{message}
{fields}
| {txt_firstname} | {firstname} | |
| {txt_lastname} * | {lastname} | |
| {txt_email} * | {email} | |
| {txt_subject} * | {subject} | |
| {txt_comment} | {comment} | |
| {txt_subscribe_newsletter} | {checkbox:newsletter} | |
| {txt_receive_information} | {checkbox:information} | |
| {txt_salutation} | {radiobutton:salutation} | |
| {txt_vote} | {select:Vote} |
* = {txt_mandatory_fields}