<div id="register_form" class="register-inner">
	<div class="blue-notice">
		<b>Başöğretmenim</b>'e kayıt olmak için; aşağıdaki formu doldurarak <b>devam edebilirsin.</b>
	</div>
	<div class="social_register">
		<div class="fcont">
			<div class="facebooklogin">
				<a href="https://graph.facebook.com/oauth/authorize?client_id=226708237340694&scope=user_photos,email,user_notes,offline_access,user_birthday,user_education_history,read_stream,user_hometown,user_location&redirect_uri=http://www.basogretmenim.com/callback/facebook/" style="color: #fff">
					<b>Facebook</b> hesabın ile kayıt ol &raquo;
				</a>
			</div>
		</div>
		<div class="ocont">
			<div class="okullogin">
				<a target="_blank" href="http://www.okul.com.tr/#!/uye-girisi">
					<b>Okul.com.tr </b> hesabın ile kayıt ol &raquo;
				</a>
			</div>
		</div>
	</div>
	<div class="register_form">
		<form method="post" id="f_register" action="http://www.basogretmenim.com/Login/register">

						
			<div style="width: 360px; margin: 0 auto">

				<div class="variable-odd rad10-top rad10-bottom">
					<label class="form_variable">TC Kimlik No:</label>

					
					<input class="tckimlik first " tabindex="1" maxlength="11" type="text" name="customer_username" value=""/>

					<div style="clear: both"></div>

									</div>

				<div class="variable">

					<label class="form_variable">Şifre / Tekrar:</label>

					
					<input tabindex="3" autocomplete="off" type="password" class="" name="customer_password_again" value="" style="width: 90px"/>

					<div style="float: right; margin-right: 8px">

						
						<input tabindex="2" autocomplete="off" type="password" class="" name="customer_password" value="" style="width: 90px;"/>

					</div>
					<div style="clear: both"></div>

				</div>

				<div class="variable-odd rad10-top rad10-bottom">

					<label class="form_variable">İsim / Soyisim:</label>

					
					<input tabindex="5" type="text" class="" name="customer_lastname" style="width: 90px" value=""/>

					<div style="float: right; margin-right: 8px">

						
						<input tabindex="4" id="name" type="text" class="" name="customer_firstname" style="width: 90px" value=""/>

					</div>

					<div style="clear: both"></div>

				</div>

				<div class="variable">

					<label class="form_variable">E-posta Adresi:</label>

					
					<input tabindex="6" type="text" class="" name="customer_email" value=""/>

					<div style="clear: both"></div>

					
				</div>

				<div class="location variable-odd rad10-top rad10-bottom">

					<label class="form_variable">İl / İlçe:</label>

					<div class="rounded_input" id="select_address_district" style="float: right">

					
						<select name="address_district"  tabindex="8" style="width: 102px;" class="" >
<option value="" selected="selected">&nbsp;</option>
</select>
					</div>

