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  • Committer: Mark A. Hershberger
  • Date: 2009-09-03 17:42:45 UTC
  • Revision ID: mhershberger@intrahealth.org-20090903174245-1mi3j3ig7r2uui34
Add blank site, move sample data to separate package from -all.

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i2ce-ihris-manage-site-demo/templates/en_US/feedback_form.html
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<div id="feedback">
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<p>
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If you have a  bug report, problem with the page, feature request or question, 
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please contact us by filling out and submitting the following form. Your comments 
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and email address will be kept private in accordance with the Capacity Project's 
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<a target="_new" href="http://www.capacityproject.org/index?option=com_content&amp;task=view&amp;id=34&amp;Itemid=63">privacy policy</a>. 
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 We will use your email address only to reply to your request.
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You may also contact us by emailing us directly at 
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<a href="mailto:hris@capacityproject.org">hris@capacityproject.org</a>.
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</p>
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<hr />
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<h4>Site Feedback Form</h4>
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<!-- <p>Required fields are marked with a red asterisk (<span style="color:red;"><b>*</b></span>)</p> -->
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<div id="error" />
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<form method="POST" action="feedback">
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<input type="hidden" name="referer" id="referer" />
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<table class="tableForm">
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  <tr>
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   <td colspan="2"><label for="Comments">Comments:</label><br />
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   <textarea name="Comments" rows="10" cols="45" id="Comments"></textarea>
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   </td>
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  </tr>
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  <tr class="spacer">
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   <td><label for="Name">Name:</label></td>
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   <td><input type="text" name="Name" id="Name" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Company">Company:</label></td>
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   <td><input type="text" name="Company" id="Company" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Title">Title:</label></td>
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   <td><input type="text" name="Title" id="Title" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Industry">Industry:</label></td>
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   <td><input type="text" name="Industry" id="Industry" /></td>
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  </tr>
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  <tr>
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   <td><label for="Address">Address:</label></td>
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   <td><input type="text" name="Address" id="Address" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="City">City:</label></td>
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   <td><input type="text" name="City" id="City" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="State">State/Province:</label></td>
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   <td><input type="text" name="State" id="State" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Postal_Code">Postal Code:</label></td>
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   <td><input type="text" name="Postal_Code" id="Postal_Code" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Country">Country:</label></td>
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   <td><input type="text" name="Country" id="Country" />
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   </td>
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  </tr>
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  <tr class="spacer">
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   <td><label for="Telephone">Telephone:</label></td>
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   <td><input type="text" name="Telephone" id="Telephone" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Fax">Fax:</label></td>
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   <td><input type="text" name="Fax" id="Fax" />
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   </td>
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  </tr>
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  <tr>
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   <td><label for="Email">Email:</label></td>
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   <td><input type="text" name="Email" id="Email" />
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   </td>
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  </tr>
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  <tr class="spacer">
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   <td><!-- <p class="smallGray"><span style="color: red;">*</span> Required</p> --></td>
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   <td><input type="submit" value="Submit" name="submit" class="button" />
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    <input type="reset" value="Clear" name="reset" class="button" />
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   </td>
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  </tr>
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 </table>
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</form>
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</div><!-- /feedback -->
 
 
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