{"id":154,"date":"2026-02-18T08:37:15","date_gmt":"2026-02-18T07:37:15","guid":{"rendered":"https:\/\/www.doctaforum-events.org\/2026\/cursoleucemia2026\/?page_id=154"},"modified":"2026-03-20T10:23:48","modified_gmt":"2026-03-20T09:23:48","slug":"registration-form","status":"publish","type":"page","link":"https:\/\/www.doctaforum-events.org\/2026\/cursoleucemia2026\/registration-form\/","title":{"rendered":"Registration form"},"content":{"rendered":"<div class=\"inscriptions-form\">\r\n\t\r\n\r\n\r\n<div class=\"row\">\r\n\r\n\t<div class=\"col-sm-6\">\r\n\t\t\t\t<h2>Are you new to the event?<\/h2>\r\n\t\t\t\t<div class=\"row\">\r\n\t\t\t\t\t<div class=\"col-sm-6\">\r\n\t\t\t\t\t\t<a class=\"btn btn-primary\" href=\"Javascript:veraltaasistente();\" >Individual Registration<\/a>\r\n\t\t\t\t\t\t<div class=\"observacionesFormulario\"><\/div>\r\n\r\n\t\t\t\t\t\t<script type=\"text\/javascript\">\r\n\t\t\t\t\t\t\tfunction veraltaasistente(){\r\n\t\t\t\t\t\t\t\tjQuery(\"#altaempresa\").hide();\r\n\t\t\t\t\t\t\t\tjQuery(\"#altaasistente\").show();\r\n\t\t\t\t\t\t\t\tposition = jQuery(\"#altaasistente\").position();\r\n\t\t\t\t\t\t\t\tscroll(0,position.top);\r\n\t\t\t\t\t\t\t\t\/\/location.href=\"#altaasistente\";\r\n\t\t\t\t\t\t\t}\r\n\t\t\t\t\t\t<\/script>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<div class=\"col-sm-6\">\r\n\t\t\t\t\t\t<a class=\"btn btn-primary\" href=\"Javascript:veraltaempresa();\" >Company or Institution<\/a>\r\n\t\t\t\t\t\t<div class=\"observacionesFormulario\"><\/div>\r\n\r\n\t\t\t\t\t\t<script type=\"text\/javascript\">\r\n\t\t\t\t\t\t\tfunction veraltaempresa(){\r\n\t\t\t\t\t\t\t\tjQuery(\"#altaasistente\").hide();\r\n\t\t\t\t\t\t\t\tjQuery(\"#altaempresa\").show();\r\n\t\t\t\t\t\t\t\tposition = jQuery(\"#altaempresa\").position();\r\n\t\t\t\t\t\t\t\tscroll(0,position.top);\r\n\r\n\t\t\t\t\t\t\t\t\/\/location.href=\"#altaempresa\";\r\n\r\n\t\t\t\t\t\t\t}\r\n\t\t\t\t\t\t<\/script>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\r\n\r\n\t<\/div>\r\n\r\n\t<div class=\"col-sm-6\">\r\n\t\t<form class=\"form-horizontal\" action=\"\" method=\"POST\" name=\"frmLOGIN\" id=\"frmLOGIN\">\r\n\t\t\t<input type=\"hidden\" name=\"accion_post\" value=\"login\">\r\n\t\t\t<fieldset><legend>Registered users<\/legend>\r\n\t\r\n\r\n\t\t\t<div class=\"observacionesFormulario\"><\/div>\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"emailLogin\" class=\"col-md-3 control-label\">Email:<\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"emailLogin\" name=\"email\" value=\"\"  class=\"required form-control\" minlength=\"3\" maxlength=\"100\" \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"clave\" class=\"col-md-3 control-label\">Password:<\/label>\r\n\t\t\t<div class=\"col-md-9\">\r\n\t\t\t<input type=\"Password\" id=\"clave\" name=\"clave\" value=\"\"  class=\"form-control required\" minlength=\"3\" maxlength=\"100\" \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t  <div class=\"form-group\">\r\n\t\t\t<div class=\"col-md-offset-3 col-md-9 \">\r\n\t\t\t  <button type=\"submit\" class=\"btn btn-primary\">Send<\/button>\r\n\t\t\t  &nbsp;&nbsp;<a href=\"Javascript:mostrar();\">Remember password?<\/a>\r\n\t\t\t <\/div>\r\n\t\t  <\/div>\r\n\r\n\t\t\t<\/fieldset>\r\n\t\t<\/form>\r\n\t\t\t\t\t<script type=\"text\/javascript\">\r\n\t\t\t\t  \tfunction mostrar(){\r\n\t\t\t\t\t\tjQuery(\"#msgremember\").html('');\r\n\t\t\t\t\t\tjQuery(\"#remember\").toggle();\r\n\t\t\t\t\t}\r\n\t\t\t\t\tfunction recordar(){\r\n\t\t\t\t\t\tvar useremail;\r\n\t\t\t\t\t\t  useremail=jQuery(\"#emailRecordar\").val();\r\n\t\t\t\t\t\t\t  jQuery.post('https:\/\/doctaforum.net\/eventos\/Plantillas\/includes\/recordarClave.asp',{idEvento:6030,idIdioma:2,email:useremail},function(response){\r\n\t\t\t\t\t\t\t\t  jQuery(\"#msgremember\").html(response);\r\n\t\t\t\t\t\t\t\t  });\r\n\r\n\t\t\t\t\t\tjQuery(\"#msgremember\").html(\"<span>Revise su email, si todo es correcto le habremos enviado una nueva clave <\/span>\")\r\n\r\n\t\t\t\t\t}\r\n\t\t\t\t  <\/script>\r\n\t\t\t\t  <div id=\"remember\" style=\"display:none;\">\r\n\t\t\t\t\t<span id=\"msgremember\" class=\"error\"><\/span>\r\n\t\t\t\t  <br>\r\n\t\t\t\t\t<div class=\"form-group\">\r\n\t\t \t\t\t\t<label for=\"emailRecordar\" class=\"col-md-4 control-label\">Email:<\/label>\r\n\t\t\t\t  \t\t<div class=\"col-md-6\">\r\n\t\t\t\t  \t\t<input type=\"text\" name=\"emailRecordar\" id=\"emailRecordar\" class=\"form-control\" value=\"\"  \/>\r\n\t\t\t\t  \t\t<\/div>\r\n\t\t\t\t  \t\t<div class=\"col-md-2\">\r\n\t\t\t\t  \t\t\t<input type=\"button\" class=\"btn btn-primary\" name=\"rememberboton\" onclick=\"javascript:recordar();\" id=\"rememberboton\" value=\"Send\" \/>\r\n\t\t\t\t  \t\t<\/div>\r\n\t\t\t\t  \t<\/div>\r\n\t\t\t\t  <\/div>\r\n\r\n\t<\/div>\r\n<\/div>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\t\t<div id=\"altaempresa\" style=\"display:none;\">\r\n\t\t<!