<form id="crepair-form" action="crepair/$contact_id" method="post" > <h4>$contact_name</h4> <label id="crepair-nick-label" for="crepair-nick">$label_nick</label> <input type="text" id="crepair-nick" name="nick" value="$contact_nick" /> <div class="clear"></div> <label id="crepair-url-label" for="crepair-url">$label_url</label> <input type="text" id="crepair-url" name="url" value="$contact_url" /> <div class="clear"></div> <label id="crepair-request-label" for="crepair-request">$label_request</label> <input type="text" id="crepair-request" name="request" value="$request" /> <div class="clear"></div> <label id="crepair-confirm-label" for="crepair-confirm">$label_confirm</label> <input type="text" id="crepair-confirm" name="confirm" value="$confirm" /> <div class="clear"></div> <label id="crepair-notify-label" for="crepair-notify">$label_notify</label> <input type="text" id="crepair-notify" name="notify" value="$notify" /> <div class="clear"></div> <label id="crepair-poll-label" for="crepair-poll">$label_poll</label> <input type="text" id="crepair-poll" name="poll" value="$poll" /> <div class="clear"></div> <input type="submit" name="submit" value="$lbl_submit" /> </form>