Location: PHPKode > projects > Esvon Personals > esvon-personals/modules/Report_Abuse/tpl/report_form.htm
<!-- TITLE: Report Abuse -->

<p class=pagetitle>Report Abuse</p>

<i>{Item}: <b>##l_title##</b></i>

<p>

<center>
<font color=red><b>##err_msg##</b></font>
</center>

<p>

<font color=blue><b>What would you like to report?</b></font>

<br />

<form method ="POST">

<table border=0 width="100%">
<tr>
<td width="30%"><b>Subject:</b></td>
<td width="70%">

<input type="text" name="subj" value="##subj##" size=40>

</td>
</tr>

<tr>
<td><b>Your Email Address:</b></td>
<td>

<input type="text" name="email" value="##email##" size=30> <font class="txt8">* required field</font>

</td>
</tr>

<tr>
<td><b>What's the problem?</b></td>
<td>

<textarea name="txt" cols=40 rows=8>
##txt##
</textarea>

</td>
</tr>

<!-- IF ##EN_IMG_VER## -->

<tr bgcolor="#ffffff">
<td colspan=3 class=txt8>
Security Measure: <br>
Type characters as shown in the box. Characters are not case sensitive 
</td>
</tr>

<tr bgcolor="#ffffff">
<td><b>Verification Code:</td>
<td colspan=2>

<table border=0>
<tr>
<td>
<input name="img_text" size=20>
</td>
<td>
<img src="index.php?page=image_verify" id="img_ver">
</td>
<td>
<a href="#" OnClick="reloadImage('img_ver');return false;" class=txt8>Refresh</a>
</td>
</tr>
</table>

</td>
</tr>
<!-- ENDIF -->

<tr>
<td></td>
<td>


<input name="go" type=submit value = "Send" class="button">

</td>
</tr>

</table>

</form>

Or, cancel this and <a href="##url##">return to the page you were just looking at</a>.
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