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<html lang="en">

  <head>

    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1">
    <meta name="description" content="">
    <meta name="author" content="">

    <link rel="icon" href="../../favicon.ico">

    <title><?php if (isset($TITULO_SITE)){ echo $TITULO_SITE; } ?></title>

	<script src="http://code.jquery.com/jquery-3.2.1.min.js" integrity="sha256-hwg4gsxgFZhOsEEamdOYGBf13FyQuiTwlAQgxVSNgt4=" crossorigin="anonymous"></script>
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    <link href="bootstrap-3.3.4-dist/css/bootstrap.min.css" rel="stylesheet">
    <link rel="stylesheet" href="//code.jquery.com/ui/1.11.2/themes/smoothness/jquery-ui.css">

      </head>

<style>

.form-signin {
  max-width: 330px;
  padding: 15px;
  margin: 0 auto;
}
.form-signin .form-signin-heading,
.form-signin .checkbox {
  margin-bottom: 10px;
}
.form-signin .checkbox {
  font-weight: normal;
}
.form-signin .form-control {
  position: relative;
  height: auto;
  -webkit-box-sizing: border-box;
     -moz-box-sizing: border-box;
          box-sizing: border-box;
  padding: 10px;
  font-size: 16px;
}
.form-signin .form-control:focus {
  z-index: 2;
}
.form-signin input[type="email"] {
  margin-bottom: -1px;
  border-bottom-right-radius: 0;
  border-bottom-left-radius: 0;
}
.form-signin input[type="password"] {
  margin-bottom: 10px;
  border-top-left-radius: 0;
  border-top-right-radius: 0;
}

label {
    margin-top: 7px !important;
    margin-bottom: 2px !important;
}

</style>


  <body>

    <div class="container">

      <nav class="navbar navbar-default">
        <div class="container">
          <div class="navbar-header">
            <button type="button" class="navbar-toggle collapsed" data-toggle="collapse" data-target="#navbar" aria-expanded="false" aria-controls="navbar">
              <span class="sr-only">Toggle navigation</span>
              <span class="icon-bar"></span>
              <span class="icon-bar"></span>
              <span class="icon-bar"></span>
            </button>
			<a class="navbar-brand" href="index.php"><?php if (isset($TITULO_SITE)){ echo $TITULO_SITE; } ?></a>
          </div>
          <div id="navbar" class="navbar-collapse collapse">
          </div><!--/.nav-collapse -->
        </div><!--/.container-fluid -->
      </nav>

      
		<div class="row">
			<div class="col-md-4">
			</div>
			<div class="col-md-4">

				<form method="post" id="form_solicitarsenha" action="solicitarsenha.php">

						
						<h2>Solicita&ccedil;&atilde;o de Acesso</h2>
						<br>
						<div class="row">
							<div class="col-md-12">
								<label>Numero do RG sem Digito ou RE com digito</label>
								<input name="cota" id="cota" class="form-control" type="text" required autofocus>
							</div>
						</div>
						<div class="row">
							<div class="col-md-12">
								<label>Data Nascimento do Titular</label>
								<input name="datanascimento" id="datanascimento" class="form-control ui-nu-date" type="text" required>
							</div>
						</div>
						
						
						<br>
						<div class="row">
							<div class="col-md-12">
								<label>Login ou um E-mail para Acesso</label>
								<input name="login" id="login" class="form-control" type="text" required>
							</div>
						</div>
					
						<div class="row">
							<div class="col-md-12">
								<label>Senha</label>
								<input name="senha" id="senha" class="form-control" type="password" required>
							</div>
						</div>

						<div class="row">
							<div class="col-md-12">
								<label>Digite novamente a Senha para confirmar</label>
								<input name="senhaconfirmacao" id="senhaconfirmacao" class="form-control" type="password" required>
							</div>
						</div>

						<div class="row">
							<div class="col-md-12">
								<label>&nbsp;</label>
								<button class="btn btn-lg btn-primary btn-block" type="submit">Enviar solicita&ccedil;&atilde;o</button>
								<input type=hidden name="action" value="salvar">	
							</div>
						</div>

					</form>

			</div>
			<div class="col-md-4">
			</div>
    </div>

	<script src="bootstrap-3.3.4-dist/js/bootstrap.min.js"></script>

	<script type="text/javascript">

		$(document).ready(function() 
		{
			$(".ui-nu-date").datepicker().mask("00/00/0000", { placeholder: "__/__/____" });

		});

		$(function()
		{                                                                                                                                         
			$('.selectUsuario').change(function(){                                                                                                                 
				var url = 'trocar.php?id=' + $(this).val();                                                                                            
				location.assign( url );
			});                                                                                                                                               
		});    

	</script> 

  </body>

</html>	


