<?php 
$id_menu = 21;
include ("header.php"); 
?>
<!DOCTYPE HTML>
<html>
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
           
    <?php include ("common_in_head.php"); ?> 
           
</head>
<body>    
    <div class="container">

        <?php include('menu.php'); ?>
        
        <div class="content_holder">                
            
            <div class="gradient"></div>
            
            <div class="content_inner">
                <div class="resize_content" id="resize_content">
                    
                    <?php include('inc_top_images.php'); ?>
                        
                    <section class="content">
                        
                        <?php
	                    if (isset($_SESSION[$sessionName.'form_reply']))
	                    {
		                    $reply_flag = $_SESSION[$sessionName.'form_reply'];
		                    echo '<div class="message">';
			                    if ($reply_flag==1)
				                    echo $trans_form_nsReply[$lang];  
			                    else if ($reply_flag==2)
				                    echo $trans_formReply_email[$lang];  
			                    else if ($reply_flag==3)
				                    echo $trans_formReply_wrongCode[$lang];  
			                    else if ($reply_flag==4)
				                    echo $trans_formReply_notSent[$lang]; 
			                    else if ($reply_flag==5)
				                    echo $trans_form_nsReplyExist[$lang]; 
		                    echo '</div>';
	                    }
	                                
	                    $email = (isset($_GET['email'])) ? $_GET['email'] : '';
		                ?>
                        
                        <form id="NewsletterForm" action="<?php echo $websiteURL; ?>newsletter_submit.php" method="post">
    	                    <input type="hidden" name="back" value="<?php echo $websiteURL.$link_ext.$pagename; ?>" />
                            <input type="hidden" name="subject" value="<?php echo $websiteTitle." - ".$page_title; ?>" />
                            <input type="hidden" name="lang" value="<?php echo $lang; ?>" />
                            <input type="hidden" name="newsletter" value="yes" />
                            <input type="text" id="check" value="" style="display:none" />
                            
                            <div class="form"> 
                                                                                                           
                                <div class="left_col">
                                
                                    <header class="page_title">
                                        newsletter
                                        <div class="title_line"></div>
                                    </header> 
                                                               
                                    <div class="form_line">
                                        <label><?php echo remove_tonos($trans_form_Gender[$lang]) ?></label>
                                        <select name="Gender" class="select">
                                            <option value="Male"><?php echo do_uppercase($trans_form_Male[$lang]); ?></option>
                                            <option value="Female"><?php echo do_uppercase($trans_form_Female[$lang]); ?></option>
                                        </select>                                        
                                    </div>
                                    <div class="form_line">
                                        <label><?php echo remove_tonos($trans_form_FirstName[$lang]) ?> <span class="star">*</span></label>
                                        <input type="text" id="FirstName" name="First_name" value="" class="input required" />        
                                    </div>                                    
                                    <div class="form_line">
                                        <label><?php echo remove_tonos($trans_form_LastName[$lang]) ?> <span class="star">*</span></label>
                                        <input type="text" id="LastName" name="Last_name" value="" class="input required" />        
                                    </div>
                                    <div class="form_line">                               
                                        <label><?php echo remove_tonos($trans_form_Email[$lang]) ?> <span class="star">*</span></label>
                                        <input type="text" id="Email" name="Email" value="<?php echo $email; ?>" class="input email prefilled" />
                                    </div>
                                    <div class="form_line">
                                        <div class="form_line_small">
                                            <label><?php echo do_uppercase($trans_form_Country[$lang]); ?></label>
                                            <input type="text" id="Country" name="Country" value="" class="input_small" />        
                                        </div>
                                        <div class="form_line_small" style="margin: 0;">
                                            <label><?php echo do_uppercase($trans_form_Company[$lang]); ?></label>
                                            <input type="text" id="Company" name="Company" value="" class="input_small" />            
                                        </div>                                                                                
                                        <br clear="all"/>
                                    </div> 
                                    <div class="form_line">
                                        <div class="security_code">
                                            <label class="security_code_label"><abbr title="<?php echo $trans_form_spamMsg[$lang]; ?>"><?php echo do_uppercase($trans_form_Security_Code[$lang]); ?>  <span class="star">*</span></abbr></label>
                                            <img src="<?php echo $websiteURL; ?>RandomImage/RandomImage.php" alt="" />
                                        </div>
                                        <input type="text" id="Security_code" name="securitycode" value="" class="input_small required number" maxlength="5" />        
                                        <br clear="all"/>
                                    </div>
                               </div>
                               
                               <aside class="right_col newsletters_list">
                                    <?php include("inc_newsletters.php"); ?>
                               </aside>                        
                            
                                <br clear="all"/>
                            </div>                        
                            
                            <div class="submit_button">
                                <input type="button" value="<?php echo remove_tonos($trans_form_Submit[$lang]) ?>" onClick="check_form('NewsletterForm');" class="submit" />                                
                            </div>
                        </form>
                   
                    </section>

                </div>
                
                <?php include('footer.php'); ?>
                
            </div>                   
        </div>           
    </div>
</body>
</html>
<?php include ("bottom.php"); ?>