
  <tr>
   <td class='content'><strong>{$ibforums->lang['w_reason']}</strong><br />{$ibforums->lang['w_reason2']}</td>
   <td class='content'><textarea rows='6' cols='70' class='textinput' name='reason' style='width: 95%;'>{$ibforums->input['reason']}</textarea></td>
  </tr>
  <tr>
  <td class='content'><strong>{$ibforums->lang['w_c_subj']}</strong></td>
  <td class='content'><input type='input' name='subject' class='forminput' value='{$ibforums->input['subject']}' size='30'></td>
 </tr>
  <tr>
   <td class='content'><strong>{$ibforums->lang['w_contact']}</strong><br />{$ibforums->lang['w_contact2']}</td>
   <td class='content'>{$ibforums->lang['w_c']}&nbsp;<select name='contactmethod' class='forminput'><option value='pm'>{$ibforums->lang['w_c_p']}</option><option value='email'>{$ibforums->lang['w_c_e']}</option></select>
     <br /><textarea rows='6' cols='70' class='textinput' name='contact' style='width: 95%;'>{$ibforums->input['contact']}</textarea></td>
  </tr>
</table>
<div class='titlemedium' style='text-align: center;'><input type='submit' class='forminput' value='{$ibforums->lang['w_submit']}' /></div>
</div>
</div>
</form>