-- <div style=\"float:right;\"><a href=\"#\" onclick=\"closeModal();\">[x] Close<\/a><\/div>  -->\r\n\t\t<h2>Company or Institution<\/h2>\r\n\t\t\t<form class=\"form-horizontal\"  action=\"?accion=0&df_sesionid=&ididioma=2&idevento=6030&siteurl=https%3A%2F%2Fwww.doctaforum-events.org%2F2026%2Fcursoleucemia2026&token=QkFA0h9Y6beDmGSHvGL3YieoIQH6gBgJSvCu8RkODd\" method=\"POST\" name=\"frmALTEMP\" id=\"frmALTEMP\" >\r\n\t\t\t<input type=\"hidden\" name=\"accion_post\" value=\"altausuarioempresa\">\r\n\t\r\n\t\t\t<fieldset>\r\n\t\t\t<legend>Company or Organization Data<\/legend>\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <div class=\"col-md-3\">\r\n\t\t    <label for=\"xxxx\" class=\" control-label\">Tax ID Number:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t\t<\/div>\r\n\t\t    <div class=\"col-md-3\">\r\n\t\t\t\t\t<select name=\"TipoCIF\" id=\"TipoCIF_E\" class=\"form-control\">\r\n\t\t\t\t   \t\t\t <option value=\"1\">Vat number<\/option>\r\n\t\t\t\t   \t\t\t <option value=\"2\">ID or Passport number<\/option>\r\n\t\t\t  \t\t\t\t  <option value=\"3\">Other<\/option>\r\n\t\t\t\t\t<\/select>\r\n\t\t\t<\/div>\r\n\t\t    <div class=\"col-md-6\">\r\n\t\t\t<input type=\"text\" id=\"CIF\" name=\"CIF\" value=\"\"  class=\"required  form-control\"   maxlength=\"15\"\/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t  <div class=\"clearfix\"><\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"xxxx\" class=\"col-md-3 control-label\">Company:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Empresa_E\" name=\"Empresa\" value=\"\"  class=\"required  form-control\"  \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Direccion_E\" class=\"col-md-3 control-label\">Address:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Direccion_E\" name=\"Direccion\" value=\"\"  class=\"required  form-control\"  \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Localidad_E\" class=\"col-md-3 control-label\">Location:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Localidad_E\" name=\"Localidad\" value=\"\"  class=\"required  form-control\"  \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"CodigoPostal_E\" class=\"col-md-3 control-label\">Postal Code:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"CodigoPostal_E\" name=\"CodigoPostal\" value=\"\"  class=\"required  form-control\"  \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Pais_E\" class=\"col-md-3 control-label\">Country:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Pais_E\" name=\"Pais\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\r\n\t\t\t<h3>Personal Data<\/h3>\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Nombre_E\" class=\"col-md-3 control-label\">Name:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Nombre_E\" name=\"Nombre\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Apellidos_E\" class=\"col-md-3 control-label\">Surname:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Apellidos_E\" name=\"Apellidos\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Telefono_E\" class=\"col-md-3 control-label\">Phone:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Telefono_E\" name=\"Telefono\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\r\n\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\r\n\r\n\t\t\t\r\n\t\t\t<\/fieldset>\r\n<!--\r\n\t\t\t<br \/>\r\n\r\n<fieldset >\r\n\r\n\r\n<legend>General Reservation Terms and Conditions<\/legend>\r\n<div class=\"observacionesFormulario\"><\/div>\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"xxxx\" class=\"col-md-3 control-label\"><span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t\t<div class=\"checkbox\">\r\n<label for=\"checkLOPD\"><input type=\"checkbox\" value=\"1\" name=\"checkLOPD\" id=\"checkLOPD\" class=\"required \">\r\nI have read, I accept all the previous legal conditions \t\t<a href=\"https:\/\/www.doctaforum.net\/eventos\/Plantillas\/avisolegal.asp?idWeb=6030&idIdioma=2&idTexto=21\"  target=\"_blank\">General Reservation Terms and Conditions<\/a> \r\n<\/label>\r\n\t\t\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n<\/fieldset>\r\n-->\r\n<br \/>\r\n\t\t<fieldset >\r\n\t\t<legend>Login Data<\/legend>\r\n\t\t\t<script type=\"text\/javascript\">\r\n\t\t\t\tfunction recordarEmpresa(){\r\n\t\t\t\t\tvar useremail;\r\n\t\t\t\t\t  useremail=jQuery(\"#Email_E\").val();\r\n\t\t\t\t\t\t  jQuery.post('https:\/\/doctaforum.net\/eventos\/Plantillas\/includes\/recordarClave.asp',{idEvento:6030,idIdioma:2,email:useremail},function(response){\r\n\t\t\t\t\t\t\t  jQuery(\"#resultadoDuplicidadEmail_E\").html(response);\r\n\t\t\t\t\t\t\t  });\r\n\t\t\t\t}\r\n\t\t\t  <\/script>\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Email_E\" class=\"col-md-3 control-label\">Email:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Email_E\" name=\"Email\" value=\"\" onkeyup=\"AjaxDuplicado(this.id,this.value,'resultadoDuplicidadEmail_E')\" onblur=\"AjaxDuplicado(this.id,this.value,'resultadoDuplicidadEmail_E')\"  class=\"required  form-control\"  \/>\r\n<input type=\"Button\" style=\"display:none;\" class=\"boton\" name=\"rememberresultadoDuplicidadEmail_E\" onclick=\"javascript:recordarEmpresa();\" id=\"rememberresultadoDuplicidadEmail_E\" value=\"Remember password?