document.write("")
document.write("<DIV class=\"demoreg_header\">")
document.write("")
document.write("</DIV>")
document.write("<style type=\"text/css\">")
document.write("<!--")
document.write("@import url(\"//templates.fxserver.com/IBMdemo/templates/form/default/style.css\");")
document.write("-->")
document.write("</style>")
document.write("<script type=\"text/javascript\" src=\"//templates.fxserver.com/IBMdemo/lib/fValidate/fValidate.config.js\"></script>")
document.write("<script type=\"text/javascript\" src=\"//templates.fxserver.com/IBMdemo/lib/fValidate/fValidate.core.js\"></script>")
document.write("<script type=\"text/javascript\" src=\"//templates.fxserver.com/IBMdemo/lib/fValidate/fValidate.lang-enUS.js\"></script>")
document.write("<script type=\"text/javascript\" src=\"//templates.fxserver.com/IBMdemo/lib/fValidate/fValidate.validators.js\"></script>")
document.write("<script type=\"text/javascript\" src=\"//templates.fxserver.com/IBMdemo/lib/fValidate/fValidate.controls.js\"></script>")
document.write("")
document.write("")
document.write("<form accept-charset=\"UTF-8\" name=\"form100\" id=\"2762481\" method=\"POST\" action=\"//templates.fxserver.com/IBMdemo/index.php\" onsubmit=\"return validateForm(this);\">")
document.write("<input type=\"hidden\" name=\"unit_id\" value=\"2762481\">")
document.write("<input type=\"hidden\" name=\"lang\" value=\"fre\">")
document.write("<input type=\"hidden\" name=\"form_lang\" value=\"fre\">")
document.write("<input type=\"hidden\" name=\"op\" value=\"PROCESS_FORM\">")
document.write("<table class=\"demoreg_blocktable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td class=\"demoreg_blocktitle\" colspan=2>Formulaire d'ouverture de compte de démonstration</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_content\">")
document.write("<div class=\"demoreg_break\">1. Informations personnelles</div>")
document.write("<table class=\"demoreg_formtable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Prénom:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"firstname\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\" alt=\"blank\" emsg=\"Please, enter your first name\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Nom de Famille:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"lastname\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\" alt=\"blank\" emsg=\"Please, enter your last name\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Adresse email:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"email\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\" alt=\"email\" emsg=\"Please, enter valid email\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Adresse email (encore):</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"email2\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\" alt=\"email\" emsg=\"Please, enter valid email for confirmation\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Téléphone:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"dayphone\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\" alt=\"blank\" emsg=\"Please, enter your dayphone\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Etat:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"state\" alt=\"select\" emsg=\"Please, select state\">")
document.write("<option value=''   selected>--</option>")
document.write("")
document.write("<option value=\"  \">Foreign/Unspecified</option>")
document.write("<option value=\"AL\">Alabama</option>")
document.write("<option value=\"AK\">Alaska</option>")
document.write("<option value=\"AZ\">Arizona</option>")
document.write("<option value=\"AR\">Arkansas</option>")
document.write("<option value=\"CA\">California</option>")
document.write("<option value=\"CO\">Colorado</option>")
document.write("<option value=\"CT\">Connecticut</option>")
document.write("<option value=\"DE\">Delaware</option>")
document.write("<option value=\"FL\">Florida</option>")
document.write("<option value=\"GA\">Georgia</option>")
document.write("<option value=\"HI\">Hawaii</option>")
document.write("<option value=\"ID\">Idaho</option>")
document.write("<option value=\"IL\">Illinois</option>")
document.write("<option value=\"IN\">Indiana</option>")
document.write("<option value=\"IA\">Iowa</option>")
document.write("<option value=\"KS\">Kansas</option>")
document.write("<option value=\"KY\">Kentucky</option>")
document.write("<option value=\"LA\">Louisiana</option>")
document.write("<option value=\"ME\">Maine</option>")
