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<!--#if expr="<X-FC-URL-PARAMETER usemyownform NUMBER>==1 && <X-FC-URL-PARAMETER myownform EXISTS> && <X-FC-URL-PARAMETER myownform LENGTH> > 0" --><!--#set var="usemyownform" value="1" --><!--#endif--><!--#if expr="${usemyownform} !=1" use default form--><!--#if expr="<X-FC-URL-PARAMETER config EXISTS> && <X-FC-URL-PARAMETER config LENGTH> > 0" --><!--#set var="configF" value="<X-FC-URL-PARAMETER config LITERAL>"--><!--#elif expr="<X-FC-URL-PARAMETER amp;config EXISTS> && <X-FC-URL-PARAMETER amp;config LENGTH> > 0" --><!--#set var="configF" value="<X-FC-URL-PARAMETER amp;config LITERAL>"--><!--#elif expr="<X-FC-FIELD SITEPREF.6256 DEFAULT=0 NUMBER>==1 && <X-FC-FIELD SITEPREF.6257 LENGTH> > 0" --><!--#set var="configF" expr="@URLescape(`<X-FC-FIELD SITEPREF.6257 DEFAULT="" STRING>`, ' ')" --><!--#else --><!--#set var="configF" value=""--><!--#endif --><?xml version="1.0" encoding="<X-FC-ITEM DATA[Charset]>"?><X-FC-WHITESPACE STRIP>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<!--^ Plugins/<X-FC-URL-PARAMETER Plugin>/E141 H=<X-FC-REQUEST-TIME HEADER> LS=<X-FC-REQUEST-TIME LOGIN.START> L=<X-FC-REQUEST-TIME LOGIN> OS=<X-FC-REQUEST-TIME OPEN.START> O=<X-FC-REQUEST-TIME OPEN> T=<X-FC-REQUEST-TIME>--><X-FC-WHITESPACE STRIP>
        <!--#set var="ENVELOPE" value="<X-FC-URL-PARAMETER Envelope>"-->

        <!--#if expr="$ENVELOPE"-->
                <!--#set var="TARGET" value=" target=\"FCMSGWIN_<X-FC-ITEM DATA[MessageID] SITEID.HEX>_<X-FC-ITEM DATA[MessageID] MSGID.HEX>\""-->
        <!--#endif-->
<X-FC-WHITESPACE RETAIN>
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=<X-FC-ITEM DATA[Charset]>"/>
<title><X-FC-FIELD LANG.139.0.25 STRING></title>

<link rel="stylesheet" type="text/css" href="/.Templates/RWD/RWDComponents/RWDForms/css/validationEngine.jquery.css" media="screen" />
<link rel="stylesheet" type="text/css" href="/.Templates/RWD/RWDComponents/RWDForms/css/template.css" media="screen" />
<link rel="stylesheet" type="text/css" href="/.Templates/RWD/RWDComponents/RWDForms/css/passwordchg.css" media="screen" />

<style>

<!--#set var="pf_pagestyle_bgcolor" value="#<X-FC-URL-PARAMETER n_pbgc LITERAL>" -->
<!--#set var="pf_pagestyle_bgimg" value="" --><!--#set var="pf_pagestyle_bgimgtitle" value="0" Tile Image=0;Top Left=1;Top Center=2;Top Right=3;Left=4;Center=5;Right=6;Bottom Left=7;Bottom Center=8;Bottom Right=9;-->
<!--#set var="pf_pagestyle_ffamily" value="<X-FC-URL-PARAMETER n_pfface LITERAL>" -->
<!--#set var="pf_pagestyle_color" value="#<X-FC-URL-PARAMETER n_pfcolor LITERAL>" -->
<!--#set var="pf_pagestyle_fsize" value="<X-FC-URL-PARAMETER n_pfsize LITERAL>" -->
<!--#set var="pf_pagestyle_fstyle" value="0" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->

<!--#set var="pf_title_ffamily" value="${pf_pagestyle_ffamily}" -->
<!--#set var="pf_title_color" value="${pf_pagestyle_color}" -->
<!--#set var="pf_title_fsize" expr="2+${pf_pagestyle_fsize}" -->
<!--#set var="pf_title_fstyle" value="2" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->

<!--#set var="pf_desc_ffamily" value="${pf_pagestyle_ffamily}" -->
<!--#set var="pf_desc_color" value="${pf_pagestyle_color}" -->
<!--#set var="pf_desc_fsize" value="${pf_pagestyle_fsize}" -->
<!--#set var="pf_desc_fstyle" value="0" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->

<!--#if expr="@length($configF) > 0" --><!--#include virtual="/__WWW${configF}?Plugin=RWDForms&Templates=config&Formid=2090" --><!--#endif -->

body{
<!--#if expr="@length($pf_pagestyle_bgimg)>0" -->
        background-image:url('<!--#echo var="pf_pagestyle_bgimg" -->');
<!--#if expr="$pf_pagestyle_bgimgtitle == 0" -->background-repeat:repeat;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 1" -->background-repeat:no-repeat;background-position: Top Left;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 2" -->background-repeat:no-repeat;background-position: Top;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 3" -->background-repeat:no-repeat;background-position: Top Right;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 4" -->background-repeat:no-repeat;background-position: Left;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 5" -->background-repeat:no-repeat;background-position: Center;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 6" -->background-repeat:no-repeat;background-position: Right;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 7" -->background-repeat:no-repeat;background-position: Bottom Left;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 8" -->background-repeat:no-repeat;background-position: Bottom;
<!--#elif expr="$pf_pagestyle_bgimgtitle == 9" -->background-repeat:no-repeat;background-position: Bottom Right;
<!--#endif -->
<!--#else -->
        background-color:<!--#echo var="pf_pagestyle_bgcolor" -->;
        background-image:none;
<!--#endif -->
        color:<!--#echo var="pf_pagestyle_color" -->;
        font-size:<!--#echo var="pf_pagestyle_fsize" -->px;
        font-family:<!--#echo var="pf_pagestyle_ffamily" -->;
        text-align:left;
        padding-left:3px;
        width:95%;
<!--#if expr="$pf_pagestyle_fstyle==0" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->font-weight: normal;font-style:normal;
<!--#elif expr="$pf_pagestyle_fstyle==1"-->font-weight: normal;text-decoration: underline; font-style:normal;
<!--#elif expr="$pf_pagestyle_fstyle==2"-->font-weight: bold; font-style:normal;
<!--#elif expr="$pf_pagestyle_fstyle==3"-->font-weight: normal; font-style:italic;
<!--#elif expr="$pf_pagestyle_fstyle==4"-->font-weight: bold; font-style:italic;
<!--#endif -->
}

#pf_logo{
        text-align:left;
        width:100%;
}

#pf_title{
        color:<!--#echo var="pf_title_color" -->;
        font-size:<!--#echo var="pf_title_fsize" -->px;
        font-family:<!--#echo var="pf_title_ffamily" -->;

<!--#if expr="$pf_title_fstyle==0" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->font-weight: normal;font-style:normal;
<!--#elif expr="$pf_title_fstyle==1"-->font-weight: normal;text-decoration: underline; font-style:normal;
<!--#elif expr="$pf_title_fstyle==2"-->font-weight: bold; font-style:normal;
<!--#elif expr="$pf_title_fstyle==3"-->font-weight: normal; font-style:italic;
<!--#elif expr="$pf_title_fstyle==4"-->font-weight: bold; font-style:italic;
<!--#endif -->

}

#pf_desc{
        color:<!--#echo var="pf_desc_color" -->;
        font-size:<!--#echo var="pf_desc_fsize" -->px;
        font-family:<!--#echo var="pf_desc_ffamily" -->;
<!--#if expr="$pf_desc_fstyle==0" None=0;Underline=1;Bold=2;Italic=3;Bold Italic=4;-->font-weight: normal;text-decoration: none; font-style:normal;
<!--#elif expr="$pf_desc_fstyle==1"-->font-weight: normal;text-decoration: underline; font-style:normal;
<!--#elif expr="$pf_desc_fstyle==2"-->font-weight: bold;text-decoration: none; font-style:normal;
<!--#elif expr="$pf_desc_fstyle==3"-->font-weight: normal;text-decoration: none; font-style:italic;
<!--#elif expr="$pf_desc_fstyle==4"-->font-weight: bold;text-decoration: none; font-style:italic;
<!--#endif -->
}

#anonymous_msg{
        width:99%
}

.item{
height:120%;
}

.fcol{
        width:30%;
        text-align:right;
        padding-right:3px;
}

.scol{
        width:200px;
        text-align:left;
}

input.userinputbox, textarea.userinputbox { width:100%; }

a.closelnk:link, a.closelnk:hover, a.closelnk:visited, a.closelnk:active{text-decoration:underline;color:#<X-FC-URL-PARAMETER n_pfcolor>;font-family:<X-FC-URL-PARAMETER n_pfface>;font-size:<X-FC-URL-PARAMETER n_pfsize>px;}
</style>