\" \/><br>\r\n\t\t\t\t<div id=\"resultadoDuplicidadEmail_E\" class=\"error\"><\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Contrasena_E\" class=\"col-md-3 control-label\">Password:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Contrasena_E\" name=\"Contrasena\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\r\n\r\n\r\n\r\n\r\n\r\n\t\t<\/fieldset>\r\n\r\n\r\n\r\n\t\t<br \/>\r\n<fieldset>\r\n\t\r\n<input type=\"hidden\" name=\"consentimiento6_nomarcado\" value=\"2\">\r\n\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"consentimiento6\" class=\"col-md-3 control-label\"><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n <p><p>\r\n\tIn case the registration is made by a natural or legal person other than the assistant, such natural or legal person has previously guaranteed that the event assistant has accepted this Privacy policy. The natural or legal person responsible for the data entry in the recruitment process must provide proof of the acceptance of the assistant in case the event manager or the technical secretary is required to do so by the Spanish Data Protection Agency or other European Control Authority. The contact person details of the natural or legal person other than the person concerned who is engaged on behalf of the assistant shall be treated on the legal basis of the development of the contractual relationship between the parties, in order to manage the business relationship and will be used while the contractual relationship remains in force.<\/p><\/p> \r\n\t\t    \t<div class=\"checkbox\">\r\n<label for=\"consentimiento6\"><input type=\"checkbox\" value=\"1\" name=\"consentimiento6\" id=\"consentimiento6\"  class=\"required\"  >\r\n\tI have read and accept the <a href='https:\/\/www.doctaforum.net\/eventos\/Plantillas\/consentimiento.asp?idTipoConsentimiento=6&idWeb=6030&idIdioma=2'  target='_blank'>Privacy Information <\/a>\t\r\n<\/label>\r\n\r\n\t\t    \t<\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\t\r\n\r\n<\/fieldset>\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"xxxx\" class=\"col-md-3 control-label\"><small>The following fields are mandatory <span class=\"aviso\">*<\/span><\/small><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"submit\" class=\"btn btn-primary\" value=\"Send\">\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t<\/form>\r\n\t\t\t<br>\r\n\t\t<\/div>\r\n\r\n\r\n\r\n\t\t<div id=\"altaasistente\" style=\"display:none;\">\r\n\t\t<h2>Individual Registration<\/h2>\r\n\t\t\t<form class=\"form-horizontal\" action=\"?accion=0&df_sesionid=&ididioma=2&idevento=6030&siteurl=https%3A%2F%2Fwww.doctaforum-events.org%2F2026%2Fcursoleucemia2026&token=QkFA0h9Y6beDmGSHvGL3YieoIQH6gBgJSvCu8RkODd\" method=\"POST\" name=\"frmALTASIST\" id=\"frmALTASIST\" >\r\n<input type=\"hidden\" name=\"accion_post\" value=\"altausuarioasistente\">\r\n\t\r\n\r\n\t\t\t<fieldset >\r\n\r\n\t\t\t<legend>Personal data<\/legend>\r\n\t\t\t<div class=\"observacionesFormulario\"><\/div>\r\n\t\t\t<input type=\"hidden\" name=\"idTipoAsistente\" value=\"0\">\r\n\t\t\t<input type=\"hidden\" name=\"idCupo\" value=\"0\">\r\n\t\t\t<input type=\"hidden\" name=\"idEmpresa\" value=\"0\">\r\n\t\t\t<input type=\"hidden\" name=\"idContactoGerente\" value=\"0\">\r\n\t\t\t<input type=\"hidden\" name=\"idContactoDelegado\" value=\"0\">\r\n\r\n\t\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Tratamiento\" class=\"col-md-3 control-label\">Treatment:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t\t<select name=\"Tratamiento\" id=\"Tratamiento\"  class=\"required  form-control\" >\r\n\t\t\t\t   \t\t<option value=\"\">--<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Dr.\" >Dr.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Dra.\" >Dra.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"M.D.\" >M.D.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Mr.\" >Mr.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Mrs.\" >Mrs.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Ms.\" >Ms.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Ph.D.\" >Ph.D.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Prof.\" >Prof.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Sr.\" >Sr.<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"Sra.\" >Sra.