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<head>
<title>Registro de Participantes</title>
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<link rel="stylesheet" type="text/css" href="../imagenes/estilo.css">
<script src="../js/funciones.js"></script>
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<body topmargin="0" leftmargin="0">
<br>
<form name="formulario" method="post" action="../_registrar.php">
<input type="hidden" id="temp1" name="temp1">
<input type="hidden" id="estudiante" name="estudiante" value="0">
<input type="hidden" name="LEN" value="0">
<table align="center" cellpadding="0" cellspacing="0">
<tr>
    <td class="td1"></td><td class="td2" colspan="2"><b>Informaci&oacute;n Personal</b></td><td class="td3"></td>
</tr>
<tr>
    <td rowspan="23" class="td4"></td><td height="5px" colspan="2"></td><td rowspan="23" class="td5">
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<tr><td>* 1er Nombre:</td><td><input id="nom1" name="nom1" size="35" maxlength="30"></td></tr>
<tr><td>&nbsp; 2do Nombre:</td><td><input id="nom2" name="nom2" size="35" maxlength="30"></td></tr>
<tr><td>* 1er Apellido:</td><td><input id="ape1" name="ape1" size="35" maxlength="30"></td></tr>
<tr><td>&nbsp; 2do Apellido:</td><td><input id="ape2" name="ape2" size="35" maxlength="30"></td></tr>
<tr><td></td><td><select id="civil" name="civil">
						<option value="0">Sr.</option>
						<option value="1">Sra.</option>
						<option value="2">Srta.</option>
						<option value="4">Prof.</option>
						</select></td></tr>
<tr><td colspan="2" bgcolor="#000000" height="1px"></td></tr>
<tr><td colspan="2" height="5"></td></tr>
<tr><td>Grado Acad&eacute;mico:</td><td><select id="grado" name="grado">
						<option value="1">Dr</option>
                        <option value="2">PhD</option>
                        <option value="3">MPH</option>
                        <option value="4">MSc</option>
                        <option value="5">MA</option>
                        <option value="6">BS</option>
                        <option value="7">Ing</option>
						<option value="8">Otro</option>
						</select></td></tr>
<tr><td>T&iacute;tulo del Trabajo:</td><td><input id="titulo" name="titulo" size="35" maxlength="50"></td></tr>
<tr><td>* Instituci&oacute;n o Organizaci&oacute;n:</td><td><input id="empresa" name="empresa" size="35" maxlength="50"></td></tr>
<tr><td>* Direcci&oacute;n f&iacute;sica:</td><td><textarea id="direccion" name="direccion" style="height:51px; width:300px; overflow:hidden;"></textarea></td></tr>
<tr><td>* Ciudad:</td><td><input id="ciudad" name="ciudad" size="35" maxlength="50"></td></tr>
<tr><td>* Estado o Provincia:</td><td><input id="provincia" name="provincia" size="35" maxlength="50"></td></tr>
<tr><td>C&oacute;digo Postal:</td><td><input id="postal" name="postal" size="10" maxlength="10"></td></tr>
<tr><td>* Email:</td><td><input id="email" name="email" size="30" maxlength="50"></td></tr>
<tr><td>Confirmar Email:</td><td><input id="email2" name="email2" size="30" maxlength="50"></td></tr>
<tr><td>* Tel&eacute;fono:</td><td><input id="telefono" name="telefono" size="15" maxlength="15" onBlur="foco_i(this);">&nbsp;(Usar s&oacute;lo n&uacute;meros)</td></tr>
<tr><td>* Fax:</td><td><input id="fax" name="fax" size="15" maxlength="15" onBlur="foco_i(this);">&nbsp;(Usar s&oacute;lo n&uacute;meros)</td></tr>
<tr><td colspan="2" bgcolor="#000000" height="1px"></td></tr>
<tr><td colspan="2" height="5"></td></tr>
<tr><td>* Pa&iacute;s</td>
<td>
<select id="pais" name="pais">
<option value="1">Afganistan</option>
<option value="2">Africa del Sur</option>
<option value="3">Albania</option>
<option value="4">Alemania</option>
<option value="5">Andorra</option>
<option value="6">Angola</option>
<option value="7">Antigua y Barbuda</option>
<option value="8">Antillas Holandesas</option>
<option value="9">Arabia Saudita</option>
<option value="10">Argelia</option>
<option value="11">Argentina</option>
<option value="12">Armenia</option>
<option value="13">Aruba</option>
<option value="14">Australia</option>
<option value="15">Austria</option>
