<td>
				Work Phone
			</td> 
			<td>
				<input type=text name=Workphone maxlength=15 value="%s" %s tabindex=13>
			</td>
		</tr>	
		<tr>
			<td>
				Fax
			</td> 
			<td>
				<input type=text name=Fax maxlength=15 value="%s" %s tabindex=14>
			</td>
			
			<td>
				E-Mail
			</td> 
			<td>
				<input type=text name=Email maxlength=50 value="%s" %s tabindex=15>
			</td>
		</tr>	
		<tr>
			<td>
				Mobile
			</td> 
			<td>
				<input type=text name=Mobile maxlength=15 value="%s" %s  tabindex=16>
 			</td>
			<td>
				Pager
			</td> 
			<td>
				<input type=text name=Pager maxlength=15 value="%s" %s tabindex=17>
			</td>
		</tr>
		<tr>
			<td>
				Notes
			</td> 
			<td colspan=3>
				<textarea class=editusernotes rows=4 name=Notes tabindex=18 %s>%s</textarea>
			</td> 
		</tr>	

	</TABLE>
</td>