<script type="text/javascript" src="/.Templates/RWD/RWDjs/jquery-1.8.1.min.js"></script><noscript>Your browser does not support JavaScript!</noscript>

<script src="http://code.jquery.com/ui/1.9.1/jquery-ui.js"></script><noscript>Your browser does not support JavaScript!</noscript>

<script type="text/javascript">
           jQuery(document).ready(function(){
$(".datepicker").datepicker({ dateFormat: "yy-mm-dd" });
           });
</script><noscript>Your browser does not support JavaScript!</noscript>

<script type="text/javascript" src="/.Templates/JavaScript/URLEscape.pjs"></script><noscript>Your browser does not support JavaScript!</noscript>
<script type="text/javascript" src="/.Templates/JavaScript/AsyncFunctions.pjs"></script><noscript>Your browser does not support JavaScript!</noscript>
<script type="text/javascript">
<!--
<!--#include virtual="/Plugins/RWD/RWD/include/FCjs/FormEditFunctions.inc"-->
<!--#include virtual="/Plugins/RWD/RWD/include/FCjs/RecipientFunctions.inc"-->
<!--#include virtual="/Plugins/RWD/RWD/include/FCjs/AttachFunctions.inc"-->
//-->
var pu="<X-FC-OBJURL SLASH>";
function sdf(so){
<!--#if expr="$ENVELOPE"-->
document.forms["MainForm"].elements["BODY"].value=parent.gB();
dCAU();
<!--#endif-->

var newTextareaValue=document.getElementById('f1008').value + '\n\r\n\r________________\n\r';

if ( $('#tr8022').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label8022').html() + '  \t ' + $('#f8022').val() + '\n\r'; }
if ( $('#tr8021').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label8021').html() + '  \t ' + $('#f8021').val() + '\n\r'; }
if ( $('#tr5179').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5179').html() + '  \t ' + $('#f5179').val() + '\n\r'; }
if ( $('#tr5180').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5180').html() + '  \t ' + $('#f5180').val() + '\n\r'; }
if ( $('#tr5181').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5181').html() + '  \t ' + $('#f5181').val() + '\n\r'; }
if ( $('#tr5182').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5182').html() + '  \t ' + $('#f5182').val() + '\n\r'; }
if ( $('#tr5183').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5183').html() + '  \t ' + $('#f5183').val() + '\n\r'; }
if ( $('#tr5184').is(':visible') ) { newTextareaValue = newTextareaValue + $('#label5184').html() + '  \t ' + $('#f5184').val() + '\n\r'; }

<!--#set var="fm_idx" value="5999" -->

<!--#while expr="++$fm_idx < 6200" -->
        if ($('#label<!--#echo var="fm_idx" -->').length>0 || $('#f<!--#echo var="fm_idx" -->').length>0){ newTextareaValue +=  ( ($('#label<!--#echo var="fm_idx" -->').length>0?$('#label<!--#echo var="fm_idx" -->').html():'') + '  \t ' + ($('#f<!--#echo var="fm_idx" -->').length>0?$('#f<!--#echo var="fm_idx" -->').val():'') + '\n\r' );}
<!--#endwhile -->

document.getElementById('f1008').value=newTextareaValue;

document.forms["MainForm"].action=pu+'__Send?Plugin=<X-FC-URL-PARAMETER Plugin>&FromTemplates=141&JumpAction=4<!--#if expr="<X-FC-URL-PARAMETER confirmationmessage EXISTS> && <X-FC-URL-PARAMETER confirmationmessage LENGTH>>0" -->&confirmationmessage=<X-FC-URL-PARAMETER confirmationmessage STRING><!--#endif -->&portaluser=<X-FC-URL-PARAMETER portaluser NUMBER>&n_pbgc=<X-FC-URL-PARAMETER n_pbgc>&n_pfcolor=<X-FC-URL-PARAMETER n_pfcolor>&n_pfsize=<X-FC-URL-PARAMETER n_pfsize>&n_pfface=<!--#echo expr="@URLescape(`<X-FC-URL-PARAMETER n_pfface>`, ' ')"-->&Clear=0'+(so?'&SendOptions='+so:'');

return true;
}
</script><noscript>Your browser does not support JavaScript!</noscript>
</head>

