<div class="main">
<div class="container">
<h1>{contact_us_text}</h1>
<div class="container">
<?php echo form_open(get_link("customer_contact_us"),array()); ?>
<div class="row">
<div class="three columns">
<label>{name_text}</label>
</div>
<div class="nine columns">
<input name="name" type="text" class="full-width"/>
</div>
</div>
<div class="row">
<div class="three columns">
<label>{email_text}</label>
</div>
<div class="nine columns">
<input name="email" type="email" class="full-width lang-en ltr"/>
</div>
</div>
<?php if(isset($department)) { ?>
<div class="row">
<div class="three columns">
<label>{department_text}</label>
</div>
<div class="nine columns">
<input name="department" class="full-width"/>
</div>
</div>
<?php } ?>
<div class="row">
<div class="three columns">
<label>{subject_text}</label>
</div>
<div class="nine columns">
<input name="subject" class="full-width"/>
</div>
</div>
<div class="row">
<div class="three columns">
<label>{content_text}</label>
</div>
<div class="nine columns">
<textarea name="content" class="full-width" rows="5"></textarea>
</div>
</div>
<div class="row">
<div class="three columns">
{captcha}
</div>
<div class="nine columns">
<input name="captcha" class="lang-en"/>
</div>
</div>
<div class="row">
<div class="six columns"> </div>
<input type="submit" class=" button-primary three columns" value="{submit_text}"/>
</div>
</form>
</div>
</div>
</div>
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