echo "<table border=0 width=100% align=center cellspacing=0 cellpadding=3>\n";
htmlp_form_action("insert.php", "", "POST");
echo "\n";
$username = $auth->auth["uname"];
htmlp_form_hidden("username", $username);
echo "<tr><td align=right width=30%>" . $t->translate("Username") . ":</td><td width=70%> {$username}\n";
echo "<tr><td align=right width=30%>" . $t->translate("Nationality") . ":</td><td width=70%>\n";
htmlp_select("nationality");
echo "\n";
select_country(999);
htmlp_select_end();
echo "</td></tr>\n";
echo "<tr><td align=right width=30%>" . $t->translate("Country you currently live in") . ":</td><td width=70%>\n";
htmlp_select("actual_country");
echo "\n";
select_country(999);
htmlp_select_end();
echo "</td></tr>\n";
echo "<tr><td align=right width=30%>" . $t->translate("Year of Birth") . ":</td><td width=70%>19<input type=\"TEXT\" name=\"year_of_birth\" size=3 maxlength=2></td></tr>\n";
echo "<tr><td align=right width=30%>" . $t->translate("Gender") . ":</td><td width=70%>\n";
echo "<center><table width=80% border=0>\n";
echo "<tr>";
$db3->query("SELECT * FROM gender");
while ($db3->next_record()) {
$selected = 0;
if ($db3->f("gendid") == 1) {
$selected = 1;
}
echo "<td width=26%>";
htmlp_radio("gender", $db3->f("gendid"), $selected);
echo " " . $t->translate($db3->f("gender")) . "\n";
</div> <div class="form-group"> <div class="col-xs-12"> <label for="textbox_address2" class="control-label control-label-sm">Address, line 2</label><br /> <input type="text" id="textbox_address2" name="address2" class="form-control form-control-sm" value="<?php echo $ADK_APPLICANT->address2; ?> " maxlength="40" pattern="[\w\d\s\.\,\']*" placeholder="Apt., Floor, etc." /> <span class="help-block with-errors"></span> </div> </div> <div class="form-group"> <div class="col-xs-12"> <label for="select_country" class="control-label control-label-sm">Country*</label><br /> <?php echo select_country($ADK_APPLICANT->country); ?> <span class="help-block with-errors"></span> </div> </div> <div class="form-group"> <div class="col-xs-12 col-sm-6"> <label for="textbox_city" class="control-label control-label-sm">City*</label><br /> <input type="text" id="textbox_city" name="city" class="form-control form-control-sm" value="<?php echo $ADK_APPLICANT->city; ?> " maxlength="40" placeholder="City" pattern="[\w\d\s\.\,\']*" required /> <span class="help-block with-errors"></span> </div> </div> <div class="form-group">
</div>
<div class="form-group">
<div class="col-xs-12">
<label for="textbox_address2" class="control-label control-label-sm">Address, line 2</label><br />
<input type="text" id="textbox_address2" name="address2" class="form-control form-control-sm" value="<?php
echo $ADK_HIKER->address2;
?>
" maxlength="40" pattern="[\w\d\s\.\,\']*" placeholder="Apt., Floor, etc." />
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-12">
<label for="select_country" class="control-label control-label-sm">Country*</label><br />
<?php
echo select_country($ADK_HIKER->country);
?>
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-12 col-sm-6">
<label for="textbox_city" class="control-label control-label-sm">City*</label><br />
<input type="text" id="textbox_city" name="city" class="form-control form-control-sm" value="<?php
echo $ADK_HIKER->city;
?>
" maxlength="40" placeholder="City" pattern="[\w\d\s\.\,\']*" required />
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<input type="text" id="textbox_address1" name="address1" class="form-control form-control-sm" maxlength="40" placeholder="123 xxx St." pattern="[\w\d\s\.\,\']*" required />
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-12">
<label for="textbox_address2" class="control-label control-label-sm">Address, line 2</label><br />
<input type="text" id="textbox_address2" name="address2" class="form-control form-control-sm" maxlength="40" pattern="[\w\d\s\.\,\']*" placeholder="Apt., Floor, etc." />
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-12">
<label for="select_country" class="control-label control-label-sm">Country*</label><br />
<?php
echo select_country('United States');
?>
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-12 col-sm-6">
<label for="textbox_city" class="control-label control-label-sm">City*</label><br />
<input type="text" id="textbox_city" name="city" class="form-control form-control-sm" maxlength="40" placeholder="City" pattern="[\w\d\s\.\,\']*" required />
<span class="help-block with-errors"></span>
</div>
</div>
<div class="form-group">
<div class="col-xs-6 col-sm-3">
<label id="label_select_state" for="select_state" class="control-label control-label-sm">State*</label><br />
<?php
$db->query("SELECT * from developers WHERE username='******'");
$db->next_record();
htmlp_form_hidden("username", $username);
echo "<tr><td align=right width=30%>" . $t->translate("Username") . ":</td><td width=70%> {$username}\n";
$nationality = $db->f("nationality");
echo "<tr><td align=right width=30%>" . $t->translate("Nationality") . ":</td><td width=70%>\n";
htmlp_select("nationality");
echo "\n";
select_country($nationality);
htmlp_select_end();
echo "</td></tr>\n";
$actual_country = $db->f("actual_country");
echo "<tr><td align=right width=30%>" . $t->translate("Country you currently live in") . ":</td><td width=70%>\n";
htmlp_select("actual_country");
echo "\n";
select_country($actual_country);
htmlp_select_end();
echo "</td></tr>\n";
$year_of_birth = $db->f("year_of_birth");
echo "<tr><td align=right width=30%>" . $t->translate("Year of Birth") . ":</td><td width=70%>19<input type=\"TEXT\" name=\"year_of_birth\" size=3 maxlength=2 value=\"{$year_of_birth}\"></td></tr>\n";
$gender = $db->f("gender");
echo "<tr><td align=right width=30%>" . $t->translate("Gender") . ":</td><td width=70%>\n";
echo "<center><table width=80% border=0>\n";
echo "<tr>";
$db3->query("SELECT * FROM gender");
while ($db3->next_record()) {
$selected = 0;
if ($db3->f("gendid") == $gender) {
$selected = 1;
}
echo "<td width=26%>";