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	errfile=/home43/gzcustom/customer/customerform.php
	errline=335
<div class="gz-right">
   <div id="FormPanel1_1">
      <form role="form"  id="ConfirmForm" class="form-horizontal">
         <span id="Action" class="ConfirmForm HiddenInput">
            <input type="hidden" id="fAction" value="NewConfirm">
         </span>
         <div class="row">
            <div class="col-sm-6">
               <h3>Customer Details</h3>
               <table width="100%">
               <tr>
                   <td width="50%">Customer Name:</td>
                   <td width="50%">
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	errline=349
</td>
               </tr><tr>
                   <td>Status:</td>
                   <td>
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	errline=352
</td>
               </tr><tr>
                   <td>How did you hear about us:</td>
                   <td>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=355
</td>
               </tr>
               </table>
            </div>
            <div class="col-sm-6">
               <h3>Principal Contact</h3>
               <table width="100%">
               <tr>
                  <td width="50%">Name:</td>
                  <td width="50%">
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	errno=8
	errstr=Trying to access array offset on value of type null
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	errline=364
</td>
               </tr><tr valign="top">
                  <td>Address:</td>
                  <td>
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<br/>
                      
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=368
</td>
               </tr><tr>
                  <td>City/Town:</td>
                  <td>
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	errno=8
	errstr=Trying to access array offset on value of type null
	errfile=/home43/gzcustom/customer/customerform.php
	errline=371
                      
Error_Handler:
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	errline=372
</td>
               </tr><tr>
                  <td>Country</td>

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	errline=376

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	errfile=/home43/gzcustom/includes/database.inc
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                  <td>
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	errline=381
</td>
               </tr><tr>
                  <td>Phone:</td>
                  <td>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=384
</td>
               </tr><tr>
                  <td>Fax:</td>
                  <td>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=387
</td>
               </tr><tr>
                  <td>Mobile:</td>
                  <td>
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	errno=8
	errstr=Trying to access array offset on value of type null
	errfile=/home43/gzcustom/customer/customerform.php
	errline=390
</td>
               </tr><tr>
                  <td>Email:</td>
                  <td>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=393
</td>
               </tr></tr>
                  <td>Subscribe to Newsletter:</td>
                  <td>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=396
No</td>
               </tr>
               </table>
            </div>
         </div>
         <div id="FormButtons1_2" class="Panel-Buttons" style="display:none">
            <a href="#" class="btn btn-sm btn-confirm"
               OnClick="SaveForm(1);return false">Confirm Account Creation</a>
            <a href="/" class="btn btn-sm btn-cancel Button-2">
               Cancel</a>
         </div>
      </form>
   </div>
   <div id="FormPanel1_2" class="panel" style="display:none">
      <h2>Creating Customer ...</h2>

      <p>As part of the Account creation process, we will send an
      <i>Activation Email</i> to <b>
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	errfile=/home43/gzcustom/customer/customerform.php
	errline=413
</b>.
      This has a two-fold purpose. Firstly it confirms that the email address
      provided is valid and secondly it ensures it belongs to someone that 
      is expecting to be the principal contact for this account.</p>
      <p>If you do not receive the email, please first <b>check to see whether
      it was marked as SPAM</b> and automatically moved to your Junk mail
      folder. Please email us at
      <a href="mailto:support@godzone.net.nz?subject=Missing%20Activation%20Email">
      support@godzone.net.nz</a></p>

      <p>When the email arrives please follow the instructions it contains to
      complete the activation of this account.</p>

      <p>To ensure that you receive all future communications from us, please
      add our domain <b>godzone.net.nz</b> to your email sender's whitelist.</p>

      <div id="MonitorTasks1"></div>
         <div class="Panel-Buttons">
            <a href="http://www.godzone.net.nz" class="btn btn-sm btn-confirm">
               Continue</a>
         </div>
      </div>
   </div>
</div>
<script>
   InitForm( 1 );
   oForm[1].Fields = jQuery( 'span', '#ConfirmForm' );
   oForm[1].Action = 'customer/customerform.cgi';
   oForm[1].ProcessResult = ProcessResultDefault;
   UpdateForm(1);
</script>