<div class="row-fluid">
			<div class="span5">[first_name] [last_name] [email] [phone_1] [phone_2] [password] [confirm_password]</div>
			<div class="span5">[company] [tax_number] [address_1] [address_2] [city] [zip] [country_id] [zone_id]</div>
			</div>