					<div class="rounded_input" id="select_address_city">

																		
						<select name="address_city"  tabindex="7" id="address_city" style="width: 102px; float: left; margin-left: 23px" class="" onChange="listSelect('http://www.basogretmenim.com/Load/Address/city|district|mahalle/Off/Off/','select_address_district','address_city');">
<option value="" selected="selected">&nbsp;</option>
<option value="1#bso#Adana">Adana</option>
<option value="2#bso#Adıyaman">Adıyaman</option>
<option value="3#bso#Afyon">Afyon</option>
<option value="4#bso#Ağrı">Ağrı</option>
<option value="5#bso#Aksaray">Aksaray</option>
<option value="6#bso#Amasya">Amasya</option>
<option value="7#bso#Ankara">Ankara</option>
<option value="8#bso#Antalya">Antalya</option>
<option value="9#bso#Ardahan">Ardahan</option>
<option value="10#bso#Artvin">Artvin</option>
<option value="11#bso#Aydın">Aydın</option>
<option value="12#bso#Balıkesir">Balıkesir</option>
<option value="13#bso#Bartın">Bartın</option>
<option value="14#bso#Batman">Batman</option>
<option value="15#bso#Bayburt">Bayburt</option>
<option value="16#bso#Bilecik">Bilecik</option>
<option value="17#bso#Bingöl">Bingöl</option>
<option value="18#bso#Bitlis">Bitlis</option>
<option value="19#bso#Bolu">Bolu</option>
<option value="20#bso#Burdur">Burdur</option>
<option value="21#bso#Bursa">Bursa</option>
<option value="22#bso#Çanakkale">Çanakkale</option>
<option value="23#bso#Çankırı">Çankırı</option>
<option value="24#bso#Çorum">Çorum</option>
<option value="25#bso#Denizli">Denizli</option>
<option value="26#bso#Diyarbakır">Diyarbakır</option>
<option value="27#bso#Düzce">Düzce</option>
<option value="28#bso#Edirne">Edirne</option>
<option value="29#bso#Elazığ">Elazığ</option>
<option value="30#bso#Erzincan">Erzincan</option>
<option value="31#bso#Erzurum">Erzurum</option>
<option value="32#bso#Eskişehir">Eskişehir</option>
<option value="33#bso#Gaziantep">Gaziantep</option>
<option value="34#bso#Giresun">Giresun</option>
<option value="35#bso#Gümüşhane">Gümüşhane</option>
<option value="36#bso#Hakkari">Hakkari</option>
<option value="37#bso#Hatay">Hatay</option>
<option value="38#bso#Iğdır">Iğdır</option>
<option value="39#bso#Isparta">Isparta</option>
<option value="40#bso#İstanbul">İstanbul</option>
<option value="41#bso#İzmir">İzmir</option>
<option value="42#bso#Kahramanmaraş">Kahramanmaraş</option>
<option value="43#bso#Karabük">Karabük</option>
<option value="44#bso#Karaman">Karaman</option>
<option value="45#bso#Kars">Kars</option>
<option value="46#bso#Kastamonu">Kastamonu</option>
<option value="47#bso#Kayseri">Kayseri</option>
<option value="48#bso#Kırıkkale">Kırıkkale</option>
<option value="49#bso#Kırklareli">Kırklareli</option>
<option value="50#bso#Kırşehir">Kırşehir</option>
<option value="51#bso#Kilis">Kilis</option>
<option value="52#bso#Kocaeli">Kocaeli</option>
<option value="53#bso#Konya">Konya</option>
<option value="54#bso#Kütahya">Kütahya</option>
<option value="55#bso#Malatya">Malatya</option>
<option value="56#bso#Manisa">Manisa</option>
<option value="57#bso#Mardin">Mardin</option>
<option value="58#bso#Mersin">Mersin</option>
<option value="59#bso#Muğla">Muğla</option>
<option value="60#bso#Muş">Muş</option>
<option value="61#bso#Nevşehir">Nevşehir</option>
<option value="62#bso#Niğde">Niğde</option>
<option value="63#bso#Ordu">Ordu</option>
<option value="64#bso#Osmaniye">Osmaniye</option>
<option value="65#bso#Rize">Rize</option>
<option value="66#bso#Sakarya">Sakarya</option>
<option value="67#bso#Samsun">Samsun</option>
<option value="68#bso#Siirt">Siirt</option>
<option value="69#bso#Sinop">Sinop</option>
<option value="70#bso#Sivas">Sivas</option>
<option value="71#bso#Şanlıurfa">Şanlıurfa</option>
<option value="72#bso#Şırnak">Şırnak</option>
<option value="73#bso#Tekirdağ">Tekirdağ</option>
<option value="74#bso#Tokat">Tokat</option>
<option value="75#bso#Trabzon">Trabzon</option>
<option value="76#bso#Tunceli">Tunceli</option>
<option value="77#bso#Uşak">Uşak</option>
<option value="78#bso#Van">Van</option>
<option value="79#bso#Yalova">Yalova</option>
<option value="80#bso#Yozgat">Yozgat</option>
<option value="81#bso#Zonguldak">Zonguldak</option>
</select>
					</div>

