<form id="form1" name="form1" method="post" action="" >
<fieldset> <div class="cclear"></div>
<legend>Check ID Availability </legend>
<p class="aviso"></p>
</div>
<label for="username">Username</label>
<input id="username" name="username"><br>
<label for="E-mail">E-Mail</label>
<input id="email" name="email" value="@">
<br>
</fieldset>
<div class="clear"></div>
<fieldset><div class="clear"></div>
<legend>Set a Password</legend>
<p class="aviso2"></p>
<label for="password">Password</label>
<input id="password" name="password"><br>
<label for="Password2">Retype Password</label>
<input id="password2" name="password2"><br>
<div class="cclear"></div>
</fieldset>
<div class="clear"></div>
<fieldset><div class="clear"></div>
<legend>Account Information</legend>
<p class="aviso3"></p>
<label for="name">Name</label>
<input id="name" name="name"><br>
<label for="lastname">Last Name</label>
<input id="lastn" name="lastn"><br>
<label for="country">Country</label>
<select name="pais">
<option>Select...</option>
<option>---</option>
</select><br>
<label for="city">City</label>
<select name="ciudad">
<option>Select...</option>
<option>---</option>
</select><br>
<label for="bithyear">Bith Year</label>
<input id="bithday" name="bithday" value="YYYY/MM/DD"><br>
<label for="gender">Gender</label>
<select name="genero">
<option>Select...</option>
<option>Male</option>
<option>Female</option>
</select><br><div class="cclear"></div>
</fieldset>
<div class="cclear"></div>
<div id="verificar"></div>
<input type="submit" name="Submit" value="Register" class="green" />
</form>
</body>
</html>