<\/option>\r\n\t\t\t\t \r\n\t\t\t\t\t<\/select>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"NombreAsistente\" class=\"col-md-3 control-label\">Name:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"NombreAsistente\" name=\"NombreAsistente\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"ApellidosAsistente\" class=\"col-md-3 control-label\">Surname:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"ApellidosAsistente\" name=\"ApellidosAsistente\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"CentroTrabajo\" class=\"col-md-3 control-label\">Place of work:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"CentroTrabajo\" name=\"CentroTrabajo\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Departamento\" class=\"col-md-3 control-label\">Department:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Departamento\" name=\"Departamento\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"NIF\" class=\"col-md-3 control-label\">ID Card:<\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"NIF\" name=\"NIF\" value=\"\"  class=\" form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Telefono\" class=\"col-md-3 control-label\">Phone:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Telefono\" name=\"Telefono\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Movil\" class=\"col-md-3 control-label\">Mobile:<\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n<div class=\"input-group\">\r\n<select name=\"prefijo\" class=\"select2 form-control\" style=\"max-width: 100px;\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"\">---<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"1\" >1<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"1\" >1<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"7\" >7<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"7\" >7<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"20\" >20<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"27\" >27<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"30\" >30<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"31\" >31<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"32\" >32<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"33\" >33<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"34\" selected>34<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"36\" >36<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"39\" >39<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"40\" >40<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"41\" >41<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"43\" >43<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"44\" >44<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"45\" >45<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"46\" >46<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"47\" >47<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"48\" >48<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"49\" >49<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"51\" >51<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"52\" >52<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"53\" >53<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"54\" >54<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"55\" >55<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"56\" >56<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"57\" >57<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"58\" >58<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"60\" >60<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"61\" >61<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"62\" >62<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"63\" >63<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"64\" >64<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"65\" >65<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"66\" >66<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"81\" >81<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"82\" >82<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"84\" >84<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"86\" >86<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"90\" >90<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"91\" >91<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"92\" >92<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"93\" >93<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"94\" >94<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"95\" >95<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"98\" >98<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"211\" >211<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"212\" >212<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"213\" >213<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"216\" >216<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"218