تبلیغات
</div></div><div id="test_signup"></div><div style="direction: rtl;" id="form-wrapper-13199930924ead7f04641a0"><form id="frm-13199930924ead7f04641a0" method="post" action="http://www.mihanblog.com/web/signup/index/intreg/0/atrty/1319993092/avrvy/569399/key/19edf6779afa58d92b9b587578b8c818/" onsubmit="if(formsend('13199930924ead7f04641a0')) return false;"><fieldset>
	<legend>اطلاعات</legend>




<div class="form-row">
<label class="required" for="address">آدرس بلاگ</label>
<div class="newwebform clearfix">

<div>&nbsp;.mihanblog.com </div><div style="width: 250px;"><input name="data[address]" id="address" value="" class="english" onblur="checkblogname(this.value)" style="width: 240px;" type="text"></div><div>http://www.</div> </div>
<div id="blog-address"></div>
			<div style="display: none;">
<a href="http://www.mihanblog.com/web/signup/checkblogname/address" onclick=" ; getContent(this, {target: 'blog-address'},true); return false;" title="" class="" target="_self" id="checkblognameLink" style="color: rgb(255, 0, 0);">پیگیری آزاد بودن نام وبلاگ</a> </div>
</div>
<div class="form-row">
<label class="required" for="title">عنوان بلاگ</label>
<input name="data[title]" id="title" value="" class="large" type="text"> </div>

	
<div class="form-row">
<label class="required" for="first_name">نام</label>
<input name="data[first_name]" id="first_name" value="" class="large" type="text"> </div>

<div class="form-row">
<label class="required" for="last_name">نام خانوادگی</label>
<input name="data[last_name]" id="last_name" value="" class="large" type="text"> </div>

<div class="form-row">
		<label class="required" for="username">نام کاربری</label>
<input name="data[username]" id="username" value="" class="large english" type="text"> </div>

<div class="form-row">
<label class="required" for="userpass">رمز عبور</label>
<input name="data[userpass]" id="userpass" value="" class="large english" type="password"> </div>

<div class="form-row">
<label class="required" for="userpass_confirm">تکرار رمز عبور</label>
		<input name="data[userpass_confirm]" id="userpass_confirm" value="" onkeyup='getPasswordStrength("userpass_confirm")' class="large english" type="password">	
<div style="margin: 10px 200px 10px 0px; width: 200px; font-size: 10px; color: gray; text-align: center; line-height: 15px;">امنیت کلمه عبور
: <span id="note_userpass_confirm" style="color: blue; font-weight: bold;">&nbsp;</span>
<div style="width: 200px; height: 4px; background-color: rgb(238, 238, 238);">
<div id="strength_userpass_confirm" style="float: left; width: 0px; height: 4px; background-color: red;"></div>
</div>
</div>

</div>

<div class="form-row">
			<label class="required" for="userpass">
<input name="data[terms]" id="data[terms]" value="1" type="checkbox"> کلیه <a href="http://www.mihanblog.com/etc/main/terms" title="" class="" target="_blank">قوانین میهن بلاگ</a> را مطالعه کرده ام و قبول دارم. </label>
</div>
<div class="controls">
<input name="secfrdcodedvar" id="secfrdcodedvar" value="b41f7300239526fd653c2c494aed5dd5" type="hidden"><input value="ثبت نام" class="btn" type="submit"> </div>
</fieldset>
<input name="data[checkgetrequest]" value="true" id="data[checkgetrequest]" type="hidden"><input name="frm-id" value="13199930924ead7f04641a0" id="frm-id" type="hidden"></form></div>				<script type="text/javascript">formtarget['13199930924ead7f04641a0'] = 'test_signup';</script><div class="publishPaging"></div>