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wvengen |
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<html> |
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<head> |
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<title>Request a new certificate</title> |
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<link rel="stylesheet" type="text/css" href="stylesheet-registration_form.css"> |
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</head> |
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<body> |
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<h1>DutchGrid Certification Authorities Registration</h1> |
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<table class="reserved"> |
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<tr> |
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<th>Reserved for CA operations use</th> |
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<td class="fillin" style="text-align: right">........ - ......</td> |
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</tr> |
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<tr> |
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<td colspan="2" class="fillin"><span c="${subject}">/O=dutchgrid/O=users/O=somewhere/CN=John Doe</span></td> |
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</tr> |
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<tr> |
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<td colspan="2"> |
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<span class="check">□ ID Document valid</span> |
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<span class="check">□ PoP Challenge verified</span> |
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<span class="check">□ RA Signature OK</span> |
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</td> |
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</tr> |
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</table> |
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<div class="userdata"> |
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<table><tr> |
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<td> |
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<table class="userinfo"> |
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<tr><td colspan="2">Surname <div class="fillin" c="${surname}">Doe</div></td></tr> |
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<tr><td colspan="2">Given names <div class="fillin" c="${givennanme}">John</div></td></tr> |
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<tr> |
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<td>Place of Birth <div class="fillin" c="${birthplace}">Someplace</div></td> |
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<td style="text-align:right">Date of birth <div class="fillin" c="${birthdate}">01 Jan 1900</div></td> |
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</tr> |
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<tr><td colspan="2">Nationality <div class="fillin" c="${nationality}">NL</div></td></tr> |
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<tr><td colspan="2">Identity paper type and number(s) <div class="fillin" c="${identity}">Passport NL12345678</div></td></tr> |
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<tr><td colspan="2">SOFI number <span class="optional">(optional)</span><div class="fillin" c="${sofi}"></div></td></tr> |
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</table> |
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</td> |
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<td class="sendto"> |
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Send this form by mail or fax to |
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<pre c="${ra.address}"> |
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DutchGrid MS CA |
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NIKHEF c/o Someone |
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P.O. Box 12345 |
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NL 1009 DB Amsterdam |
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The Netherlands |
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fax: +31 20 592 5155 |
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</pre> |
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</td> |
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</tr></table> |
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The first twenty (20) characters of your proof-of-posession challenge: |
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<div class="pop" c="${modulus.first20}">0123456789ABCDEF0123</div> |
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</div> |
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</body> |
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</html> |
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