<body dir="<X-FC-FIELD LANG.7500 DEFAULT="ltr" STRING>" onload="self.focus();document.forms['MainForm'].elements['FieldID:8022=STRING'].focus();document.forms['MainForm'].elements['FieldID:8022=STRING'].select();">
<div id="anonymous_msg">
<form id="fm_anonymous_msg" name="MainForm" action="<X-FC-OBJURL SLASH>__FormSave?Plugin=<X-FC-URL-PARAMETER Plugin>&FormID=141&FromTemplates=141&JumpAction=4&Close=-2&n_pbgc=<X-FC-URL-PARAMETER n_pbgc>&n_pfcolor=<X-FC-URL-PARAMETER n_pfcolor>&n_pfsize=<X-FC-URL-PARAMETER n_pfsize>&n_pfface=<!--#echo expr="@URLescape(`<X-FC-URL-PARAMETER n_pfface>`, ' ')"-->&portaluser=<X-FC-URL-PARAMETER portaluser NUMBER><!--#if expr="<X-FC-URL-PARAMETER confirmationmessage EXISTS> && <X-FC-URL-PARAMETER confirmationmessage LENGTH>>0" -->&confirmationmessage=<X-FC-URL-PARAMETER confirmationmessage STRING><!--#endif -->" method="post" enctype="multipart/form-data" onsubmit="if(CS){CS=0;}else{return false;}" autocomplete="off">

<input type="hidden" name="CharSet" value="<X-FC-ITEM DATA[Charset]>"/>
<input type="hidden" name="VKey" value="<X-FC-SESSION VKEY>"/>
<input type="hidden" name="KeepNames" value="1"/>
<input type="hidden" name="TO" value="<X-FC-URL-PARAMETER sendto>"/>            
<input type="hidden" name="FieldID:2091=STRING" value="<!--#echo var="DOCUMENT_URI"-->"/>       
<input type="hidden" name="FieldID:2092=STRING" value="<!--#echo var="REMOTE_ADDR"-->"/>        
<input type="hidden" name="FieldID:2096=STRING" value="<X-FC-USER USERID>"/>    
<!--#rem pre-set variables -->
<!--#set var="pf_title" value="" -->
<!--#set var="pf_f1_inc" value="1" --><!--#set var="pf_f1_req" value="1" --><!--#set var="pf_f1_label" value="Name:" -->
<!--#set var="pf_f2_inc" value="1" --><!--#set var="pf_f2_req" value="1" --><!--#set var="pf_f2_label" value="Email:" -->
<!--#set var="pf_f3_inc" value="1" --><!--#set var="pf_f3_req" value="0" --><!--#set var="pf_f3_label" value="Subject:" -->
<!--#set var="pf_f4_inc" value="1" --><!--#set var="pf_f4_req" value="1" --><!--#set var="pf_f4_label" value="Message" -->

<!--#rem Text=1;Number=2;Date=3;Dropdown List=4 -->
<!--#set var="pf_a1_inc" value="0" --><!--#set var="pf_a1_label" value="Field1" --><!--#set var="pf_a1_type" value="1" --><!--#set var="pf_a1_presetdata" value="" --><!--#set var="pf_a1_req" value="0" -->
<!--#set var="pf_a2_inc" value="0" --><!--#set var="pf_a2_label" value="Field2" --><!--#set var="pf_a2_type" value="1" --><!--#set var="pf_a2_presetdata" value="" --><!--#set var="pf_a2_req" value="0" -->
<!--#set var="pf_a3_inc" value="0" --><!--#set var="pf_a3_label" value="Field3" --><!--#set var="pf_a3_type" value="1" --><!--#set var="pf_a3_presetdata" value="" --><!--#set var="pf_a3_req" value="0" -->
<!--#set var="pf_a4_inc" value="0" --><!--#set var="pf_a4_label" value="Field4" --><!--#set var="pf_a4_type" value="1" --><!--#set var="pf_a4_presetdata" value="" --><!--#set var="pf_a4_req" value="0" -->
<!--#set var="pf_a5_inc" value="0" --><!--#set var="pf_a5_label" value="Field5" --><!--#set var="pf_a5_type" value="1" --><!--#set var="pf_a5_presetdata" value="" --><!--#set var="pf_a5_req" value="0" -->
<!--#set var="pf_a6_inc" value="0" --><!--#set var="pf_a6_label" value="Field6" --><!--#set var="pf_a6_type" value="4" --><!--#set var="pf_a6_presetdata" value="Option1;Option2" --><!--#set var="pf_a6_req" value="0" -->