document.write("<option value=\"MD\">Maryland</option>")
document.write("<option value=\"MA\">Massachusetts</option>")
document.write("<option value=\"MI\">Michigan</option>")
document.write("<option value=\"MN\">Minnesota</option>")
document.write("<option value=\"MS\">Mississippi</option>")
document.write("<option value=\"MO\">Missouri</option>")
document.write("<option value=\"MT\">Montana</option>")
document.write("<option value=\"NE\">Nebraska</option>")
document.write("<option value=\"NV\">Nevada</option>")
document.write("<option value=\"NH\">New Hampshire</option>")
document.write("<option value=\"NJ\">New Jersey</option>")
document.write("<option value=\"NM\">New Mexico</option>")
document.write("<option value=\"NY\">New York</option>")
document.write("<option value=\"NC\">North Carolina</option>")
document.write("<option value=\"ND\">North Dakota</option>")
document.write("<option value=\"OH\">Ohio</option>")
document.write("<option value=\"OK\">Oklahoma</option>")
document.write("<option value=\"OR\">Oregon</option>")
document.write("<option value=\"PA\">Pennsylvania</option>")
document.write("<option value=\"PR\">Puerto Rico</option>")
document.write("<option value=\"RI\">Rhode Island</option>")
document.write("<option value=\"SC\">South Carolina</option>")
document.write("<option value=\"SD\">South Dakota</option>")
document.write("<option value=\"TN\">Tennessee</option>")
document.write("<option value=\"TX\">Texas</option>")
document.write("<option value=\"UT\">Utah</option>")
document.write("<option value=\"VT\">Vermont</option>")
document.write("<option value=\"VA\">Virginia</option>")
document.write("<option value=\"WA\">Washington</option>")
document.write("<option value=\"WV\">West Virginia</option>")
document.write("<option value=\"WI\">Wisconsin</option>")
document.write("<option value=\"WY\">Wyoming</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Pays:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"country\" alt=\"select\" emsg=\"Please, select country\">")
document.write("<option value=''   selected=\"selected\">--</option>")
document.write("")
document.write("<option value=\"AF\">Afghanistan</option>")
document.write("<option value=\"AL\">Albania</option>")
document.write("<option value=\"DZ\">Algeria</option>")
document.write("<option value=\"AS\">American Samoa</option>")
document.write("<option value=\"AD\">Andorra</option>")
document.write("<option value=\"AO\">Angola</option>")
document.write("<option value=\"AI\">Anguilla</option>")
document.write("<option value=\"AQ\">Antarctica</option>")
document.write("<option value=\"AG\">Antigua and Barbuda</option>")
document.write("<option value=\"AR\">Argentina</option>")
document.write("<option value=\"AM\">Armenia</option>")
document.write("<option value=\"AW\">Aruba</option>")
document.write("<option value=\"AC\">Ascension Island</option>")
document.write("<option value=\"AU\">Australia</option>")
document.write("<option value=\"AT\">Austria</option>")
document.write("<option value=\"AZ\">Azerbaijan</option>")
document.write("<option value=\"BS\">Bahamas</option>")
document.write("<option value=\"BH\">Bahrain</option>")
document.write("<option value=\"BD\">Bangladesh</option>")
document.write("<option value=\"BB\">Barbados</option>")
document.write("<option value=\"BY\">Belarus</option>")
document.write("<option value=\"BE\">Belgium</option>")
document.write("<option value=\"BZ\">Belize</option>")
document.write("<option value=\"BJ\">Benin</option>")
document.write("<option value=\"BM\">Bermuda</option>")
document.write("<option value=\"BT\">Bhutan</option>")
document.write("<option value=\"BO\">Bolivia</option>")
document.write("<option value=\"BA\">Bosnia and Herzegovina</option>")
document.write("<option value=\"BW\">Botswana</option>")
document.write("<option value=\"BV\">Bouvet Island</option>")
document.write("<option value=\"BR\">Brazil</option>")
document.write("<option value=\"IO\">British Indian Ocean Territory</option>")
document.write("<option value=\"BP\">British Possessions</option>")
document.write("<option value=\"VG\">British Virgin Islands</option>")
document.write("<option value=\"BN\">Brunei Darussalam</option>")
document.write("<option value=\"BG\">Bulgaria</option>")
document.write("<option value=\"BF\">Burkina Faso</option>")
document.write("<option value=\"BI\">Burundi</option>")
document.write("<option value=\"CM\">Cameroon</option>")
document.write("<option value=\"CA\">Canada</option>")
