<?PHP include($targetedX);
include($exCD."/contact2.inc.php");

$saveCheck=$targetedX;
include("./../function/autoX-loadingS10.inc.php");
?>

<input type="hidden" name="checkDx" value="<?PHP echo $checkDx;?>">
<input type="hidden" name="sectionK" value="">

<div id='div-tpl1' class="box-body">
<div class="padd-lr10">

<?PHP 
echo "
<div class='ph1'></div>
<div class='infoboxline'></div>
<div class='ph1'></div>
";

echo "<div class='col-md-12 tpl1H trcolor'>".$formcontactinfoA."</div>";

include($exCD."/content.inc.php");
if($secContact == "on"){$checked1="checked";}else{$checked1="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda  wd150p formtitle'>".$formcontactinfo1.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='secContact' id='secContact' value='on' $checked1>
<label class='onoffswitch-label' for='secContact'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'><span class='formsub'>".$formcontactinfo1a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($checkfields == "on"){$checked1="checked";}else{$checked1="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda  wd150p formtitle'>".$formcontactinfo2.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkfields' id='checkfields' value='on' $checked1>
<label class='onoffswitch-label' for='checkfields'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'><span class='formsub'>".$formcontactinfo2a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($posF == "1"){$posFX=$formcontactinfo3c2;}
else{$posFX=$formcontactinfo3c1;}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo3.":</div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<select name='posF' class='formfieldD'>
<option value='$posF' class='formfield1'>".$posFX."</option>";
include("./functions/dd-blockposition3.inc.php");
echo "</select>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'></span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($posK == "1"){$posX=$formcontactinfo3b1;}
elseif($posK == "2"){$posX=$formcontactinfo3b2;}
elseif($posK == "3"){$posX=$formcontactinfo3b3;}
elseif($posK == "4"){$posX=$formcontactinfo3b4;}
elseif($posK == "5"){$posX=$formcontactinfo3b5;}
elseif($posK == "6"){$posX=$formcontactinfo3b6;}
elseif($posK == "E"){$posX=$formcontactinfo3bE;}
else{$posX="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'></div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<select name='posK' class='formfieldD'>
<option value='$posK' class='formfield1'>".$posX."</option>";
include("./functions/dd-blockposition2b.inc.php");
echo "</select>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo3a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoM."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo29.":</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='255' -->
<input class='formfield1 effect-1' type='text' maxlength='255' id='wmMail' name='wmMail' value='$wmMail'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo29a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo30.":</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='255' -->
<input class='formfield1 effect-1' type='text' maxlength='255' id='wmWebsite' name='wmWebsite' value='$wmWebsite' placeholder=' ".$formcontactinfo28g." '> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo28g."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($mailsaveX1 == "on"){$checked1="checked";}else{$checked1="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda  wd150p formtitle'>".$formcontactinfo32.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='mailsaveX1' id='mailsaveX1' value='on' $checked1>
<label class='onoffswitch-label' for='mailsaveX1'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'><span class='formsub'>".$formcontactinfo32a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($mailsaveX2 == "on"){$checked1="checked";}else{$checked1="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda  wd150p formtitle'>".$formcontactinfo33.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='mailsaveX2' id='mailsaveX2' value='on' $checked1>
<label class='onoffswitch-label' for='mailsaveX2'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'><span class='formsub'>".$formcontactinfo33a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoB."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo5.":</div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='35' -->
<input class='formfield1 effect-1' type='text' maxlength='35' id='formTitle1' name='formTitle1' value='$formTitle1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo5a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo5b.":</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='subTitle1' name='subTitle1' value='$subTitle1'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo5c."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($formText1 == ""){$formText1x="-";}else{$formText1x=$formText1;}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo6.":</div>
<div class='tpl1-tdcx'>
<span class='formsub'>".$formcontactinfo6a."</span>
<span class='formsub resF fwb'>".$formcontactinfo6b."</span>
<div class='form-container'>
<input class='formfield1 effect-1' type='text' id='formText1' name='formText1' value='$formText1'> 
<span class='focus-border'></span>
</div>
<span class='formsub tdu'>".$formcontactinfo6c."</span><br>
<span class='formsub'>".$formText1x."</span>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo7.":</div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='20' -->
<input class='formfield1 effect-1' type='text' maxlength='20' id='sendA' name='sendA' value='$sendA'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo7a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo8.":</div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='20' -->
<input class='formfield1 effect-1' type='text' maxlength='20' id='sendB' name='sendB' value='$sendB'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$formcontactinfo8a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoC."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo9.":</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='wmHead2' name='wmHead2' value='$wmHead2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo10." 1:</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='100' -->
<input class='formfield1 effect-1' type='text' maxlength='100' id='wmContent1' name='wmContent1' value='$wmContent1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max100."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo10." 2:</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='100' -->
<input class='formfield1 effect-1' type='text' maxlength='100' id='wmContent2' name='wmContent2' value='$wmContent2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max100."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo10." 3:</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='100' -->
<input class='formfield1 effect-1' type='text' maxlength='100' id='wmContent3' name='wmContent3' value='$wmContent3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max100."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo11.":</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='wmSignature8' name='wmSignature8' value='$wmSignature8'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo12.":</div>
<div class='tpl1-tdbx wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='wmSignature9' name='wmSignature9' value='$wmSignature9'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoD."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda wd75p headline1'>".$formcontactinfo13."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo13c."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield01s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield01p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 1:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield01s' id='ctfield01s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield01s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield01p' id='ctfield01p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield01p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield01f' name='ctfield01f' value='$ctfield01f'> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='salutation1' name='salutation1' value='$salutation1'> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='salutation2' name='salutation2' value='$salutation2'> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='salutation3' name='salutation3' value='$salutation3'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$ctfield01f."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield02s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield02p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 2:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield02s' id='ctfield02s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield02s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield02p' id='ctfield02p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield02p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield02f' name='ctfield02f' value='$ctfield02f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$ctfield02f."