<option value="16">Azerbaijan</option>
<option value="17">Bahamas</option>
<option value="18">Bahrain</option>
<option value="19">Bangladesh</option>
<option value="20">Barbados</option>
<option value="21">Bielorrusia</option>
<option value="22">Belgica</option>
<option value="23">Belice</option>
<option value="24">Benin</option>
<option value="25">Bermudas</option>
<option value="26">Bolivia</option>
<option value="27">Bosnia</option>
<option value="28">Botswana</option>
<option value="29">Brasil</option>
<option value="30">Brunei Darussulam</option>
<option value="31">Bulgaria</option>
<option value="32">Burkina Faso</option>
<option value="33">Burundi</option>
<option value="34">Butan</option>
<option value="35">Camboya</option>
<option value="36">Camerun</option>
<option value="37">Canada</option>
<option value="38">Cape Verde</option>
<option value="39">Chad</option>
<option value="40">Chile</option>
<option value="41">China</option>
<option value="42">Chipre</option>
<option value="218">Ciudad del Baticano</option>
<option value="43">Colombia</option>
<option value="44">Comoros</option>
<option value="45">Congo</option>
<option value="46">Corea del Norte</option>
<option value="47">Corea del Sur</option>
<option value="48">Costa de Marfíl</option>
<option value="49">Costa Rica</option>
<option value="50">Croasia</option>
<option value="51">Cuba</option>
<option value="52">Dinamarca</option>
<option value="53">Djibouti</option>
<option value="54">Dominica</option>
<option value="55">Ecuador</option>
<option value="56">Egipto</option>
<option value="57">El Salvador</option>
<option value="58">EUA</option>
<option value="59">Eritrea</option>
<option value="60">Eslovenia</option>
<option value="61">Espa&ntilde;a</option>
<option value="62">Estados Unidos</option>
<option value="63">Estonia</option>
<option value="64">Etiopia</option>
<option value="65">Fiji</option>
<option value="66">Filipinas</option>
<option value="67">Finlandia</option>
<option value="68">Francia</option>
<option value="69">Gabon</option>
<option value="70">Gambia</option>
<option value="71">Georgia</option>
<option value="72">Ghana</option>
<option value="73">Granada</option>
<option value="74">Grecia</option>
<option value="75">Groenlandia</option>
<option value="76">Guadalupe</option>
<option value="77">Guam</option>
<option value="78">Guatemala</option>
<option value="79">Guayana Francesa</option>
<option value="80">Guerney</option>
<option value="81">Guinea</option>
<option value="82">Guinea-Bissau</option>
<option value="83">Guinea Equatorial</option>
<option value="84">Guyana</option>
<option value="85">Haiti</option>
<option value="86">Holanda</option>
<option value="87">Honduras</option>
<option value="88">Hong Kong</option>
<option value="89">Hungria</option>
<option value="90">India</option>
<option value="91">Indonesia</option>
<option value="92">Irak</option>
<option value="93">Iran</option>
<option value="94">Irlanda</option>
<option value="95">Islandia</option>
<option value="96">Islas Caiman</option>
<option value="97">Islas Faroe</option>
<option value="98">Islas Malvinas</option>
<option value="99">Islas Marshall</option>
<option value="100">Islas Solomon</option>
<option value="101">Islas Virgenes Britanicas</option>
<option value="102">Islas Virgenes (U.S.)</option>
<option value="103">Israel</option>
<option value="104">Italia</option>
<option value="105">Jamaica</option>
<option value="106">Japon</option>
<option value="107">Jersey</option>
<option value="108">Jordania</option>
<option value="109">Kazakhstan</option>
<option value="110">Kenia</option>
<option value="111">Kiribati</option>
<option value="112">Kuwait</option>
<option value="113">Kyrgyzstan</option>
<option value="114">Laos</option>
<option value="115">Latvia</option>
<option value="116">Lesotho</option>
<option value="117">Libano</option>
<option value="118">Liberia</option>
<option value="119">Libia</option>
<option value="120">Liechtenstein</option>
<option value="121">Lituania</option>
<option value="122">Luxemburgo</option>
<option value="123">Macao</option>
<option value="124">Macedonia</option>