document.write("<option value=\"CV\">Cape Verde</option>")
document.write("<option value=\"KY\">Cayman Islands</option>")
document.write("<option value=\"CF\">Central African Republic</option>")
document.write("<option value=\"TD\">Chad</option>")
document.write("<option value=\"CL\">Chile</option>")
document.write("<option value=\"CN\">China</option>")
document.write("<option value=\"CX\">Christmas Island</option>")
document.write("<option value=\"CC\">Cocos (Keeling) Islands</option>")
document.write("<option value=\"CO\">Colombia</option>")
document.write("<option value=\"KM\">Comoros</option>")
document.write("<option value=\"CG\">Congo (Brazzaville)</option>")
document.write("<option value=\"CD\">Congo (Kinshasa)</option>")
document.write("<option value=\"CK\">Cook Islands</option>")
document.write("<option value=\"CR\">Costa Rica</option>")
document.write("<option value=\"HR\">Croatia</option>")
document.write("<option value=\"CU\">Cuba</option>")
document.write("<option value=\"CY\">Cyprus</option>")
document.write("<option value=\"CZ\">Czechy</option>")
document.write("<option value=\"DK\">Denmark</option>")
document.write("<option value=\"DJ\">Djibouti</option>")
document.write("<option value=\"DM\">Dominica</option>")
document.write("<option value=\"DO\">Dominican Republic</option>")
document.write("<option value=\"TP\">East Timor</option>")
document.write("<option value=\"EC\">Ecuador</option>")
document.write("<option value=\"EG\">Egypt</option>")
document.write("<option value=\"SV\">El Salvador</option>")
document.write("<option value=\"GQ\">Equatorial Guinea</option>")
document.write("<option value=\"ER\">Eritrea</option>")
document.write("<option value=\"EE\">Estonia</option>")
document.write("<option value=\"ET\">Ethiopia</option>")
document.write("<option value=\"EU\">European Trading</option>")
document.write("<option value=\"FO\">Faeroe Islands</option>")
document.write("<option value=\"FK\">Falkland Islands (Malvinas)</option>")
document.write("<option value=\"FJ\">Fiji</option>")
document.write("<option value=\"FI\">Finland</option>")
document.write("<option value=\"FR\">France</option>")
document.write("<option value=\"PF\">French Polynesia</option>")
document.write("<option value=\"TF\">French Southern Territories</option>")
document.write("<option value=\"GF\">French West Indies</option>")
document.write("<option value=\"GA\">Gabon</option>")
document.write("<option value=\"GM\">Gambia</option>")
document.write("<option value=\"GZ\">Gaza Strip</option>")
document.write("<option value=\"GE\">Georgia</option>")
document.write("<option value=\"DE\">Germany</option>")
document.write("<option value=\"GH\">Ghana</option>")
document.write("<option value=\"GI\">Gibraltar</option>")
document.write("<option value=\"GR\">Greece</option>")
document.write("<option value=\"GL\">Greenland</option>")
document.write("<option value=\"GD\">Grenada</option>")
document.write("<option value=\"GP\">Guadeloupe</option>")
document.write("<option value=\"GU\">Guam</option>")
document.write("<option value=\"GT\">Guatemala</option>")
document.write("<option value=\"GG\">Guernsey, C.I.</option>")
document.write("<option value=\"GN\">Guinea</option>")
document.write("<option value=\"GW\">Guinea-Bissau</option>")
document.write("<option value=\"GY\">Guyana</option>")
document.write("<option value=\"HT\">Haiti</option>")
document.write("<option value=\"VA\">Holy See (Vatican City)</option>")
document.write("<option value=\"HN\">Honduras</option>")
document.write("<option value=\"HK\">Hong Kong</option>")
document.write("<option value=\"HU\">Hungary</option>")
document.write("<option value=\"IS\">Iceland</option>")
document.write("<option value=\"IN\">India</option>")
document.write("<option value=\"ID\">Indonesia</option>")
document.write("<option value=\"IR\">Iran</option>")
document.write("<option value=\"IQ\">Iraq</option>")
document.write("<option value=\"IE\">Ireland</option>")
document.write("<option value=\"IM\">Isle of Man</option>")
document.write("<option value=\"IL\">Israel</option>")
document.write("<option value=\"IT\">Italy</option>")
document.write("<option value=\"CI\">Ivory Coast (Cote D'Ivoire)</option>")
document.write("<option value=\"JM\">Jamaica</option>")
document.write("<option value=\"JP\">Japan</option>")
document.write("<option value=\"JE\">Jersey, C.I.</option>")
document.write("<option value=\"JO\">Jordan</option>")
document.write("<option value=\"KH\">Kampuchea (Cambodia)</option>")
document.write("<option value=\"KZ\">Kazakhstan</option>")
