{txt_script_name}

{txt_welcome_text}

{message}

{fields}
   

{txt_send_referer}

{url}


{txt_firstname}*   
{txt_lastname}   
{txt_sender_email}*   
{txt_friend_email}*   
{txt_comment}   
{txt_subscribe_newsletter}   {txt_yes}
{txt_receive_information}   {txt_yes}
{txt_salutation}   Mr
Ms
{txt_vote}  
 

* = {txt_mandatory_fields}