2 {%form,formMethodPost=modules.php?module=login&what=refback%}
3 <input type="hidden" name="id" value="$content[id]" />
4 <div class="table dashed">
5 <div class="table_header bottom">
6 <strong>{--MEMBER_REFBACK_EDIT_TITLE--}</strong><br />
7 <span class="notice">{--MEMBER_REFBACK_REFID--}: $content[refid]</span>
10 {--MEMBER_ENTER_REFBACK_PERCENTS--}:
11 <input type="text" class="form_field" name="refback_percents" size="6" maxlength="7" value="{%pipe,translateComma=$content[refback_percents]%}" />%
13 <div align="center" class="bottom">
14 {--MEMBER_ENTER_REFBACK_NOTICE_FOR_RECIPIENT--}:<br />
15 <textarea class="form_field" rows="5" cols="30" name="refback_note"></textarea>
17 <div class="table_footer">
18 <input type="reset" class="form_reset" value="{--CLEAR_FORM--}" />
19 <input type="submit" class="form_submit" name="edit" value="{--MEMBER_REFBACK_EDIT_SUBMIT--}" />
26 {--MEMBER_REFBACK_MIN_MAX_NOTICE--}