<!--#if expr="@length($configF)>0" --><!--#include virtual="/__WWW${configF}?Plugin=RWDForms&Templates=config&Formid=2089" --><!--#endif -->

<!--#if expr="@length($pf_logo) > 0 && $pf_logoposition == 1"-->
<table width="95%" style="border:0;vertical-align:top;text-align:center;">
<tr><td id="pf_logo" style="border:0;vertical-align:top;text-align:center;"><img src="<!--#echo var="pf_logo" -->" border="0" title="0" alt="0" /></td></tr>
</table>
<!--#endif -->

<table width="95%" style="border:0;vertical-align:top;"><tr><td width="100%"><div style="width:100%;"><!--#if expr="@length($pf_logo) > 0 && $pf_logoposition == 2"--><img src="<!--#echo var="pf_logo" -->" border="0" title="0" alt="0" style="float:left;margin:2px 6px 6px 2px;" /><!--#elif expr="@length($pf_logo) > 0 && $pf_logoposition == 3"--><img src="<!--#echo var="pf_logo" -->" border="0" title="0" alt="0" style="float:right;margin:2px 2px 6px 6px;" /><!--#endif -->
<p id="pf_title"><!--#echo var="pf_title" --></p>
<p id="pf_desc"><!--#if expr="@length($configF)>0" --><!--#include virtual="/__WWW${configF}?Plugin=RWDForms&Templates=config&Formid=5191" --><!--#endif -->
</p>
<div></td></tr></table>

<table width="95%" style="border:0;vertical-align:top;">
<tr<!--#if expr="$pf_f1_inc == 0" --> style="display:none;"<!--#endif --> id="tr8022">
        <td class="fcol" id="label8022"><!--#if expr="$pf_f1_req == 1" -->*<!--#endif --><!--#echo var="pf_f1_label" --></td>
        <td class="scol"><input class="<!--#if expr="$pf_f1_req == 1 && $pf_f1_inc == 1" --><!--#endif -->text-input userinputbox" name="FieldID:8022=STRING" id="f8022" type="text" value="" /><!--#rem Category : 8022 _ Name --></td>
</tr>

<tr<!--#if expr="$pf_f2_inc == 0" --> style="display:none;"<!--#endif --> id="tr8021">
        <td class="fcol" width="30%" id="label8021"><!--#if expr="$pf_f2_req == 1" -->*<!--#endif --><!--#echo var="pf_f2_label" --></td>
        <td class="scol"><input class="<!--#if expr="$pf_f2_req == 1 && $pf_f2_inc == 1" --><!--#endif -->text-input userinputbox" name="FieldID:8021=STRING" id="f8021" type="text" value="" /><!--#rem Keyword : 8021 _ Email -->
</td></tr>

<tr<!--#if expr="$pf_f3_inc == 0" --> style="display:none;"<!--#endif --> id="tr7">
        <td class="fcol" id="label7"><!--#if expr="$pf_f3_req == 1" -->*<!--#endif --><!--#echo var="pf_f3_label" --></td>
        <td class="scol"><input class="<!--#if expr="$pf_f3_req == 1 && $pf_f3_inc == 1" --><!--#endif -->text-input userinputbox" name="FieldID:7=STRING" id="f7" type="text" value=""/></td>
</tr>

<tr<!--#if expr="$pf_f4_inc == 0" --> style="display:none;"<!--#endif --> id="tr1008">
        <td class="fcol" id="label1008"><!--#if expr="$pf_f4_req == 1" -->*<!--#endif --><!--#echo var="pf_f4_label" --></td>
        <td class="scol"><textarea class="<!--#if expr="$pf_f4_req == 1 && $pf_f4_inc == 1" --><!--#endif -->text-input userinputbox" name="body" id="f1008"></textarea></td>
</tr>