document.write("<option value=\"KE\">Kenya</option>")
document.write("<option value=\"KI\">Kiribati</option>")
document.write("<option value=\"KR\">Korea</option>")
document.write("<option value=\"KW\">Kuwait</option>")
document.write("<option value=\"KG\">Kyrgyzstan</option>")
document.write("<option value=\"LA\">Laos</option>")
document.write("<option value=\"LV\">Latvia</option>")
document.write("<option value=\"LB\">Lebanon</option>")
document.write("<option value=\"LS\">Lesotho</option>")
document.write("<option value=\"LR\">Liberia</option>")
document.write("<option value=\"LY\">Libya</option>")
document.write("<option value=\"LI\">Liechtenstein</option>")
document.write("<option value=\"LT\">Lithuania</option>")
document.write("<option value=\"LU\">Luxembourg</option>")
document.write("<option value=\"ME\">Montenegro</option>")
document.write("<option value=\"MO\">Macau</option>")
document.write("<option value=\"MK\">Macedonia</option>")
document.write("<option value=\"MG\">Malagasy (Madagascar)</option>")
document.write("<option value=\"MW\">Malawi</option>")
document.write("<option value=\"MY\">Malaysia</option>")
document.write("<option value=\"MV\">Maldives</option>")
document.write("<option value=\"ML\">Mali</option>")
document.write("<option value=\"MT\">Malta</option>")
document.write("<option value=\"MQ\">Martinique</option>")
document.write("<option value=\"MR\">Mauritania</option>")
document.write("<option value=\"MU\">Mauritius</option>")
document.write("<option value=\"YT\">Mayotte</option>")
document.write("<option value=\"FX\">Metropolitan France (ex overseas)</option>")
document.write("<option value=\"MX\">Mexico</option>")
document.write("<option value=\"FM\">Micronesia</option>")
document.write("<option value=\"MD\">Moldova</option>")
document.write("<option value=\"MC\">Monaco</option>")
document.write("<option value=\"MN\">Mongolia</option>")
document.write("<option value=\"MS\">Montserrat</option>")
document.write("<option value=\"MA\">Morocco</option>")
document.write("<option value=\"MZ\">Mozambique</option>")
document.write("<option value=\"MM\">Myanmar (Burma)</option>")
document.write("<option value=\"NA\">Namibia</option>")
document.write("<option value=\"NR\">Nauru</option>")
document.write("<option value=\"NP\">Nepal</option>")
document.write("<option value=\"NL\">Netherlands</option>")
document.write("<option value=\"AN\">Netherlands Antilles</option>")
document.write("<option value=\"NC\">New Caledonia</option>")
document.write("<option value=\"NZ\">New Zealand</option>")
document.write("<option value=\"NI\">Nicaragua</option>")
document.write("<option value=\"NE\">Niger</option>")
document.write("<option value=\"NG\">Nigeria</option>")
document.write("<option value=\"NU\">Niue</option>")
document.write("<option value=\"NF\">Norfolk Island</option>")
document.write("<option value=\"KP\">North Korea</option>")
document.write("<option value=\"MP\">Northern Mariana Islands</option>")
document.write("<option value=\"NO\">Norway</option>")
document.write("<option value=\"OM\">Oman</option>")
document.write("<option value=\"PK\">Pakistan</option>")
document.write("<option value=\"PW\">Palau</option>")
document.write("<option value=\"PX\">Palestine</option>")
document.write("<option value=\"PA\">Panama</option>")
document.write("<option value=\"PZ\">Panama Canal Zone</option>")
document.write("<option value=\"PG\">Papua New Guinea</option>")
document.write("<option value=\"PY\">Paraguay</option>")
document.write("<option value=\"PE\">Peru</option>")
document.write("<option value=\"PH\">Philippines</option>")
document.write("<option value=\"PN\">Pitcairn Island</option>")
document.write("<option value=\"PL\">Poland</option>")
document.write("<option value=\"PT\">Portugal</option>")
document.write("<option value=\"PR\">Puerto Rico</option>")
document.write("<option value=\"QA\">Qatar</option>")
document.write("<option value=\"RE\">Reunion</option>")
document.write("<option value=\"RO\">Romania</option>")
document.write("<option value=\"RU\">Russia</option>")
document.write("<option value=\"RW\">Rwanda</option>")
document.write("<option value=\"LC\">Saint Lucia</option>")
document.write("<option value=\"SM\">San Marino</option>")
document.write("<option value=\"ST\">Sao Tome and Principe</option>")
document.write("<option value=\"SA\">Saudi Arabia</option>")
document.write("<option value=\"SN\">Senegal</option>")
document.write("<option value=\"RS\">Serbia</option>")
