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   <td rowspan="3" align="center" valign="top" bgcolor="#DFDFFF"><font color="#FF9900" size="2" face="Arial, Helvetica, sans-serif"><font color="#FF0000"><em>b</em></font><font color="#000000">eauty</font><font size="2"><em><font color="#000000">s</font><strong><font color="#808080">tyling <br>
      </font></strong><font color="#808080"> <font color="#000000"><a href="mailto:info@beautystyling.nl">Meer
      informatie</a><br>
036-534 38 90 <br>
06-514 68 639</font><strong> </strong></font></em></font></font></td>

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</font>

    <font color="#000066" face="Geneva, Arial, Helvetica, sans-serif"> <strong><font color="#9CA5F3" size="+2"><img src="images/welkom.png" width="463" height="43"></font></strong></font></td>

   <td><img src="images/spacer.gif" width="1" height="22" border="0" alt=""></td>

  </tr>

  <tr>

   <td rowspan="3" valign="bottom" bgcolor="#DFDFFF">        <div align="center"><font color="#666666" size="-7" face="Arial, Helvetica, sans-serif"><a href="aanmelden.php" target="_parent">Schrijf
        nu in</a><font color="#000000">, en ontvang de beste aanbiedingen op beautygebied.</font>
        </font> <img src="images/spacer.gif" width="80" height="40"> <br><a href="inlog.php" target="_parent"><img src="images/inloggen.gif" border="0"></a><br>
    </div></td>

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    <td colspan="12" rowspan="6">
	<TABLE id="mainborder" cellspacing="0" cellPadding="0" width="660" border=0>
	<tr>	<TD id=infocell align="top"  width="660"> <DIV style="overflow: auto; width: 660; height: 340">
		
  <h2 align="center"><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Meld u aan en wordt lid van onze VSP-club!</font></h2>
  <br>

  <form method="post">

  <table border="0" align="center">

    <tr>

      <td colspan="2"><strong>Persoonlijke

        gegevens:</strong></td>

    </tr>

    <tr>

      <td>* Voornaam: </td>

      <td>

        <input type="text" name="voornaam">

      </td>

    </tr>

    <tr>

      <td>* Achternaam: </td>

      <td>

        <input type="text" name="achternaam">

        Tussenvoegsel(s):

        <input type="text" name="tussenvoegsel" size="7">

      </td>

    </tr>

    <tr>

      <td>* Straatnaam: </td>

      <td>

        <input type="text" name="straatnaam">

        Huisnummer:

        <input type="text" name="huisnummer" size="4">

      </td>

    </tr>

    <tr>

      <td>* Postcode: </td>

      <td>

        <input type="text" name="postcode" maxlength="6" size="7">

      </td>

    </tr>

    <tr>

      <td>* Woonplaats:</td>

      <td>

        <input type="text" name="woonplaats">

      </td>

    </tr>

    <tr>

      <td>* E-mail: </td>

      <td>

        <input type="text" name="email">

      </td>

    </tr>

    <tr>

      <td>* Geboortedatum: </td>

      <td>

        <label for="dag" >

        <select name="dag">

          <option value=""  selected  > Dag

          <option value="01"> 01

          <option value="02"> 02

          <option value="03"> 03

          <option value="04"> 04

          <option value="05"> 05

          <option value="06"> 06

          <option value="07"> 07

          <option value="08"> 08

          <option value="9"> 09

          <option value="10"> 10

          <option value="11"> 11

          <option value="12"> 12

          <option value="13"> 13

          <option value="14"> 14

          <option value="15"> 15

          <option value="16"> 16

          <option value="17"> 17

          <option value="18"> 18

          <option value="19"> 19

          <option value="20"> 20

          <option value="21"> 21

          <option value="22"> 22

          <option value="23"> 23

          <option value="24"> 24

          <option value="25"> 25

          <option value="26"> 26

          <option value="27"> 27

          <option value="28"> 28

          <option value="29"> 29

          <option value="30"> 30

          <option value="31"> 31

          <option value"32">

        </select>

        </label>

        <label for="maand" >

        <select name="maand">

          <option value=""  selected  > Maand

          <option value="01"> Januari

          <option value="02"> Februari

          <option value="03"> Maart

          <option value="04"> April

          <option value="05"> Mei

          <option value="06"> Juni

          <option value="07"> Juli

          <option value="08"> Augustus

          <option value="09"> September

          <option value="10"> Oktober

          <option value="11"> November

          <option value="12"> December

        </select>

        </label>

        <input type="text" name="jaar" size="5" maxlength="4" value="">

        (Voorbeeld: 2003)</td>

    </tr>

    <tr>

      <td>&nbsp;</td>

    </tr>

    <tr>

      <td colspan="2"><strong>Login

        gegevens:</strong></td>

    </tr>

    <tr>

      <td>* Gebruikersnaam: </td>

      <td>

        <input type="text" name="gebruikersnaam">

      </td>

    </tr>

    <tr>

      <td>* Wachtwoord: </td>

      <td>

        <input type="password" name="paswoord">

      </td>

    </tr>

    <tr>

      <td>* Wachtwoord: </td>

      <td>

        <input type="password" name="paswoord2">

      </td>

    </tr>

    <tr>

      <td>&nbsp;</td>

    </tr>

    <tr>

      <td>Beroep: </td>

      <td>

        <select name="beroep">

          <option value="geen keuze geselecteerd"  > [Kies een beroep]

