<?php
 
$mydoc =& JFactory::getDocument();
$mytitle = $mydoc->getTitle();
 
?>
<h2>
<?php echo $mytitle; ?> opening soon! <br /><br />Get notified of <?php echo $mytitle; ?>'s opening date. Take advantage of our grand opening!</h2>
<img align="left" src="images/kickboxing-comingsoon.jpg" alt="<?php echo $mytitle; ?> kickboxing" />
<div style="background-color:#F0F0F0;border-color:#CFCFCF;border-style:solid;border-width:1px;width:320px;float:right;">

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 250px;">Name</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_1" name="name" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Phone</label>
    <input class="cf_inputbox" maxlength="150" size="30" title="" id="text_2" name="phone" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<?php
$article_id =& JRequest::getInt('id', '', 'get'); 
?>
<input type='hidden' name='article_id' value='<?php echo $mytitle; ?>' />

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Email</label>
    <input class="cf_inputbox required" maxlength="150" size="30" title="" id="text_3" name="email" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_button">
    <input value="Submit" name="button_4" type="submit" />
  </div>
  <div class="cfclear">&nbsp;</div>
</div>
</div>