document.write("<option value=\"SC\">Seychelles</option>")
document.write("<option value=\"SL\">Sierra Leone</option>")
document.write("<option value=\"SG\">Singapore</option>")
document.write("<option value=\"SK\">Slovakia</option>")
document.write("<option value=\"SI\">Slovenia</option>")
document.write("<option value=\"SB\">Solomon Islands</option>")
document.write("<option value=\"SO\">Somalia</option>")
document.write("<option value=\"ZA\">South Africa</option>")
document.write("<option value=\"GS\">South Georgia and Sandwich Islands</option>")
document.write("<option value=\"ES\">Spain</option>")
document.write("<option value=\"LK\">Sri Lanka</option>")
document.write("<option value=\"SH\">St. Helena</option>")
document.write("<option value=\"KN\">St. Kitts-Nevis-Anguilla</option>")
document.write("<option value=\"PM\">St. Pierre and Miquelon</option>")
document.write("<option value=\"VC\">St. Vincent and the Grenadines</option>")
document.write("<option value=\"SD\">Sudan</option>")
document.write("<option value=\"SR\">Suriname</option>")
document.write("<option value=\"SJ\">Svalbard and Jan Mayen Islands</option>")
document.write("<option value=\"SZ\">Swaziland</option>")
document.write("<option value=\"SE\">Sweden</option>")
document.write("<option value=\"CH\">Switzerland</option>")
document.write("<option value=\"SY\">Syria</option>")
document.write("<option value=\"TW\">Taiwan</option>")
document.write("<option value=\"TJ\">Tajikistan</option>")
document.write("<option value=\"TZ\">Tanzania</option>")
document.write("<option value=\"TH\">Thailand</option>")
document.write("<option value=\"TG\">Togo</option>")
document.write("<option value=\"TK\">Tokelau</option>")
document.write("<option value=\"TO\">Tonga</option>")
document.write("<option value=\"TT\">Trinidad and Tobago</option>")
document.write("<option value=\"TN\">Tunisia</option>")
document.write("<option value=\"TR\">Turkey</option>")
document.write("<option value=\"TM\">Turkmenistan</option>")
document.write("<option value=\"TC\">Turks and Caicos Islands</option>")
document.write("<option value=\"TV\">Tuvalu</option>")
document.write("<option value=\"UM\">U.S. Minor Outlying Islands</option>")
document.write("<option value=\"VI\">U.S. Virgin Islands</option>")
document.write("<option value=\"UG\">Uganda</option>")
document.write("<option value=\"UA\">Ukraine</option>")
document.write("<option value=\"AE\">United Arab Emirates/Dubai</option>")
document.write("<option value=\"GB\">United Kingdom</option>")
document.write("<option value=\"US\">United States of America</option>")
document.write("<option value=\"UY\">Uruguay</option>")
document.write("<option value=\"UZ\">Uzbekistan</option>")
document.write("<option value=\"VU\">Vanuatu (New Hebrides)</option>")
document.write("<option value=\"VE\">Venezuela</option>")
document.write("<option value=\"VN\">Vietnam</option>")
document.write("<option value=\"WF\">Wallis and Futuna Islands</option>")
document.write("<option value=\"WZ\">West Bank</option>")
document.write("<option value=\"EH\">Western Sahara</option>")
document.write("<option value=\"WS\">Western Samoa</option>")
document.write("<option value=\"YE\">Yemen</option>")
document.write("<option value=\"ZM\">Zambia</option>")
document.write("<option value=\"ZW\">Zimbabwe</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Language préféré:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"user_lang\" alt=\"select\" emsg=\"Please, select your preferred language\">")
document.write("<option value=\"\">--</option>")
document.write("<option value=\"ara\">العربيه</option>")
document.write("<option value=\"chs\">繁体中文</option>")
document.write("<option value=\"cht\">簡體中文</option>")
document.write("<option value=\"czh\">Czech</option>")
document.write("<option value=\"eng\" selected=\"selected\">English</option>")
document.write("<option value=\"fre\">French</option>")
document.write("<option value=\"ger\">Deutsch</option>")
document.write("<option value=\"jap\">日本語</option>")
document.write("<option value=\"pol\">Polish</option>")
document.write("<option value=\"rus\">Русский</option>")
document.write("<option value=\"slo\">Slovenian</option>")
document.write("<option value=\"spa\">Spanish</option>")
document.write("<option value=\"tur\">Turkish</option>")
document.write("<option value=\"vie\">Vietnamese</option>")
document.write("<option value=\"ina\">Indonesian</option>")
document.write("<option value=\"bul\">Bulgarian</option>")