          <option value="Algemeen leidinggevend"  > Algemeen leidinggevend

          <option value="Boekhouding/financieel"  > Boekhouding/financieel

          <option value="Computers (Internet)"  > Computers (Internet)

          <option value="Computers (Overige)"  > Computers (overige)

          <option value="Consulent/adviserend"  > Consulent/adviserend

          <option value="Gepensioneerd"  > Gepensioneerd

          <option value="Hoger management"  > Hoger management

          <option value="Huisvrouw"  > Huisvrouw

          <option value="Klantenservice"  > Klantenservice

          <option value="Medisch/juridisch etc."  > Medisch/juridisch etc.

          <option value="Onderwijs"  > Onderwijs

          <option value="Overheid/leger"  > Overheid/leger

          <option value="Productie/fabriek"  > Productie/fabriek

          <option value="Research en ontwikkeling"  > Research en ontwikkeling

          <option value="Student"  > Student

          <option value="Techniek"  > Techniek

          <option value="Verkoop/marketing/reclame"  > Verkoop/marketing/reclame

          <option value="Werkloos"  > Werkloos

          <option value="Winkelier/ambachtelijk"  > Winkelier/ambachtelijk

          <option value="Zelfstanding/eigenaar"  > Zelfstanding/eigenaar

          <option value="Overig"  > Overig

        </select>



    <tr>

      <td>&nbsp;</td>

    </tr>

    <tr>

      <td>Interesses: </td>

      <td>

        <input type="checkbox" name="hairstyling" value="hairstyling" >

        Hairstyling</td>

    </tr>

    <tr>

      <td>&nbsp;</td>

          <td>

        <input type="checkbox" name="fotografie" value="fotografie" >

        Fotografie</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

        <input type="checkbox" name="bruiloft" value="bruiloft" >

        Bruiloft</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

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        Visagie</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

        <input type="checkbox" name="mode" value="mode" >

        Mode</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

        <input type="checkbox" name="nagelstyling" value="nagelstyling" >

        Nagelstyling</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

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        Metamorfose</td>

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    <tr>

      <td>&nbsp;</td>



      <td>

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        Workshops</td>

    </tr>

    <tr>

      <td>&nbsp;</td>



      <td>

        <input type="checkbox" name="model" value="model" >

        Model</td>

    </tr>

    <tr>

      <td>&nbsp;</td>


      <td>

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        Modeshows</td>

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	<tr><td>&nbsp;</td></tr>

    <tr>

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   <td rowspan="5" align="center" valign="top" bgcolor="#CCCCFF"><font color="#FF9900" size="3" face="Arial, Helvetica, sans-serif"><strong><em>Beautytip</em></strong></font> <br>     <font face="Verdana" size="1">Zorg dat je voldoende slaap krijgt. Wie uitgerust is, voelt zich goed - en als je je goed voelt, zie je er ook goed uit. Bovendien vernieuwt je huid zich sneller tijdens je slaap dan overdag.<BR> <a href="shop/index.html" target="_blank">Bestel in de Webshop</a>
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     <font color="#FF9900" size="3" face="Arial, Helvetica, sans-serif"><strong><em>Beautytip</em></strong></font><br>     <font face="Verdana" size="1">Zorg dat je voldoende slaap krijgt. Wie uitgerust is, voelt zich goed - en als je je goed voelt, zie je er ook goed uit. Bovendien vernieuwt je huid zich sneller tijdens je slaap dan overdag.<BR> <a href="shop/index.html" target="_blank">Bestel in de Webshop</a>
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   <td align="left" valign="top" bgcolor="#CCCCFF"><p align="center"><font color="#FF9900" size="3" face="Arial, Helvetica, sans-serif"><strong><em>Beautytip</em></strong></font><br>
     <font face="Verdana" size="1">Bezoek nu onze webshop met de professionele producten van Make-up Studio. Make-up studio biedt zowel de veeleisende professional als de moderne vrouw een absoluut kwaliteitsproduct.<BR><a href="shop/index.html" target="_blank"><img src="images/webshop.gif" width="129" height="86" border="0"></a></font>     </p>
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