28 lines
1.3 KiB
HTML
28 lines
1.3 KiB
HTML
<div class="st_application" style="padding-bottom: 10px">
|
|
<h1 class="st_title">{__ text="Newsletter - prośba o wypisanie z listy"}</h1>
|
|
|
|
<form action="{$form.action}" method="post" style="width: 172px; margin: 0 auto">
|
|
<p>
|
|
<label for="newsletter_email">{__ text="Adres e-mail"}</label><br />
|
|
<input type="text" name="newsletter[email]" value="{$form.email}" id="newsletter_email" style="width: 164px" />
|
|
{if $form.errors.email}
|
|
<span style="color: red">{$form.errors.email}</span>
|
|
{/if}
|
|
</p>
|
|
<p>{$form.captcha}</p>
|
|
<p>
|
|
<label for="newsletter_captcha">{__ text="Cyfry z obrazka"}</label><br />
|
|
<input type="text" name="newsletter[captcha]" id="newsletter_captcha" style="width: 164px" />
|
|
{if $form.errors.captcha}
|
|
<span style="color: red">{$form.errors.captcha}</span>
|
|
{/if}
|
|
</p>
|
|
<div id="st_button-user-remind" class="st_button-container">
|
|
<div class="st_button st_align-right">
|
|
<div class="st_button-left">
|
|
<input type="submit" value="{__ text='Wyślij'}" />
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</form>
|
|
</div> |