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield03s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield03p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 3:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield03s' id='ctfield03s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield03s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield03p' id='ctfield03p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield03p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield03f' name='ctfield03f' value='$ctfield03f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$ctfield03f."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield04s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield04p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 4:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield04s' id='ctfield04s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield04s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield04p' id='ctfield04p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield04p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield04f' name='ctfield04f' value='$ctfield04f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield05s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield05p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 5:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield05s' id='ctfield05s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield05s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield05p' id='ctfield05p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield05p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield05f' name='ctfield05f' value='$ctfield05f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$ctfield05f."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield06s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield06p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 6:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield06s' id='ctfield06s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield06s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield06p' id='ctfield06p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield06p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield06f' name='ctfield06f' value='$ctfield06f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$formcontactinfo14b."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield07s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield07p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 7:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield07s' id='ctfield07s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield07s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield07p' id='ctfield07p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield07p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield07f' name='ctfield07f' value='$ctfield07f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield08s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield08p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 8:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield08s' id='ctfield08s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield08s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield08p' id='ctfield08p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield08p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield08f' name='ctfield08f' value='$ctfield08f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield09s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield09p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 9:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield09s' id='ctfield09s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield09s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield09p' id='ctfield09p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield09p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield09f' name='ctfield09f' value='$ctfield09f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield10s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield10p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 10:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield10s' id='ctfield10s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield10s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield10p' id='ctfield10p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield10p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield10f' name='ctfield10f' value='$ctfield10f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield11s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield11p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 11:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield11s' id='ctfield11s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield11s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield11p' id='ctfield11p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield11p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield11f' name='ctfield11f' value='$ctfield11f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub resF'>[".$formcontactinfo14c."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield12s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield12p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 12:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield12s' id='ctfield12s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield12s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield12p' id='ctfield12p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield12p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield12f' name='ctfield12f' value='$ctfield12f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield13s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield13p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 13:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield13s' id='ctfield13s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield13s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield13p' id='ctfield13p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield13p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield13f' name='ctfield13f' value='$ctfield13f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield14s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield14p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 14:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield14s' id='ctfield14s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield14s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield14p' id='ctfield14p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield14p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield14f' name='ctfield14f' value='$ctfield14f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield15s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield15p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 15:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield15s' id='ctfield15s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield15s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield15p' id='ctfield15p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield15p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield15f' name='ctfield15f' value='$ctfield15f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield16s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield16p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 16:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield16s' id='ctfield16s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield16s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield16p' id='ctfield16p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield16p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield16f' name='ctfield16f' value='$ctfield16f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield17s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield17p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 17:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield17s' id='ctfield17s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield17s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield17p' id='ctfield17p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield17p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield17f' name='ctfield17f' value='$ctfield17f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield18s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield18p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 18:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield18s' id='ctfield18s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield18s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield18p' id='ctfield18p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield18p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield18f' name='ctfield18f' value='$ctfield18f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14a."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield19s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield19p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 19:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield19s' id='ctfield19s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield19s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield19p' id='ctfield19p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield19p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield19f' name='ctfield19f' value='$ctfield19f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14d."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

