brett

<?php
	
	require("header.php");
	
	$f = new Form("Client Information", "add.php", $main);
	$f->add_input("first_name", "First Name");
	$f->add_input("last_name", "Last Name");
	$f->add_input("email", "E-mail Address");
	$f->add_input("email2", "Secondary E-mail");
	$f->add_input("company", "Company Name");
	$f->add_input("address1", "Address Line One");
	$f->add_input("address2", "Address Line Two");
	$f->add_input("city", "City");
	$f->add_input("state", "State / Region", "Ex: 'WA'");
	$f->add_input("zip", "Zip / Postal Code", "(00000-0000)");
	$f->add_selection("country", "Country", unserialize(base64_decode(COUNTRIES_ARRAY)));
	$f->add_input("phone", "Phone Number", "(+0.0000000000)");
	$f->add_input("phone2", "Alternate Phone Number", "(+0.0000000000)");
	$f->add_input("fax", "Fax Number", "(+0.0000000000)");
	
	$f->add_header("Billing Information");
	$f->add_selection("billing_method", "Billing Method", unserialize(base64_decode(BILLING_METHOD_ARRAY)));
	$f->add_input("billing_cc_number", "Credit Card Number", "Visa, Mastercard, Discover, American Express");
	$f->add_input("billing_cc_exp_date", "Expiration Date", "MM/YYYY");
	
	$f->add_header("Account Information");	
	$f->add_input("username", "Username");
	$f->add_input("password", "Password", "", 30, "", "password");
	$f->add_hidden("status", 1);
	$f->close_form("Save Client");
	echo $f->get();
	require("footer.php");
	
?>