<option value="125">Madagascar</option>
<option value="126">Malasia</option>
<option value="127">Malawi</option>
<option value="128">Maldivas</option>
<option value="129">Mali</option>
<option value="130">Malta</option>
<option value="131">Marruecos</option>
<option value="132">Martinica</option>
<option value="133">Mauricio</option>
<option value="134">Mauritania</option>
<option value="135">Mexico</option>
<option value="136">Micronesia</option>
<option value="137">Moldova</option>
<option value="138">Monaco</option>
<option value="139">Mongolia</option>
<option value="140">Mozambique</option>
<option value="141">Myanmar (Burma)</option>
<option value="142">Namibia</option>
<option value="143">Nepal</option>
<option value="144">Nicaragua</option>
<option value="145">Niger</option>
<option value="146">Nigeria</option>
<option value="147">Noruega</option>
<option value="148">Nueva Caledonia</option>
<option value="149">Nueva Zelandia</option>
<option value="150">Oman</option>
<option value="151">Pakistan</option>
<option value="152">Palestina</option>
<option value="153">Panama</option>
<option value="154">Papua Nueva Guinea</option>
<option value="155">Paraguay</option>
<option value="156">Peru</option>
<option value="157">Polinesia Francesa</option>
<option value="158">Polonia</option>
<option value="159">Portugal</option>
<option value="160">Puerto Rico</option>
<option value="161">Qatar</option>
<option value="162">Reino Unido</option>
<option value="163">Republica Centroafricana</option>
<option value="164">Republica Checa</option>
<option value="165">Republica Democratica del Congo</option>
<option value="166">Republica Dominicana</option>
<option value="167">Republica Eslovaca</option>
<option value="168">Reunion</option>
<option value="169">Ruanda</option>
<option value="170">Rumania</option>
<option value="171">Rusia</option>
<option value="172">Sahara</option>
<option value="173">Samoa</option>
<option value="174">San Cristobal-Nevis (St. Kitts)</option>
<option value="175">San Marino</option>
<option value="176">San Vincente y las Granadinas</option>
<option value="177">Santa Helena</option>
<option value="178">Santa Lucia</option>
<option value="179">Santa Sede (Vaticano)</option>
<option value="180">Sao Tome & Principe</option>
<option value="181">Senegal</option>
<option value="182">Seychelles</option>
<option value="183">Sierra Leona</option>
<option value="184">Singapur</option>
<option value="185">Siria</option>
<option value="186">Somalia</option>
<option value="187">Sri Lanka (Ceilan)</option>
<option value="188">Sudan</option>
<option value="189">Suecia</option>
<option value="190">Suiza</option>
<option value="191">Sur Africa</option>
<option value="192">Surinam</option>
<option value="193">Swaziland</option>
<option value="194">Tailandia</option>
<option value="195">Taiwan</option>
<option value="196">Tajikistan</option>
<option value="197">Tanzania</option>
<option value="198">Timor Oriental</option>
<option value="199">Togo</option>
<option value="200">Tokelau</option>
<option value="201">Tonga</option>
<option value="202">Trinidad & Tobago</option>
<option value="203">Tunisia</option>
<option value="204">Turkmenistan</option>
<option value="205">Turquia</option>
<option value="206">Ucrania</option>
<option value="207">Uganda</option>
<option value="208">Union Europea</option>
<option value="209">Uruguay</option>
<option value="210">Uzbekistan</option>
<option value="211">Vanuatu</option>
<option value="212">Venezuela</option>
<option value="213">Vietnam</option>
<option value="214">Yemen</option>
<option value="215">Yugoslavia</option>
<option value="216">Zambia</option>
<option value="217">Zimbabwe</option>
</select></td></tr>
<tr align="center"><td height="5" colspan="2"></td></tr>
<tr>
    <td class="td6"></td><td class="td7" colspan="2"></td><td class="td8"></td>
</tr>
</table>
<center>
<font size="-1">* Campos Obligatorios</font>
<br>
<br>
<input type="button" class="boton" value="Registrar" onClick="Registrar(this);">
</center>
</form>
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</body>
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