<div class="form_item">
<div class="form_element cf_textbox"><label class="cf_label">Name</label> <span>{text_0}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_textbox"><label class="cf_label">Address</label> <span>{text_1}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_password"><label class="cf_label">City</label> <span>{text_9}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_textbox"><label class="cf_label">Postal Code</label> <span>{text_5}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_textbox"><label class="cf_label">Phone</label> <span>{text_6}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_textbox"><label class="cf_label">Email</label> <span>{text_4}</span></div>
</div>
<div class="form_item">
<div class="form_element cf_dropdown"><label class="cf_label">Location</label> <span>{USERNAME}<br />Comments {text_8}</span></div>
</div>