Fancy Jquery form

Step 1: jQuery Tools Account Please enter your login information:

• 1. Enter Your Email Address *
  Your password will be sent to this address. Your address will not made public.
• 2. Pick a username
  Your preferred username to be used when logging in.
• 3. Choose a Password *
  Must be at least 8 characters long. Verify Password *
  
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Step 2: Contact Information Please tell us where you live:

• 1. Enter Your Street Address *
  Example: Random Street 69 A 666
• 2. Enter Your Zip Code *
  This must be a numeric value 3. and The City * -- please select -- Helsinki Berlin New York
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Step 3: Congratulations! You are now a happy member of "Domain Name Here"

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