<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<title>Untitled Document</title>
</head>
<body>
<table width="580" border="0" cellpadding="0" cellspacing="0">
<!--DWLayoutTable-->
<tr>
<td width="35" height="67"> </td>
<td width="483"> </td>
<td width="62"> </td>
</tr>
<tr>
<td height="254"> </td>
<td valign="top"><form name="form1" method="post" action="<?php echo $_SERVER['PHP_SELF'] ?>">
<table width="400" height="200" border="0" cellpadding="0" cellspacing="0">
<?php if(isset($displayErrorArray) && ($displayErrorArray))if(array_keys($displayErrorArray, 'firstName')){?>
<tr>
<td width="80" height="10"><div align="center"></div></td>
<td width="160" height="10"><span class="smallTextRed">First Name is a required field </span></td>
</tr>
<?php } ?>
<tr>
<td width="100">First Name </td>
<td width="300"><div align="center">
<input name="firstName" type="text" id="firstName">
</div></td>
</tr>
<?php if(isset($displayErrorArray) && ($displayErrorArray))if(array_keys($displayErrorArray, 'lastName')){?>
<tr class="smallText2">
<td height="10" class="smallText"> </td>
<td height="10"><span class="smallTextRed">Last Name is required </span></td>
</tr>
<?php } ?>
<tr>
<td width="100">Last Name </td>
<td width="300"><div align="center">
<input name="lastName" type="text" id="lastName">
</div></td>
</tr>
<tr>
<td width="100"> </td>
<td width="300"> </td>
</tr>
<tr>
<td width="100"> </td>
<td width="300"><input type="submit" name="Submit" value="Submit"></td>
</tr>
</table>
</form></td>
<td> </td>
</tr>
<tr>
<td height="19"> </td>
<td> </td>
<td> </td>
</tr>
</table>
</body>
</html>
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