+<div class="mindcoding_logo"></div>
+<div class="spacer"></div>
+
+<form action="/action/register" method="POST" class="jsform">
+<div class="main">
+<table>
+<tr> <td>Username <td><input type="text" name="username" required>
+<tr> <td>Password <td><input type="password" name="password" required>
+<tr> <td>Confirm password <td><input type="password" name="confirm_password" required>
+
+<tr> <td>Full name <td><input type="text" name="name" required>
+<tr> <td>Email <td><input type="email" name="email" required>
+<tr> <td>Phone <td><input type="tel" name="phone" required>
+<tr> <td>Town <td><input type="text" name="town" required>
+<tr> <td>University <td><input type="text" name="university" required>
+<tr> <td>Level <td><select name="level"> <option>Highschool</option> <option>Undergraduate</option> <option>Master</option> <option>Doctorate</option> <option>Other</option> </select>
+
+<tr> <td colspan="2"><input type="submit" value="Register" class="submit">
+</table>
+<div class="logos">
+<a href="http://www.societatea-hermes.ro"><div class="hermes"></div></a>
+<a href="https://www.facebook.com/mindcodingcluj"><div class="fb"></div></a>
+</div>
+</div>
+</form>