					<div style="clear: both"></div>

				</div>

				<div class="variable referencing">

					<div id="reference_enter" class="variable-odd rad10-top rad10-bottom" style="background-color: #EDFCFC">

						<div class="info_ref">
							<div>

								<div id="reference_info" style="margin-bottom: 10px; text-align: center; padding: 5px; background-color: #F4FCFC; display: none"><b>Referans Numarası;</b> ücretsiz hizmet almanızı sağlayan, çeşitli kurumlar veya belediyeler tarafından size verilen 8 haneli geçici numaradır.<br /><br /> <i>Referans numarası olmadan da kayıt işlemini tamamlayabilirsiniz.</i></div>

							</div>

							<i>Referans numaran var mı?  <span id="what_is_reference">Referans numarası nedir?</span></i>

						</div>

						<label class="form_variable">Kurum-Belediye:</label>

						<div class="rounded_input" id="select_reference_owner" style="float: right">

						
							<select name="reference_owner"  id="reference_owner" tabindex="9" style="width: 212px;" class="">
<option value="" selected="selected"></option>
<option value="22">Açılım Dershanesi</option>
<option value="25">AFS Bilgisayar</option>
<option value="11">Akçakoca Belediyesi</option>
<option value="29">Akıl Defteri</option>
<option value="41">DEÇEV</option>
<option value="49">Dr. Behçet Uz Çocuk Hastanesi İlköğretim Okulu</option>
<option value="31">Düzce Belediyesi</option>
<option value="46">Eğitim Yayıncılık</option>
<option value="6">Gaziemir Belediyesi</option>
<option value="2">Gelecek  Dershanesi</option>
<option value="37">Gelecek Dershanesi Ödüllü Sınav Öğrencileri</option>
<option value="47">Gördes Kaymakamlığı</option>
<option value="19">Hisar Mat-Fen Dershanesi</option>
<option value="30">Karacasu Belediyesi</option>
<option value="4">Kula Belediyesi</option>
<option value="10">LMS</option>
<option value="44">Manyas Belediyesi</option>
<option value="39">Nazilli Belediyesi</option>
<option value="24">Özbilgi Dershaneleri</option>
<option value="34">Söke Belediyesi</option>
<option value="18">Tavşanlı Belediyesi</option>
<option value="15">Tire Belediyesi</option>
<option value="48">Türk Ekonomi Bankası</option>
<option value="42">Üçgen Matematik - Ege Sistem</option>
</select>
						</div>

						<div style="clear: both"></div>

						<label class="form_variable">Referans No:</label>

						<div class="rounded_input" id="select_reference_owner" style="float: right">

						
							<input id="reference_enter" tabindex="10" maxlength="8" type="text" class="" name="customer_reference" value=""/>

							
						</div>

						<div style="clear: both"></div>

					</div>

				</div>

				<div style="clear: both"></div>
			</div>
			<div class="register-buttons">
				<div style="float: left; padding: 7px 0px 0px 20px">
										<input tabindex="9" type="checkbox" name="customer_agree"  style="width: 30px; float: left; margin-top: 1px"/>
					<a target="_blank" class="" href="http://www.basogretmenim.com/hakkimizda/kurallarvekosullar">Kullanım Koşulları'nı okudum, kabul ediyorum.</a>
				</div>
				<a tabindex="10" class="button teal" href="javascript:void(0)" onclick="$('form#f_register').submit()">Kayıt Ol &raquo;</a>
				<div style="clear: both"></div>
			</div>
		</form>
	</div>
</div>
<script>
	$(document).ready(function() {
		$('#what_is_reference').click(function () {
			$('#reference_info').toggle();
		});
		$('.tckimlik').priceFormat({
			prefix: '',
			centsSeparator: '',
			thousandsSeparator: '',
			centsLimit: 0,
			limit:11,
			onEnterLogin: true
	});
	});
</script>