if($ctfield20s == "on"){$checked1="checked";}else{$checked1="";}
if($ctfield20p == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda wd75p formtitle'>".$formcontactinfo14." 20:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield20s' id='ctfield20s' value='on' $checked1>
<label class='onoffswitch-label' for='ctfield20s'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ctfield20p' id='ctfield20p' value='on' $checked2>
<label class='onoffswitch-label' for='ctfield20p'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='ctfield20f' name='ctfield20f' value='$ctfield20f'> 
<span class='focus-border'></span>
</div>

</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo14e."]</span></div>

<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoE."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo15a.":</div>
<div class='tpl1-tdbx'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='100' -->
<input class='formfield1 effect-1' type='text' maxlength='100' id='fieldtxt1a' name='fieldtxt1a' value='$fieldtxt1a'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdbx'><span class='formtitle'> &nbsp; ".$formcontactinfo15b." </span></div>

<div class='tpl1-tdbx'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='fieldtxt1b' name='fieldtxt1b' value='$fieldtxt1b'> 
<span class='focus-border'></span>
</div>
</div>

<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo15c.":</div>
<div class='tpl1-tdbx  wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='150' -->
<input class='formfield1 effect-1' type='text' maxlength='150' id='fieldtxt2a' name='fieldtxt2a' value='$fieldtxt2a'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoF."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo16a."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($checkboxAs == "on"){$checked1="checked";}else{$checked1="";}
if($checkboxAp == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo16." 1:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxAs' id='checkboxAs' value='on' $checked1>
<label class='onoffswitch-label' for='checkboxAs'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxAp' id='checkboxAp' value='on' $checked2>
<label class='onoffswitch-label' for='checkboxAp'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='checkbox1F' name='checkbox1F' value='$checkbox1F' placeholder=' ".$formcontactinfo16b." '> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='250' -->
<input class='formfield1 effect-1' type='text' maxlength='250' id='checkbox1I' name='checkbox1I' value='$checkbox1I' placeholder=' ".$formcontactinfo16c." '>  
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($checkboxBs == "on"){$checked1="checked";}else{$checked1="";}
if($checkboxBp == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo16." 2:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxBs' id='checkboxBs' value='on' $checked1>
<label class='onoffswitch-label' for='checkboxBs'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxBp' id='checkboxBp' value='on' $checked2>
<label class='onoffswitch-label' for='checkboxBp'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='checkbox2F' name='checkbox2F' value='$checkbox2F' placeholder=' ".$formcontactinfo16b." '> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='250' -->
<input class='formfield1 effect-1' type='text' maxlength='250' id='checkbox2I' name='checkbox2I' value='$checkbox2I' placeholder=' ".$formcontactinfo16c." '>  
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($checkboxCs == "on"){$checked1="checked";}else{$checked1="";}
if($checkboxCp == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo16." 3:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxCs' id='checkboxCs' value='on' $checked1>
<label class='onoffswitch-label' for='checkboxCs'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='checkboxCp' id='checkboxCp' value='on' $checked2>
<label class='onoffswitch-label' for='checkboxCp'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc wd50x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='checkbox3F' name='checkbox3F' value='$checkbox3F' placeholder=' ".$formcontactinfo16b." '> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='250' -->
<input class='formfield1 effect-1' type='text' maxlength='250' id='checkbox3I' name='checkbox3I' value='$checkbox3I' placeholder=' ".$formcontactinfo16c." '>  
<div class='font14'>".$formcontactinfo34."</div>
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoG."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda wd150p headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx headline2'>".$formcontactinfo17."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($infoA == "on"){$checked1="checked";}else{$checked1="";}
$messageX=file_get_contents($exCC."/contactinfo.inc.php");
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo18.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='infoA' id='infoA' value='on' $checked1>
<label class='onoffswitch-label' for='infoA'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo18a."]</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($infotextA == "on"){$checked1="checked";}else{$checked1="";}
$messageX=file_get_contents($exCC."/contactinfo.inc.php");
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo19.":</div>

<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='infotextA' id='infotextA' value='on' $checked1>
<label class='onoffswitch-label' for='infotextA'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>