\" >218<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"220\" >220<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"221\" >221<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"222\" >222<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"223\" >223<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"224\" >224<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"225\" >225<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"226\" >226<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"227\" >227<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"228\" >228<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"229\" >229<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"230\" >230<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"231\" >231<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"232\" >232<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"233\" >233<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"234\" >234<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"235\" >235<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"236\" >236<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"237\" >237<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"238\" >238<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"239\" >239<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"240\" >240<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"241\" >241<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"242\" >242<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"243\" >243<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"244\" >244<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"245\" >245<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"248\" >248<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"249\" >249<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"250\" >250<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"251\" >251<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"252\" >252<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"253\" >253<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"254\" >254<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"255\" >255<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"256\" >256<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"257\" >257<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"258\" >258<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"260\" >260<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"261\" >261<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"263\" >263<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"264\" >264<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"265\" >265<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"266\" >266<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"267\" >267<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"268\" >268<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"269\" >269<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"291\" >291<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"351\" >351<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"352\" >352<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"353\" >353<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"354\" >354<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"355\" >355<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"356\" >356<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"357\" >357<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"358\" >358<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"359\" >359<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"370\" >370<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"371\" >371<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"372\" >372<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"373\" >373<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"374\" >374<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"375\" >375<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"376\" >376<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"377\" >377<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"378\" >378<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"380\" >380<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"381\" >381<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"382\" >382<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"385\" >385<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"386\" >386<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"387\" >387<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"389\" >389<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"420\" >420<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"421\" >421<