<?xml version="1.0"?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" dir="{txt_content_direction}">
<head>
<title>{txt_script_name} {txt_script_version}</title>
<meta http-equiv="Content-Type" content="text/html; charset={txt_charset}" />
</head>
<style type="text/css">
<!--
h4 {
font-family:Arial,Helvetica,Geneva,Sans-serif,sans-serif;
}
p, td, br, form, div, span, blockquote {
font-family:Arial,Helvetica,Geneva,Sans-serif,sans-serif;
font-size:9pt;
}
#poweredby {
text-align:center;
}
-->
</style>
<body>
<h4>{txt_script_name}</h4>
<!-- Display error messages (required fields etc.) -->
<LOOP NAME="message">
<blockquote style="color:#FF5F00;">
<p style="font-weight:bold;">{message}</p>
<blockquote>{fields}</blockquote>
</blockquote>
</LOOP NAME="message">
<!-- Display posted information -->
<LOOP NAME="display_data">
<table border="0" cellpadding="3" cellspacing="0">
<tr>
<td>{txt_firstname}</td>
<td> </td>
<td>{firstname}</td>
</tr>
<tr>
<td>{txt_lastname} *</td>
<td> </td>
<td>{lastname}</td>
</tr>
<tr>
<td>{txt_email} *</td>
<td> </td>
<td>{email}</td>
</tr>
<tr>
<td>{txt_subject} *</td>
<td> </td>
<td>{subject}</td>
</tr>
<tr valign="top">
<td>{txt_comment}</td>
<td> </td>
<td>{comment}</td>
</tr>
<tr valign="top">
<td>{txt_subscribe_newsletter}</td>
<td> </td>
<td>{checkbox:newsletter}</td>
</tr>
<tr valign="top">
<td>{txt_receive_information}</td>
<td> </td>
<td>{checkbox:information}</td>
</tr>
<tr valign="top">
<td>{txt_salutation}</td>
<td> </td>
<td>{radiobutton:salutation}</td>
</tr>
<tr valign="top">
<td>{txt_vote}</td>
<td> </td>
<td>{select:Vote}</td>
</tr>
</table>
</LOOP NAME="display_data">
<!-- Display form -->
<IF NAME="display_form">
<form action="./index.php" method="post">
<!-- <input type="hidden" name="thanks" value="./docu/thanks.html" /> -->
<input type="hidden" name="required_fields" value="lastname, email, subject" />
<input type="hidden" name="email_fields" value="email" />
<input type="hidden" name="html_template" value="advanced_form.tpl.html" />
<input type="hidden" name="mail_template" value="all_content_mail.tpl.txt" />
<table border="0" cellpadding="3" cellspacing="0">
<tr>
<td>{txt_firstname}</td>
<td> </td>
<td><input type="Text" name="firstname" value="{firstname}" size="40" /></td>
</tr>
<tr>
<td>{txt_lastname} *</td>
<td> </td>
<td><input type="Text" name="lastname" value="{lastname}" size="40" /></td>
</tr>
<tr>
<td>{txt_email} *</td>
<td> </td>
<td><input type="Text" name="email" value="{email}" size="40" /></td>
</tr>
<tr>
<td>{txt_subject} *</td>
<td> </td>
<td><input type="Text" name="subject" value="{subject}" size="40" /></td>
</tr>
<tr valign="top">
<td>{txt_comment}</td>
<td> </td>
<td><textarea name="comment" cols="30" rows="10">{comment}</textarea></td>
</tr>
<tr valign="top">
<td>{txt_subscribe_newsletter}</td>
<td> </td>
<td><input type="checkbox" name="newsletter" value="Yes" {checkbox:newsletter=Yes} /> {txt_yes}</td>
</tr>
<tr valign="top">
<td>{txt_receive_information}</td>
<td> </td>
<td><input type="checkbox" name="information" value="Yes" {checkbox:information=Yes} /> {txt_yes}</td>
</tr>
<tr valign="top">
<td>{txt_salutation}</td>
<td> </td>
<td>
<input type="radio" name="salutation" value="Mr" {radiobutton:salutation=Mr} /> Mr<br />
<input type="radio" name="salutation" value="Ms" {radiobutton:salutation=Ms} /> Ms<br />
</td>
</tr>
<tr valign="top">
<td>{txt_vote}</td>
<td> </td>
<td>
<select name="Vote" size="1">
<option value="Yes" {select:Vote=Yes}>{txt_yes}</option>
<option value="No" {select:Vote=No}>{txt_no}</option>
</select>
</td>
</tr>
<tr valign="top">
<td> </td>
<td> </td>
<td>
<!-- <input type="submit" name="mode_preview" value="{txt_preview}" /> -->
<input type="submit" name="send" value="{txt_submit}" />
</td>
</tr>
</table>
</form>
<p>* = {txt_mandatory_fields}</p>
</IF NAME="display_form">
</body>
</html>