<!--#rem Additional Fields -->
<tr<!--#if expr="$pf_a1_inc == 0" --> style="display:none;"<!--#endif --> id="tr5179">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a1_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a1_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a1_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a1_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5179"><!--#if expr="$pf_a1_req == 1" -->*<!--#endif --><!--#echo var="pf_a1_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a1_type == 4 && @indexof($pf_a1_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5179=STRING" id="f5179">
                <!--#while expr="@indexof($pf_a1_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a1_thisoption" expr="@split($pf_a1_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a1_thisoption" -->"><!--#echo var="pf_a1_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a1_presetdata) > 0" --><option value="<!--#echo var="pf_a1_presetdata" -->"><!--#echo var="pf_a1_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a1_req == 1 && $pf_a1_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a1_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5179=STRING" id="f5179" type="text" value="<!--#echo var="pf_a1_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 1 : 5179----------------------- -->


<tr<!--#if expr="$pf_a2_inc == 0" --> style="display:none;"<!--#endif --> id="tr5180">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a2_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a2_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a2_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a2_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5180"><!--#if expr="$pf_a2_req == 1" -->*<!--#endif --><!--#echo var="pf_a2_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a2_type == 4 && @indexof($pf_a2_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5180=STRING" id="f5180">
                <!--#while expr="@indexof($pf_a2_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a2_thisoption" expr="@split($pf_a2_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a2_thisoption" -->"><!--#echo var="pf_a2_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a2_presetdata) > 0" --><option value="<!--#echo var="pf_a2_presetdata" -->"><!--#echo var="pf_a2_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a2_req == 1 && $pf_a2_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a2_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5180=STRING" id="f5180" type="text" value="<!--#echo var="pf_a2_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 2 : 5180----------------------- -->

<tr<!--#if expr="$pf_a3_inc == 0" --> style="display:none;"<!--#endif --> id="tr5181">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a3_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a3_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a3_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a3_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5181"><!--#if expr="$pf_a3_req == 1" -->*<!--#endif --><!--#echo var="pf_a3_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a3_type == 4 && @indexof($pf_a3_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5181=STRING" id="f5181">
                <!--#while expr="@indexof($pf_a3_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a3_thisoption" expr="@split($pf_a3_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a3_thisoption" -->"><!--#echo var="pf_a3_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a3_presetdata) > 0" --><option value="<!--#echo var="pf_a3_presetdata" -->"><!--#echo var="pf_a3_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a3_req == 1 && $pf_a3_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a3_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5181=STRING" id="f5181" type="text" value="<!--#echo var="pf_a3_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 3 : 5181----------------------- -->

<tr<!--#if expr="$pf_a4_inc == 0" --> style="display:none;"<!--#endif --> id="tr5182">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a4_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a4_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a4_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a4_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5182"><!--#if expr="$pf_a4_req == 1" -->*<!--#endif --><!--#echo var="pf_a4_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a4_type == 4 && @indexof($pf_a4_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5182=STRING" id="f5182">
                <!--#while expr="@indexof($pf_a4_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a4_thisoption" expr="@split($pf_a4_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a4_thisoption" -->"><!--#echo var="pf_a4_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a4_presetdata) > 0" --><option value="<!--#echo var="pf_a4_presetdata" -->"><!--#echo var="pf_a4_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a4_req == 1 && $pf_a4_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a4_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5182=STRING" id="f5182" type="text" value="<!--#echo var="pf_a4_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 4 : 5182----------------------- -->

<tr<!--#if expr="$pf_a5_inc == 0" --> style="display:none;"<!--#endif --> id="tr5183">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a5_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a5_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a5_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a5_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5183"><!--#if expr="$pf_a5_req == 1" -->*<!--#endif --><!--#echo var="pf_a5_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a5_type == 4 && @indexof($pf_a5_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5183=STRING" id="f5183">
                <!--#while expr="@indexof($pf_a5_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a5_thisoption" expr="@split($pf_a5_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a5_thisoption" -->"><!--#echo var="pf_a5_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a5_presetdata) > 0" --><option value="<!--#echo var="pf_a5_presetdata" -->"><!--#echo var="pf_a5_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a5_req == 1 && $pf_a5_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a5_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5183=STRING" id="f5183" type="text" value="<!--#echo var="pf_a5_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 5 : 5183 ----------------------- -->

