<tr>
<td align="right"><span class="required">*</span>Confirm Password:</td>
<td align="left"><input name="confirmpassword" type="password" class="textfield" id="confirmpassword" value="" maxlength="20"></td>
</tr>
<tr>
<td align="right"><span class="required">*</span>Total # of ACL Nodes:</td>
<td align="left"><input name="tot_acl_nodes" type="text" class="textfield numeric" id="tot_acl_nodes" value="5" maxlength="2"></td>
</tr>
<tr>
<td align="right"><span class="required">*</span>Total # of SIP Accounts:</td>
<td align="left"><input name="tot_sip_acc" type="text" class="textfield numeric" id="tot_sip_acc" value="5" maxlength="5"></td>
</tr>
<tr>
<td align="right"><span class="required">*</span> SIP IP:</td>
<td align="left"><select name="sip_ip[]" id="sip_ip" class="textfield" multiple="multiple" size="5">
<?php echo get_all_sip_ips(); ?>
</select></td>
</tr>
<tr>
<td align="right"> </td>
<td align="left"><input type="checkbox" value="Y" name="email_check" id="email_check">
Email this Information to Customer</td>
</tr>
</tbody>
</table></td>
</tr>
<?php }?>
<tr>
<td align="right" colspan="2"> </td>
</tr>
<tr>
<tbody>
<tr>
<td align="right" width="45%"><span class="required">*</span> Username:</td>
<td align="left" width="55%"><input type="text" name="username" id="username" maxlength="50" class="textfield" value="<?php echo $row->username;?>"></td>
<input type="hidden" name="old_username" id="old_username" value="<?php echo $row->username;?>" />
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> Password:</td>
<td align="left" width="55%"><input type="password" name="password" id="password" maxlength="50" class="textfield"></td>
</tr>
<tr>
<td align="right"><span class="required">*</span> SIP IP:</td>
<td align="left">
<select name="sip_ip" id="sip_ip" class="textfield">
<?php echo get_all_sip_ips($row->domain); ?>
</select>
</td>
</tr>
<tr>
<td align="right" colspan="2"> </td>
</tr>
<tr>
<td align="center" colspan="2"><input border="0" id="submitaddSipAccessForm" type="image" src="<?php echo base_url();?>assets/images/btn-submit.png"></td>
</tr>
</tbody></table>
</form>
</td>