{js:artTemplate}
{js:areaSelect}

<div class="wrapper clearfix">
	<div class="wrap_box">
		<div id="fp_form">
			<h3 class="notice">申请加盟商户</h3>
			<p class="tips">加入我们的电商平台，成为我们的供应商，一起共创美好未来</p>
			<div class="box">
				<form action="{url:/simple/seller_reg}" method="post" enctype='multipart/form-data' name="sellerForm">
					<table class="form_table">
						<colgroup>
							<col width="300px" />
							<col />
						</colgroup>

						<tbody>
							<tr>
								<th>登陆用户名：</th>
								<td><input class="normal" name="seller_name" type="text" value="" pattern="required" alt="用户名不能为空" /><label>* 用户名称（必填）</label></td>
							</tr>
							<tr>
								<th>密码：</th><td><input class="normal" name="password" type="password" bind='repassword' pattern="required" /><label>* 登录密码</label></td>
							</tr>
							<tr>
								<th>确认密码：</th><td><input class="normal" name="repassword" type="password" bind='password' pattern="required" /><label>* 重复确认密码</label></td>
							</tr>
							<tr>
								<th>商户真实全称：</th>
								<td><input class="normal" name="true_name" type="text" value="" pattern="required" /></td>
							</tr>
							<tr>
								<th>商户资质材料：</th>
								<td>
									<input type='file' name='paper_img' />
								</td>
							</tr>
							<tr>
								<th>固定电话：</th>
								<td><input type="text" class="normal" name="phone" pattern="phone" /><label>* 固定电话联系方式，如：010-88888888</label></td>
							</tr>
							<tr>
								<th>手机号码：</th>
								<td><input type="text" class="normal" name="mobile" pattern="mobi" /><label>* 移动电话联系方式：如：13000000000</label></td>
							</tr>
							<tr>
								<th>邮箱：</th>
								<td><input type="text" class="normal" name="email" pattern="email" /><label>* 电子邮箱联系方式：如：aircheng@163.com</label></td>
							</tr>
							<tr>
								<th>地区：</th>
								<td>
									<select name="province" child="city,area"></select>
									<select name="city" child="area"></select>
									<select name="area"></select>
								</td>
							</tr>
							<tr>
								<th>详细地址：</th><td><input class="normal" name="address" type="text" empty value="" /></td>
							</tr>
							<tr>
								<th>企业官网：</th>
								<td><input class="normal" name="home_url" type="text" pattern="url" empty value="" /><label>填写完整的网址，如：http://zwshop.ds-bay.com</label></td>
							</tr>
							<tr>
								<td></td>
								<td>
									<input class="submit" type="submit" value="申请加盟" />
								</td>
							</tr>
						</tbody>
					</table>
				</form>
			</div>
		</div>
	</div>
</div>

<script type="text/javascript">
var areaInstance = new areaSelect('province');
areaInstance.init();
</script>