document.write("<option value=\"ltu\">Lithuanian</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Ou avez-vous entendu parler de nous?:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"heardfrom\" alt=\"select\" emsg=\"Please, select where did you hear about us\">")
document.write("<option value=\"\" selected=\"selected\">--</option>")
document.write("<option value=\"Introducing Broker\">référent de courtier</option>")
document.write("")
document.write("<option value=\"Internet Search\">recherche internet</option>")
document.write("<option value=\"Trading Expo\">salon de trading</option>")
document.write("<option value=\"Seminar\">Séminaire</option>")
document.write("<option value=\"Magazine or Newspaper\">Magazine ou journal</option>")
document.write("<option value=\"Friend\">Ami</option>")
document.write("<option value=\"Other\">Autre</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Merci de préciser si autre:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"otherfrom\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\"></td>")
document.write("</tr>")
document.write("</table>")
document.write("")
document.write("<div class=\"demoreg_break\">2. Configuration de comptes</div>")
document.write("<table class=\"demoreg_formtable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Login:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"username\" type=\"text\" value=\"\" size=\"30\" maxlength=\"30\" alt=\"custom\" pattern=\"^[a-zA-Z][a-zA-Z0-9]*$\" emsg=\"Your username must begin with a letter and can only contain standard letters and numbers.\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Nombre de comptes:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"accounts\">")
document.write("<option value=\"1\" selected=\"selected\">1</option>")
document.write("<option value=\"2\">2</option>")
document.write("<option value=\"3\">3</option>")
document.write("<option value=\"4\">4</option>")
document.write("<option value=\"5\">5</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Devise de référence:</td>")
document.write("<td class=\"demoreg_field\">")
document.write("<select class=\"demoreg_input\" name=\"currency\">")
document.write("<option value=\"AUD\">AUD</option>")
document.write("<option value=\"CAD\">CAD</option>")
document.write("<option value=\"CHF\">CHF</option>")
document.write("<option value=\"EUR\">EUR</option>")
document.write("<option value=\"GBP\">GBP</option>")
document.write("<option value=\"JPY\">JPY</option>")
document.write("<option value=\"NZD\">NZD</option>")
document.write("<option value=\"USD\" selected=\"selected\">USD</option>")
document.write("</select><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Dépôt initial:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"deposit\" type=\"text\"")
document.write("value=\"10000\"")
document.write("size=\"30\" maxlength=\"30\" alt=\"blank\" emsg=\"Please, enter deposit\"><span class=\"demoreg_emphasis\">*</span></td>")
document.write("</tr>")
document.write("</table>")
document.write("<div class=\"demoreg_break\">3. Champs optionnels</div>")
document.write("<table class=\"demoreg_formtable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Téléphone domicile (inclus code zône):</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"homephone\" type=\"text\" id=\"HomePhone\" value=\"\" size=\"30\" maxlength=\"255\">")
document.write("</td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Adresse 1:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"address1\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\"></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Adresse 2:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"address2\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\"></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Ville:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"city\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\"></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Région (si non US):</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"province\" type=\"text\" value=\"\" size=\"30\" maxlength=\"30\"></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Code postal:</td>")
document.write("<td class=\"demoreg_field\"><input class=\"demoreg_input\" name=\"zip\" type=\"text\" value=\"\" size=\"30\" maxlength=\"255\"></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Commentaires:</td>")
document.write("<td class=\"demoreg_field\"><textarea class=\"demoreg_input\" name=\"comments\" cols=\"30\" rows=\"4\" maxlength=\"255\"></textarea></td>")
