{template 'header'}
<div id="head-bar">
<div class="head-bar">
<div class="head-bar-back"><a href="{if $back_link}{$back_link}{else}javascript:Dback();" id="back-{$js_pageid}{/if}" data-direction="reverse"><img src="{DT_MOB}static/img/icon-back.png" width="24" height="24"/></a></div>
<div class="head-bar-title">{$head_name}</div>
<div class="head-bar-right">
<a href="{DT_MOB}channel.php" data-transition="slideup"></a>
</div>
</div>
<div class="head-bar-fix" id="load-fix-{$js_pageid}" style="height:0;"></div>
<div class="head-bar-fix" id="head-fix-{$js_pageid}"></div>
</div>
<div class="ui-form">
<form method="post" action="sign.php" data-ajax="false" id="sign_form" onsubmit="return sign_check();">
<input type="hidden" name="forward" value="{$forward}"/>
<input type="hidden" name="itemid" value="{$itemid}"/>

<p>报名人数<em>*</em><b id="damount"></b></p>
<div><input type="tel" name="amount" value="1" id="amount" style="width:100px;"/></div>

<p>联系人<em>*</em><b id="dtruename"></b></p>
<div><input type="text" name="truename" value="{$truename}" id="truename" style="width:50%;"/></div>

<p>手机号码<em>*</em><b id="dmobile"></b></p>
<div><input type="tel" name="mobile" value="{$mobile}" id="mobile" style="width:50%;"/></div>

<p>公司名称</p>
<div><input type="text" name="company" id="company" value="{$company}"/></div>


<p>所在地区</p>
<div>{ajax_area_select('areaid', '请选择', $areaid)}</div>

<p>街道地址</p>
<div><input type="text" name="address" id="address" value="{$address}"/></div>

<p>邮政编码</p>
<div><input type="tel" name="postcode" id="postcode" value="{$postcode}" style="width:50%;"/></div>

<p>电子邮箱</p>
<div><input type="email" name="email" id="email" value="{$email}"/></div>

{if $DT[im_qq]}
<p>QQ</p>
<div><input type="tel" name="qq" id="qq" value="{$qq}" style="width:50%;" style="width:50%;"/></div>
{/if}

{if $DT[im_wx]}
<p>微信</p>
<div><input type="text" name="wx" id="wx" value="{$wx}" style="width:50%;" style="width:50%;"/></div>
{/if}

<p>备注事项</p>
<div><textarea name="content" id="content"></textarea></div>

{if $need_captcha}
<p>验证码<em>*</em><b id="dcaptcha"></b></p>
<div>{template 'captcha', 'chip'}</div>
{/if}

<div class="blank-16"></div>
<input type="submit" name="submit" value="提交报名" class="btn-blue"/>
<div class="blank-16"></div>

</form>
</div>
{if !$_userid}<script type="text/javascript" src="{DT_STATIC}file/script/guest.js?v={if DT_DEBUG}{DT_TIME}{else}{DT_REFRESH}{/if}"></script>{/if}
<script type="text/javascript">
function sign_check() {
	var l;
	var f;
	f = 'amount';
	l = parseInt(Dd(f).value);
	if(l < 1) {
		Dmsg('请填写报名人数', f);
		return false;
	}
	Dd(f).value = l;
	f = 'truename';
	l = Dd(f).value.length;
	if(l < 2) {
		Dmsg('请填写联系人', f);
		return false;
	}
	f = 'mobile';
	l = Dd(f).value.length;
	if(l < 11) {
		Dmsg('请填写手机', f);
		return false;
	}
	{if $need_captcha}
	f = 'captcha';
	if($('#c'+f).html().indexOf('ok.png') == -1) {
		Dmsg('请填写正确的验证码', f);
		return false;
	}
	{/if}
}
</script>
{template 'footer'}