{header}
Members Area
Changing Personal Details
{intro_text}
Please re-enter the data into fields shown in red:
{errors_list}
Login Information
Login
*
Letters and numbers only
Password
*
Three characters or more; capitalization doesn't matter
Confirm Password
*
Personal Details
Name
{name_required}
First Name
{first_name_required}
Last Name
{last_name_required}
Company Name
{company_name_required}
Email
{email_required}
Address
{address1_required}
{address2_required}
City
{city_required}
Province
{province_required}
State
{state_code_required}
{state_code_description}
for United States only
Zip/Postal Code
{zip_required}
Country
{country_code_required}
{country_code_description}
Phone
{phone_required}
Daytime Phone
{daytime_phone_required}
Evening Phone
{evening_phone_required}
Cell phone
{cell_phone_required}
Fax
{fax_required}
Delivery Details
If the delivery details is the same as above tick here
if not then please complete the details below
Name
{delivery_name_required}
First Name
{delivery_first_name_required}
Last Name
{delivery_last_name_required}
Company Name
{delivery_company_name_required}
Email
{delivery_email_required}
Street Address 1
{delivery_address1_required}
Street Address 2
{delivery_address2_required}
City
{delivery_city_required}
Province
{delivery_province_required}
State (for US only)
{delivery_state_code_required}
{delivery_state_code_description}
Zip/Postal Code
{delivery_zip_required}
Country
{delivery_country_code_required}
{delivery_country_code_description}
Phone
{delivery_phone_required}
Daytime Phone
{delivery_daytime_phone_required}
Evening Phone
{delivery_evening_phone_required}
Cell phone
{delivery_cell_phone_required}
Fax
{delivery_fax_required}
{footer}