SE DEBEN COMPLETAR TODOS LOS CAMPOS<style type="text/css">
<!--
.Estilo1 {
	font-family: Arial, Helvetica, sans-serif;
	font-size: 12px;
	color: #FFFFFF;
}
-->
</style>


<FORM name=form1 method=POST>
  <table width="281" border="1" align="center" bordercolor="#666666">
  <tr bgcolor="#999999">
    <td width="121"><div align="right" class="Estilo1">Login:</div></td>
    <td width="144"><input type=text name='log' value=""></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">Contrase&ntilde;a:</div></td>
    <td><input type=password name='pass'></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">Nombre:</div></td>
    <td><input name='nom' type=text value="" size="50"></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">Apellido:</div></td>
    <td><input name='ape' type=text value="" size="50"></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">Empresa: </div></td>
    <td><input name='emp' type=text value="" size="50"></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">E-Mail:</div></td>
    <td><input name='mail' type=text value="" size="50"></td>
  </tr>
  <tr bgcolor="#999999">
    <td><div align="right" class="Estilo1">Telefono:</div></td>
    <td><input name='tel' type=text value="" size="50"></td>
  </tr>
  <tr bgcolor="#999999">
    <td colspan="2">
        <div align="center">
          <input name="submit" type=submit value="Registrarse">
      </div></td></tr>
</table>
  </FORM>