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"423\" >423<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"501\" >501<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"502\" >502<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"503\" >503<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"504\" >504<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"505\" >505<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"506\" >506<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"507\" >507<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"509\" >509<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"591\" >591<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"592\" >592<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"593\" >593<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"595\" >595<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"597\" >597<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"598\" >598<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"670\" >670<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"673\" >673<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"674\" >674<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"675\" >675<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"676\" >676<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"677\" >677<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"678\" >678<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"679\" >679<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"680\" >680<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"685\" >685<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"686\" >686<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"688\" >688<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"691\" >691<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"692\" >692<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"850\" >850<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"855\" >855<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"856\" >856<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"880\" >880<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"960\" >960<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"961\" >961<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"962\" >962<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"963\" >963<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"964\" >964<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"965\" >965<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"966\" >966<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"967\" >967<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"968\" >968<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"971\" >971<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"972\" >972<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"973\" >973<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"974\" >974<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"975\" >975<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"976\" >976<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"977\" >977<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"992\" >992<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"993\" >993<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"994\" >994<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"995\" >995<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"996\" >996<\/option>\r\n\t\t\t\t \r\n\t\t   \t\t\t <option value=\"998\" >998<\/option>\r\n\t\t\t\t \r\n\t\t<\/select>\r\n\t\t\t<input type=\"text\" id=\"Movil\" name=\"Movil\" value=\"\"  class=\" form-control\"  \/>\r\n\r\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Direccion\" class=\"col-md-3 control-label\">Address:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Direccion\" name=\"Direccion\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Localidad\" class=\"col-md-3 control-label\">Location:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Localidad\" name=\"Localidad\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"CodigoPostal\" class=\"col-md-3 control-label\">Postal Code:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"CodigoPostal\" name=\"CodigoPostal\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Pais\" class=\"col-md-3 control-label\">Country:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Pais\" name=\"Pais\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"xxxx\" class=\"col-md-3 control-label\">MIR finalized YES\/NO:<span class=\"aviso\">*<\/span><\/label>\r\n\r\n\t\t\t\t\t<div class=\"col-md-9\">\r\n\t\t\t\t\t<select name=\"INT1\" class=\"required  form-control\" >\r\n                                \t<option value=\"\">--<\/option>\r\n\t\t\t\t\t\t\t\t\t<option value=\"1\"  >Yes<\/option>\r\n\t\t\t\t\t\t\t\t\t<option value=\"2\" >No<\/option>\r\n\t\t\t\t\t\t\t\t<\/select>\r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\r\n\t\t<\/fieldset>\r\n\r\n\r\n<br \/>\r\n\t\t<fieldset >\r\n\r\n\t<legend>Login Data<\/legend>\r\n\t\t\t<!