<h5>Email address of recipient</h5>
<input type="text" class="input" size="20" name="to" />
<h5>Your name</h5>
<input type="text" class="input" size="20" name="name" />
<h5>Your email address</h5>
<input type="text" class="input" size="20" name="from" />
<h5>Personal message</h5>
<textarea name="message" class="textarea" rows="6" cols="18"></textarea>
<h5>What would you like to send?</h5>
<p><input type="radio" name="what" value="link" checked /> Link only<br />
<input type="radio" name="what" value="text" /> Full text
</p>
<br />
{if captcha}
Submit the word you see below:<br /><br />
%%captcha%%
<br />
<input type="text" name="captcha" value="" size="20" maxlength="20" style="width:140px;" />
{/if}
<br /><br />
<input class="button" type="submit" value=" SUBMIT " />