<div class='tpl1-tdc'>
<span class='formsub'>".$formcontactinfo19a."</span>
<div class='form-container'><textarea id='messageX' name='messageX' class='texteditor-inner effect-1' wrap='virtual'>".$messageX."</textarea>
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($hintA == "on"){$checked1="checked";}else{$checked1="";}
$messageX=file_get_contents($exCC."/contactinfo.inc.php");
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo20.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='hintA' id='hintA' value='on' $checked1>
<label class='onoffswitch-label' for='hintA'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo20a."]</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($ipA == "on"){$checked1="checked";}else{$checked1="";}
$messageX=file_get_contents($exCC."/contactinfo.inc.php");
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo21.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='ipA' id='ipA' value='on' $checked1>
<label class='onoffswitch-label' for='ipA'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>[".$formcontactinfo21a."]</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoH."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo19."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($dropA == "on"){$checked1="checked";}else{$checked1="";}
if($dropP1 == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo22." 1:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropA' id='dropA' value='on' $checked1>
<label class='onoffswitch-label' for='dropA'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropP1' id='dropP1' value='on' $checked2>
<label class='onoffswitch-label' for='dropP1'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='dropA0' name='dropA0' value='$dropA0' placeholder=' ".$formcontactinfo15b." '> 
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 1:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA1' name='dropA1' value='$dropA1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 2:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA2' name='dropA2' value='$dropA2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 3:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA3' name='dropA3' value='$dropA3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 4:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA4' name='dropA4' value='$dropA4'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 5:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA5' name='dropA5' value='$dropA5'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 6:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA6' name='dropA6' value='$dropA6'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 7:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA7' name='dropA7' value='$dropA7'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 8:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA8' name='dropA8' value='$dropA8'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 9:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropA9' name='dropA9' value='$dropA9'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoI."</div>";
echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo19."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($dropB == "on"){$checked1="checked";}else{$checked1="";}
if($dropP2 == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo22." 2:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropB' id='dropB' value='on' $checked1>
<label class='onoffswitch-label' for='dropB'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropP2' id='dropP2' value='on' $checked2>
<label class='onoffswitch-label' for='dropP2'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='dropB0' name='dropB0' value='$dropB0' placeholder=' ".$formcontactinfo15b." '> 
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 1:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB1' name='dropB1' value='$dropB1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 2:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB2' name='dropB2' value='$dropB2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 3:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB3' name='dropB3' value='$dropB3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 4:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB4' name='dropB4' value='$dropB4'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 5:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB5' name='dropB5' value='$dropB5'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 6:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB6' name='dropB6' value='$dropB6'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 7:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB7' name='dropB7' value='$dropB7'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 8:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB8' name='dropB8' value='$dropB8'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 9:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropB9' name='dropB9' value='$dropB9'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoJ."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo19."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($dropC == "on"){$checked1="checked";}else{$checked1="";}
if($dropP3 == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo22." 1:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropC' id='dropC' value='on' $checked1>
<label class='onoffswitch-label' for='dropC'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropP3' id='dropP3' value='on' $checked2>
<label class='onoffswitch-label' for='dropP3'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='dropC0' name='dropC0' value='$dropC0' placeholder=' ".$formcontactinfo15b." '> 
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 1:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC1' name='dropC1' value='$dropC1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 2:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC2' name='dropC2' value='$dropC2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 3:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC3' name='dropC3' value='$dropC3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 4:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC4' name='dropC4' value='$dropC4'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 5:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC5' name='dropC5' value='$dropC5'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 6:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC6' name='dropC6' value='$dropC6'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 7:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC7' name='dropC7' value='$dropC7'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 8:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC8' name='dropC8' value='$dropC8'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 9:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropC9' name='dropC9' value='$dropC9'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoK."</div>";

echo "<div class='clearX'></div>
<div class='tpl1tb hdcolor'>
<div class='tpl1-tda headline1'>".$areaX."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13a."</div>
<div class='tpl1-tdbx wd125s headline1'>".$formcontactinfo13b."</div>
<div class='tpl1-tdcx headline2'>".$formcontactinfo19."</div>
<div class='clearX ph1 clearX'></div>
</div>
";

