+++ /dev/null
-<h3>{TITLE}</h3>\r
-<div class="row">\r
- <p>{MESSAGE}</p>\r
-</div>\r
-\r
-<div class="input-form">\r
-<div class="row">\r
-<form name="{FORM_NAME}" method="post" action="{FORM_ACTION}">\r
- <div style="display:none;"><label for="{SELECT_NAME}">Select</label></div>\r
- <select name="{SELECT_NAME}" id="{SELECT_NAME}">\r
- <!-- BEGIN OPTION_VALUE -->\r
- <option value="{VALUE}">{TEXT}</option>\r
- <!-- END OPTION_VALUE -->\r
- </select>\r
- <input type="submit" class="button" name="{SUBMIT_NAME}" value="{SUBMIT_VALUE}"/>\r
-</form>\r
-</div>\r
-</div>\r