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<!-- BEGIN form_title_block -->
<h1>{form_title}</h1>
<!-- END form_title_block -->
{qf_javascript}
<!-- BEGIN qf_static -->
<p>{qf_element}</p>
<!-- END qf_static -->
<form {qf_attributes}>
<div class="tblBasic">
<!-- BEGIN qf_hidden_block -->
<!-- BEGIN qf_hidden_loop -->
{qf_hidden}
<!-- END qf_hidden_loop -->
<!-- END qf_hidden_block -->
<table border="0" cellpadding="0" cellspacing="0" class="tblBasicGrey">
<!-- BEGIN qf_main_loop -->
<!-- BEGIN qf_header -->
<tr>
<th class="colFirst"> </th>
<th class="colLast">{qf_header}</th>
</tr>
<!-- END qf_header -->
<!-- BEGIN qf_element -->
<tr>
<td class="colFirstRT"><!-- BEGIN qf_element_required --><span class="txtRequiredField">*</span><!-- END qf_element_required --> <span class="txtFormLabel">{qf_label}</span></td>
<td class="colLast"><!-- BEGIN qf_element_error --><span class="txtRequiredField">{qf_error}</span><br /><!-- END qf_element_error -->{qf_element}</td>
</tr>
<!-- END qf_element -->
<!-- BEGIN qf_textarea -->
<tr>
<td class="colFirstRT"><!-- BEGIN qf_textarea_required --><span class="txtRequiredField">*</span><!-- END qf_textarea_required --> <span class="txtFormLabel">{qf_label}</span></td>
<td class="colLast"><!-- BEGIN qf_textarea_error --><span class="txtRequiredField">{qf_error}</span><br /><!-- END qf_textarea_error -->{qf_element}</td>
</tr>
<!-- END qf_textarea -->
<!-- BEGIN qf_submit -->
<tr class="lastrow">
<td class="colFirst"> </td>
<td class="colLast">{qf_element}</td>
</tr>
<!-- END qf_submit -->
<!-- END qf_main_loop -->
</table>
</div>
</form>
<!-- BEGIN qf_required_note -->
<p>{qf_required_note}</p>
<!-- END qf_required_note -->
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