if($dropD == "on"){$checked1="checked";}else{$checked1="";}
if($dropP4 == "on"){$checked2="checked";}else{$checked2="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda formtitle'>".$formcontactinfo22." 1:</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropD' id='dropD' value='on' $checked1>
<label class='onoffswitch-label' for='dropD'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='dropP4' id='dropP4' value='on' $checked2>
<label class='onoffswitch-label' for='dropP4'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='12' -->
<input class='formfield1 effect-1' type='text' maxlength='12' id='dropD0' name='dropD0' value='$dropD0' placeholder=' ".$formcontactinfo15b." '> 
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 1:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD1' name='dropD1' value='$dropD1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 2:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD2' name='dropD2' value='$dropD2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 3:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD3' name='dropD3' value='$dropD3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 4:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD4' name='dropD4' value='$dropD4'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 5:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD5' name='dropD5' value='$dropD5'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 6:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD6' name='dropD6' value='$dropD6'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 7:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD7' name='dropD7' value='$dropD7'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 8:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD8' name='dropD8' value='$dropD8'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo14." 9:</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='dropD9' name='dropD9' value='$dropD9'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max50."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='tpl1H col-md-12 trcolor'>".$formcontactinfoL."</div>";

if($mailsend1x == "on"){$checked1="checked";}else{$checked1="";}
echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tda  wd200p formtitle'>".$formcontactinfo31.":</div>
<div class='tpl1-tdb'>
<div class='onoffswitch'>
<input type='checkbox' class='onoffswitch-checkbox' name='mailsend1x' id='mailsend1x' value='on' $checked1>
<label class='onoffswitch-label' for='mailsend1x'>
<span class='onoffswitch-inner'></span>
<span class='onoffswitch-switch'></span>
</label>
</div>
</div>
<div class='tpl1-tdc'><span class='formsub'>".$formcontactinfo31a."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo23.":</div>
<div class='tpl1-tdbx wd300p'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='75' -->
<input class='formfield1 effect-1' type='text' maxlength='75' id='mailsubject1' name='mailsubject1' value='$mailsubject1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='tpl1-tdcx'><span class='formsub'>".$max75."</span></div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax formtitle'>".$formcontactinfo24.":</div>
<div class='tpl1-tdbx wd300p'>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='salutationZ1' name='salutationZ1' value='$salutationZ1'> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='salutationZ2' name='salutationZ2' value='$salutationZ2'> 
<span class='focus-border'></span>
</div>

<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='50' -->
<input class='formfield1 effect-1' type='text' maxlength='50' id='salutationZ4' name='salutationZ4' value='$salutationZ4'> 
<span class='focus-border'></span>
</div>

</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo25." 1:</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmText1' name='wmText1' value='$wmText1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo25." 2:</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmText2' name='wmText2' value='$wmText2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo25." 3:</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmText3' name='wmText3' value='$wmText3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo25." 4:</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmText4' name='wmText4' value='$wmText4'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo25." 5:</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmText5' name='wmText5' value='$wmText5'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo26.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmTextFoo' name='wmTextFoo' value='$wmTextFoo'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo27.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmSignature1' name='wmSignature1' value='$wmSignature1'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28a.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmSignature2' name='wmSignature2' value='$wmSignature2'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28b.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmSignature3' name='wmSignature3' value='$wmSignature3'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28c.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='255' -->
<input class='formfield1 effect-1' type='text' maxlength='255' id='wmSignatureM' name='wmSignatureM' value='$wmSignatureM'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28d.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='255' -->
<input class='formfield1 effect-1' type='text' maxlength='255' id='wmSignature4' name='wmSignature4' value='$wmSignature4' placeholder=' ".$formcontactinfo28g." '>  
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28e.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='255' -->
<input class='formfield1 effect-1' type='text' maxlength='255' id='wmSignature5' name='wmSignature5' value='$wmSignature5' placeholder=' ".$formcontactinfo28h." '> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "<div class='clearX'></div>
<div class='tpl1tb menu-out4'>
<div class='tpl1-tdax wd150p formtitle'>".$formcontactinfo28.", ".$formcontactinfo28f.":</div>
<div class='tpl1-tdbx wd75x'>
<div class='form-container'>
<!--webbot bot='Validation' B-Value-Required='TRUE' I-Maximum-Length='200' -->
<input class='formfield1 effect-1' type='text' maxlength='200' id='wmSignature6' name='wmSignature6' value='$wmSignature6'> 
<span class='focus-border'></span>
</div>
</div>
<div class='clearX ph1 clearX'></div>
</div>
";

echo "
<div class='ph10'></div>
<div class='infoboxline'></div>
<div class='ph1'></div>
";

echo "
<div class='txtVM txtR'><button type='submit' id='save' name='save' class='btn form-btn1'><i class='fa fa-arrow-circle-right'></i> ".$saveD."</button></div>
";
?>

<div class="clearX box-footer"></div>
</div>
</div>
