<TMPL_INCLUDE header.html>

<input type='hidden' value='legal_type_quiz' name='action'>

<table border=1>
<tr><td>

<table border=0 width=550 align=center>
  <tr bgcolor=#90c0ff>
    <th align=left colspan=2><font size=+1>You have chosen municipality restricted domain name [<a href="help.cgi?tld=ca&topic=ca_domain_name"><img src="<TMPL_VAR CGI>?action=help_icon" alt="?" border=0></a>]</font></th>
  </tr>

  <tr bgcolor=#e0e0e0>
    <td align=right><b>Domain Name:</b></td>
    <td><B><TMPL_VAR DOMAIN></B></td>
  </tr>

  <tr bgcolor=#e0e0e0>
    <td align=right><b>Registration Period:</b></td>
    <td>
     <select name=period>
      <tmpl_if period>
      <option value="<TMPL_VAR PERIOD>" SELECTED> <TMPL_VAR PERIOD>
      <tmpl_else>
      <option value="1" SELECTED> 1
      </tmpl_if> 
      <option value="2"> 2
      <option value="3"> 3
      <option value="4"> 4
      <option value="5"> 5
      <option value="6"> 6
      <option value="7"> 7
      <option value="8"> 8
      <option value="9"> 9
      <option value="10"> 10
      </select> Year(s)
    </td>
  </tr>
  
  <TMPL_IF allow_auto_renew>
  
  <tr bgcolor=#e0e0e0>
    <td>
      <font color=red>
	********ATTENTION********<BR>
	A payment system must be implemented before
	giving your customers access to turn auto renew
	on for a new domain.
      </font><br>
	Auto Renew:
    </td>
    <td>
    <TMPL_IF auto_renew>
      <input type=radio name=auto_renew value=1 checked> Yes<br>
      <input type=radio name=auto_renew value=0 > No<br>
    <TMPL_ELSE>
      <input type=radio name=auto_renew value=1 > Yes<br>
      <input type=radio name=auto_renew value=0 checked> No<br>
    </TMPL_IF>
    </td>
  </tr>
  </TMPL_IF>
</table>

<table width=550>
  <tr bgcolor=#90c0ff>
    <th align="center" colspan=2><font size=+1>Supplementary Domain Information</font></th>
  </tr>
  
	<input type=hidden name=isa_trademark value=0>
	

  <tr bgcolor=#e0e0e0>
    <th width=50% align="left"><b>Add domain to existing CIRA profile?</th>&nbsp;
    <td>
    <TMPL_IF linked><input type=radio name=linked value=1 checked>Yes&nbsp;
      <input type=radio name=linked value=0>No
    <TMPL_ELSE>
      <input type=radio name=linked value=1>Yes&nbsp;
      <input type=radio name=linked value=0 checked>No
    </TMPL_IF>
    </td>
  </tr>

</table>

<table border=0 cellspacing=0 cellpadding=1 width=100%>
  <tr>
    <td align=left>
      <input type=submit value="  Next  ">
    </td>
    <td align=right>
      <input type=submit name='back' value="  Back  ">
    </td>
  </tr>
</table>

</td></tr>

</table>
<TMPL_INCLUDE footer.html>