<tr<!--#if expr="$pf_a6_inc == 0" --> style="display:none;"<!--#endif --> id="tr5184">
<!--#set var="pf_a_validate" value="" -->
<!--#if expr="$pf_a6_type == 1" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#elif expr="$pf_a6_type == 2" --><!--#set var="pf_a_validate" value="validate[required],custom[integer]" -->
<!--#elif expr="$pf_a6_type == 3" --><!--#set var="pf_a_validate" value="validate[required],custom[date]" -->
<!--#elif expr="$pf_a6_type == 4" --><!--#set var="pf_a_validate" value="validate[required]" -->
<!--#endif -->
        <td class="fcol" id="label5184"><!--#if expr="$pf_a6_req == 1" -->*<!--#endif --><!--#echo var="pf_a6_label" --></td>
        <td class="scol">
        <!--#if expr="$pf_a6_type == 4 && @indexof($pf_a6_presetdata, `;`)!=-1" -->
                <select class="userinputbox" name="FieldID:5184=STRING" id="f5184">
                <!--#while expr="@indexof($pf_a6_presetdata, `;`)!=-1" -->
                <!--#set var="pf_a6_thisoption" expr="@split($pf_a6_presetdata,`;`)" -->
                        <option value="<!--#echo var="pf_a6_thisoption" -->"><!--#echo var="pf_a6_thisoption" --></option>
                <!--#endwhile -->
<!--#if expr="@length($pf_a6_presetdata) > 0" --><option value="<!--#echo var="pf_a6_presetdata" -->"><!--#echo var="pf_a6_presetdata" --></option><!--#endif -->
                </select>
        <!--#else -->
                <input class="<!--#if expr="$pf_a6_req == 1 && $pf_a6_inc == 1" --><!--#echo var="pf_a_validate" --> <!--#endif -->text-input<!--#if expr="$pf_a5_type == 3" --> datepicker<!--#endif --> userinputbox" name="FieldID:5184=STRING" id="f5184" type="text" value="<!--#echo var="pf_a6_presetdata" -->" />
        <!--#endif -->
        </td>
</tr><!-- ------------------ Field 6 : 5184----------------------- -->

<tr><td class="fcol" style="text-align:right;padding-right:5px;"><input id="MB:ST" class="button" type="submit" value=" <X-FC-FIELD LANG.CMD.152.0 STRING> " onclick="return sdf();"/></td>
      <td class="scol" style="text-align:left;vertical-align:bottom;padding-left:0;margin-left:0;"><input class="button" type="button" value=" Cancel and close the lightbox " onclick="self.location.replace('/login/logout?Plugin=<X-FC-URL-PARAMETER Plugin>&closemodal=1');"/></td>

</tr>
</table>


</form>
</div>
        <!--#if expr="$SRVR_ERR_FCPCODE"-->
<script type="text/javascript"><X-FC-WHITESPACE RETAIN>
<!--
alert("<X-FC-FIELD LANG.ERR.`$SRVR_ERR_FCPCODE` ESCAPED> [<!--#echo var="SRVR_ERR_FCPCODE"-->]");
//-->
<X-FC-WHITESPACE STRIP></script><noscript>Your browser does not support JavaScript!</noscript>
        <!--#endif-->
<img name="TOUCHME" src="<X-FC-OBJURL SLASH>__Touch?TouchCount=0" alt="TOUCHME" width="1" height="1" border="0" style="display:none;"/>

</body>

<X-FC-WHITESPACE RETAIN>
<!--*Plugins/<X-FC-URL-PARAMETER Plugin>/ BSS=<X-FC-REQUEST-TIME BODY.SETUPSTART> BSE=<X-FC-REQUEST-TIME BODY.SETUPEND> BSD=<X-FC-REQUEST-TIME BODY.STYLEDONE> B=<X-FC-REQUEST-TIME BODY> D=<X-FC-REQUEST-TIME>-->
</html>
<!--#else usemyownform-->
<!--#if expr="@indexof(`<X-FC-URL-PARAMETER myownform STRING>`, `.inc`)!=-1" -->
        <!--#include virtual="/Plugins/RWDUser/<X-FC-URL-PARAMETER myownform STRING>" -->
<!--#else -->
        
        <p>The referred form name must have the extension of '.inc'. You can go back to "/Internet Services/Plugins/RWDUser/" and rename <X-FC-URL-PARAMETER myownform STRING> to <X-FC-URL-PARAMETER myownform STRING>.inc, then change the form usemyownform parameter value accordingly.
        </p>
        <p>
                <input class="button" type="button" value=" Click here to close the lightbox " onclick="self.location.replace('/login/logout?Plugin=<X-FC-URL-PARAMETER Plugin>&closemodal=1');"/>
        </p>
<!--#endif -->
<!--#endif usemyownform or use default form-->