--<script type=\"text\/javascript\">\r\n\t\t\t\tfunction recordarAsistente(){\r\n\t\t\t\t\tvar useremail;\r\n\t\t\t\t\t  useremail=jQuery(\"#Email\").val();\r\n\t\t\t\t\t\t  jQuery.post('https:\/\/doctaforum.net\/eventos\/Plantillas\/includes\/recordarClave.asp',{idEvento:6030,idIdioma:2,email:useremail},function(response){\r\n\t\t\t\t\t\t\t  jQuery(\"#resultadoDuplicidadEmail\").html(response);\r\n\t\t\t\t\t\t\t  });\r\n\t\t\t\t}\r\n\t\t\t  <\/script>-->\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Email\" class=\"col-md-3 control-label\">Email:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t\t<input type=\"text\" id=\"Email\" name=\"Email\" value=\"\" onkeyup=\"AjaxDuplicado(this.id,this.value,'resultadoDuplicidadEmail')\" onblur=\"AjaxDuplicado(this.id,this.value,'resultadoDuplicidadEmail')\" class=\"required form-control\" maxlength=\"100\" \/>\r\n\t\t\t\t<input type=\"Button\" style=\"display:none;\" class=\"boton\" name=\"rememberresultadoDuplicidadEmail\" onclick=\"javascript:recordarAsistente();\" id=\"rememberresultadoDuplicidadEmail\" value=\"Remember password?\" \/>\r\n\t\t\t\t<div id=\"resultadoDuplicidadEmail\" class=\"error\"><\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"Contrasena\" class=\"col-md-3 control-label\">Password:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"Contrasena\" name=\"Contrasena\" value=\"\"  class=\"required  form-control\"  \/>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\r\n\r\n\r\n\r\n\t\t<\/fieldset>\r\n\t\t<br \/>\r\n\r\n\t\t\t\t\t\r\n\t\t<fieldset >\r\n\t\t<legend>Invoice<\/legend>\r\n\t\t<div class=\"observacionesFormulario\"><\/div>\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"\" class=\"col-md-3 control-label\"><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t    \t<div class=\"checkbox\">\r\n\t\t    \t\t<label>\r\n\t\t\t\t\t<input type=\"checkbox\" value=\"1\" name=\"utilizarDP\" id=\"utilizarDP\"> <label for=\"utilizarDP\">Use personal data<\/label>\r\n\t\t\t\t<\/div>\r\n\t\t\t<\/div>\r\n\t\t<\/div>\r\n\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"CIFFacturacion\" class=\"col-md-3 control-label\">Tax ID Number:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-3\">\r\n\t\t\t\t<select name=\"TipoCIFFacturacion\" id=\"TipoCIFFacturacion\" class=\"form-control\">\r\n\t\t\t\t   \t\t\t <option value=\"1\">Vat number<\/option>\r\n\t\t\t\t   \t\t\t <option value=\"2\">ID or Passport number<\/option>\r\n\t\t\t  \t\t\t\t  <option value=\"3\">Other<\/option>\r\n\t\t\t\t\t<\/select>\r\n\r\n\t\t\t<\/div>\r\n\t\t    <div class=\"col-md-6\">\r\n\t\t\t\t\t<input type=\"text\" name=\"CIFFacturacion\" id=\"CIFFacturacion\" value=\"\"  class=\"form-control required\" maxlength=\"15\" \/>\r\n\t\t\t\t\t<br\/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"NombreFacturacion\" class=\"col-md-3 control-label\">Company:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"NombreFacturacion\" name=\"NombreFacturacion\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"DireccionF\" class=\"col-md-3 control-label\">Address:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"DireccionF\" name=\"DireccionF\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"LocalidadF\" class=\"col-md-3 control-label\">Location:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"LocalidadF\" name=\"LocalidadF\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"CodigoPostalF\" class=\"col-md-3 control-label\">Postal Code:<span class=\"aviso\">*<\/span><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t<input type=\"text\" id=\"CodigoPostalF\" name=\"CodigoPostalF\" value=\"\"  class=\"required  form-control\"  \/>\r\n\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\r\n\t\t\t\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"idProvinciaF\" class=\"col-md-3 control-label\">State:<\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\t\t\t\t\t<select name=\"idProvinciaF\" id=\"idProvinciaF\" class=\" form-control\">\r\n\t\t\t   \t\t\t <option value=\"\">---<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"15\">A CORU\u00d1A<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"1\">ALAVA\/ARABA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"2\">ALBACETE <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"3\">ALICANTE<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"4\">ALMER\u00cdA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"33\">ASTURIAS <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"5\">AVILA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"6\">BADAJOZ <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"8\">BARCELONA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"9\">BURGOS <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"10\">C\u00c1CERES <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"11\">C\u00c1DIZ <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"39\">CANTABRIA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"12\">CASTELL\u00d3N <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"51\">CEUTA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"13\">CIUDAD REAL <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"14\">C\u00d3RDOBA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"16\">CUENCA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"17\">GIRONA<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"18\">GRANADA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"19\">GUADALAJARA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"20\">GUIP\u00daZCOA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"21\">HUELVA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"22\">HUESCA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"7\">ILLES BALEARS<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"23\">JA\u00c9N<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"26\">LA RIOJA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"35\">LAS PALMAS <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"24\">LE\u00d3N<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"25\">LLEIDA<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"27\">LUGO <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"28\">MADRID <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"29\">M\u00c1LAGA<\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"52\">MELILLA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"30\">MURCIA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"31\">NAVARRA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"32\">OURENSE\/ORENSE <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"34\">PALENCIA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"36\">PONTEVEDRA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"37\">SALAMANCA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"40\">SEGOVIA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"41\">SEVILLA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"42\">SORIA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"38\">STA CRUZ DE TENERIFE <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"43\">TARRAGONA <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"44\">TERUEL <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"45\">TOLEDO <\/option>\r\n\t\t\t\t\t\t \r\n\t\t\t\t   \t\t\t <option value=\"46\">VALENCIA 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value=\"2\">\r\n\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"consentimiento1\" class=\"col-md-3 control-label\"><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\r\n\t\t    \t<div class=\"checkbox\">\r\n<label for=\"consentimiento1\"><input type=\"checkbox\" value=\"1\" name=\"consentimiento1\" id=\"consentimiento1\"  class=\"required\"  >\r\n\tI have read and accept the <a href='https:\/\/www.doctaforum.net\/eventos\/Plantillas\/consentimiento.asp?idTipoConsentimiento=1&idWeb=6030&idIdioma=2'  target='_blank'>Privacy Information<\/a>\t\r\n<\/label>\r\n\r\n\t\t    \t<\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\t\r\n\t\r\n<input type=\"hidden\" name=\"consentimiento3_nomarcado\" value=\"2\">\r\n\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"consentimiento3\" class=\"col-md-3 control-label\"><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\r\n\t\t    \t<div class=\"checkbox\">\r\n<label for=\"consentimiento3\"><input type=\"checkbox\" value=\"1\" name=\"consentimiento3\" id=\"consentimiento3\"  class=\"required\"  >\r\n\tI have read and accept the terms and conditions for <a href='https:\/\/www.doctaforum.net\/eventos\/Plantillas\/consentimiento.asp?idTipoConsentimiento=3&idWeb=6030&idIdioma=2'  target='_blank'>registration in the event<\/a>\t\r\n<\/label>\r\n\r\n\t\t    \t<\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\t\r\n\t\r\n<input type=\"hidden\" name=\"consentimiento4_nomarcado\" value=\"2\">\r\n\r\n\t\t  <div class=\"form-group\">\r\n\t\t    <label for=\"consentimiento4\" class=\"col-md-3 control-label\"><\/label>\r\n\t\t    <div class=\"col-md-9\">\r\n\r\n\t\t    \t<div class=\"checkbox\">\r\n<label for=\"consentimiento4\"><input type=\"checkbox\" value=\"1\" name=\"consentimiento4\" id=\"consentimiento4\"  >\r\n\tI have read and accept future notifications from the Foundation with the stated purposes.\t\r\n<\/label>\r\n\r\n\t\t    \t<\/div>\r\n\t\t\t<\/div>\r\n\t\t  <\/div>\t\r\n\r\n<\/fieldset>\r\n\r\n\r\n\t\t  <div 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