document.write("</tr>")
document.write("</table>")
document.write("")
document.write("<hr />")
document.write("")
document.write("<table class=\"demoreg_formtable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td class=\"demoreg_img_code\" colspan=\"2\"><img id='captcha_img' src='//templates.fxserver.com/IBMdemo/Sartsna/image.php?sid=1fa80a4ff0d766de43622cd401283909052' width='240' height='70' class='demoreg_img_code'  onClick='this.src +=\"&\"+ Math.round(Math.random()*100000); return false;' onLoad='this.style.display=\"\"' ALT='If you cannot read the code, click on image to change it.' TITLE='If you cannot read the code, click on image to change it.' /><input id='captcha_sid' type='hidden' name='sid' value='1fa80a4ff0d766de43622cd401283909052' /></td>")
document.write("</tr>")
document.write("<tr>")
document.write("<td class=\"demoreg_fieldname\">Ecrire le code ci-dessus (si vous ne pouvez pas cliquez sur l'image pour le renouveler):</td>")
document.write("<td class=\"demoreg_field\"><input class='demoreg_input' id='captcha_code' name='code' type='text' value='' size='30' maxlength='255'  alt='blank' emsg='Please, enter code'><span class=\"demoreg_emphasis\">*</span>")
document.write("</td>")
document.write("</tr>")
document.write("</table>")
document.write("<table class=\"demoreg_formtable\" border=0 cellpadding=3 cellspacing=0 align=\"center\">")
document.write("<tr>")
document.write("<td align=\"center\"><input class=\"demoreg_button\" type=\"submit\" name=\"register\" value=\"Enregistrer le Compte de Démonstration\">")
document.write("<input class=\"demoreg_button\" name=\"Reset\" type=\"reset\" value=\"Effacer\"></td>")
document.write("</tr>")
document.write("</table>")
document.write("</td>")
document.write("</tr>")
document.write("</table>")
document.write("<div style=\"display:none\">")
document.write("URL: <input type=\"text\" name=\"url\" value=\"\">")
document.write("</div><input type=\"hidden\" name=\"formref\" value=\"undefined\" id=\"formreffa5004cfda017283ac925809f831beb4\">")
document.write("<script>try { document.getElementById(\"formreffa5004cfda017283ac925809f831beb4\").value = document.referrer } catch (e) {}</script><input type=\"hidden\" name=\"formloc\" value=\"undefined\" id=\"formlocfa5004cfda017283ac925809f831beb4\">")
document.write("<script>try { document.getElementById(\"formlocfa5004cfda017283ac925809f831beb4\").value = document.location } catch (e) {}</script><input type=\"hidden\" name=\"track_id\" value=\"\" id=\"idtrackfa5004cfda017283ac925809f831beb4\">")
document.write("<input type=\"hidden\" name=\"lrc_date\" value=\"\" id=\"dttrackfa5004cfda017283ac925809f831beb4\">")
document.write("<input type=\"hidden\" name=\"lrc_url\"  value=\"\" id=\"lutrackfa5004cfda017283ac925809f831beb4\">")
document.write("<input type=\"hidden\" name=\"lrc_ref\"  value=\"\" id=\"lrtrackfa5004cfda017283ac925809f831beb4\">")
document.write("<script>")
document.write("function cb_trackfa5004cfda017283ac925809f831beb4(id, dt, lu, lr) {")
document.write("try {")
document.write("document.getElementById(\"idtrackfa5004cfda017283ac925809f831beb4\").value = id;")
document.write("document.getElementById(\"dttrackfa5004cfda017283ac925809f831beb4\").value = dt;")
document.write("document.getElementById(\"lutrackfa5004cfda017283ac925809f831beb4\").value = lu;")
document.write("document.getElementById(\"lrtrackfa5004cfda017283ac925809f831beb4\").value = lr;")
document.write("} catch (e) {}")
document.write("}")
document.write("</script>")
document.write("<script src=\"//cts.cmsfx.com/cts/callback/?func=cb_trackfa5004cfda017283ac925809f831beb4\">&nbsp;</script><input type=\"hidden\" name=\"form_id\" value=\"350\" /><!-- Get browser charset -->")
document.write("<input id=\"charset974749989116\"  type=\"hidden\" name=\"charset\" value=\"UTF-8\"><!-- Get referer -->")
document.write("<input id=\"referer974749989116\"  type=\"hidden\" name=\"referer\" value=\"\">")
document.write("<script language=\"JavaScript\">")
document.write("if (typeof(document.getElementById) == 'function') {")
document.write("var referer = document.getElementById(\"referer974749989116\");")
document.write("if (referer != null) {")
document.write("referer.value = ( typeof(document.location) != 'undefined' ? document.location : referer.value );")
document.write("}")
document.write("}")
document.write("</script></form>")
document.write("<DIV class=\"demoreg_footer\">")
document.write("")
document.write("</DIV>")