<{if $form.errors}> <{/if}> <{$form.javascript}> > <{$form.hidden}>
<{$form.header.header1}>
<{$form.txt1.label}> <{$form.txt1.html}>
<{$form.tel.label}> <{$form.tel.html}>
<{$form.zip.label}> <{$form.zip.html}>
<{$form.sel1.label}> <{$form.sel1.html}>
<{$form.sel2.label}> <{$form.sel2.html}>
<{$form.cb1.label}> <{$form.cb1.html}>
<{$form.cb2.label}> <{$form.cb2.html}>
<{$form.cb3.label}> <{$form.cb3.html}>
<{$form.rb1.label}> <{$form.rb1.html}>
<{$form.rb2.label}> <{$form.rb2.html}>
<{$form.rb3.label}> <{$form.rb3.html}>
<{$form.rb4.label}> <{$form.rb4.html}>
<{$form.acb1.label}> <{$form.acb1.html}>
<{$form.acb2.label}> <{$form.acb2.html}>
<{$form.date1.label}> <{$form.date1.html}>
<{$form.submit_button.html}> <{$form.reset_button.html}>

Registered Rules: