<%@ Page Title="" Language="vb" AutoEventWireup="false" MasterPageFile="Application.master" CodeBehind="PreviousAddresses.aspx.vb" Inherits="Web.PreviousAddresses" %>
<%@ MasterType VirtualPath="Application.Master" %>
<%@ Register Src="~/_include/controls/StatePicker.ascx" TagPrefix="ctrl" TagName="StatePicker" %>
<asp:Content ID="Content1" ContentPlaceHolderID="phContent" runat="server">

    <header>
        <h1>Addresses for the Past Three Years</h1>
        <h2>(Prior to date of application)</h2>
    </header>

    <section>
        <h3>Most Recent Address</h3>
        <ul class="formFields">
            <li class="big">
                <asp:RequiredFieldValidator runat="server" ControlToValidate="txtStreet1"
                    Text="required" Display="Dynamic" CssClass="required" />
                <asp:Label runat="server" AssociatedControlID="txtStreet1"
                    Text="Street Address" />
                <asp:TextBox ID="txtStreet1" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:RequiredFieldValidator runat="server" ControlToValidate="txtCity1"
                    Text="required" Display="Dynamic" CssClass="required" />
                <asp:Label runat="server" AssociatedControlID="txtCity1"
                    Text="City" />
                <asp:TextBox ID="txtCity1" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:RequiredFieldValidator runat="server" ControlToValidate="ddlState1"
                    Text="required" Display="Dynamic" CssClass="required" />
                <asp:Label runat="server" AssociatedControlID="ddlState1"
                    Text="State" />
                <ctrl:StatePicker ID="ddlState1" runat="server" />
            </li>
            <li class="right">
                <asp:RequiredFieldValidator runat="server" ControlToValidate="txtZip1"
                    Text="required" Display="Dynamic" CssClass="required" />
                <asp:Label runat="server" AssociatedControlID="txtZip1"
                    Text="Zip" />
                <asp:TextBox ID="txtZip1" runat="server"
                    MaxLength="50" />
            </li>
        </ul>
        <ul class="formFields">
            <li class="left">
                <asp:RequiredFieldValidator runat="server" ControlToValidate="txtDuration1"
                    Text="required" Display="Dynamic" CssClass="required" />
                <asp:Label runat="server" AssociatedControlID="txtDuration1"
                    Text="How Long" />
                <asp:TextBox ID="txtDuration1" runat="server" MaxLength="50" />
            </li>
        </ul>
    </section>

    <section>
        <h3>Previous Address</h3>
        <ul class="formFields">
            <li class="big">
                <asp:Label runat="server" AssociatedControlID="txtStreet2"
                    Text="Street Address" />
                <asp:TextBox ID="txtStreet2" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="txtCity2"
                    Text="City" />
                <asp:TextBox ID="txtCity2" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="ddlState2"
                    Text="State" />
                <ctrl:StatePicker ID="ddlState2" runat="server" />
            </li>
            <li class="right">
                <asp:Label runat="server" AssociatedControlID="txtZip2"
                    Text="Zip" />
                <asp:TextBox ID="txtZip2" runat="server"
                    MaxLength="50" />
            </li>
        </ul>
        <ul class="formFields">
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="txtDuration2"
                    Text="How Long" />
                <asp:TextBox ID="txtDuration2" runat="server" MaxLength="50" />
            </li>
        </ul>
    </section>

    <section>
        <h3>Previous Address</h3>
        <ul class="formFields">
            <li class="big">
                <asp:Label runat="server" AssociatedControlID="txtStreet3"
                    Text="Street Address" />
                <asp:TextBox ID="txtStreet3" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="txtCity3"
                    Text="City" />
                <asp:TextBox ID="txtCity3" runat="server"
                    MaxLength="50" />
            </li>
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="ddlState3"
                    Text="State" />
                <ctrl:StatePicker ID="ddlState3" runat="server" />
            </li>
            <li class="right">
                <asp:Label runat="server" AssociatedControlID="txtZip3"
                    Text="Zip" />
                <asp:TextBox ID="txtZip3" runat="server"
                    MaxLength="50" />
            </li>
        </ul>
        <ul class="formFields">
            <li class="left">
                <asp:Label runat="server" AssociatedControlID="txtDuration3"
                    Text="How Long" />
                <asp:TextBox ID="txtDuration3" runat="server" MaxLength="50" />
            </li>
        </ul>
    </section>

</asp:Content>
