<!--S:Form-->


						<div class="form {SET_FORM_STYLE}">
							<form class="contact-form ajax" action="{SCRIPT}" method="post" data-sending="{LANG_SENDING}">
									
									<div class="row">
										{FIELDS}
									</div>
									{CAPCHA}
									
									<div class="responsebox"></div>

									<div class="form-line form-buttons">
											<button type="submit" class="btn btn-large">{LANG_BUTTON}</button>
											&nbsp;&nbsp;
											<button type="reset" class="btn btn-large">{LANG_RESET}</button>
									</div>

							</form>
						</div>
<!--E:Form-->


<!--S:Group-->
			{DATA}
<!--E:Group-->

<!--S:Element-->
			{CONTENT}
<!--E:Element-->

<!--S:Empty-->

<!--E:Empty-->

<!--S:Small-->			

								<div class="form-line col-md-6 col-sm-6 col-xs-12">
									<label>{ITEM_TITLE}{HOLDER_REQUIRED}</label>
									<div class="form-line-group">
										<span class="form-line-group-label form-line-group-option">{ITEM_TITLE}{HOLDER_REQUIRED}</span>
										{FIELD}
									</div>
								</div>

<!--E:Small-->

<!--S:Big-->

								<div class="form-line col-md-9 col-xs-12">
									<label>{ITEM_TITLE}{HOLDER_REQUIRED}</label>
									<div class="form-line-group">
										<span class="form-line-group-label form-line-group-option">{ITEM_TITLE}{HOLDER_REQUIRED}</span>
										{FIELD}
									</div>
								</div>
<!--E:Big-->

<!--S:Full-->

								<div class="form-line col-md-12">
									<label>{ITEM_TITLE}{HOLDER_REQUIRED}</label>
									<div class="form-line-group">
										<span class="form-line-group-label form-line-group-option">{ITEM_TITLE}{HOLDER_REQUIRED}</span>
										{FIELD}
									</div>
								</div>
<!--E:Full-->

<!--S:separator-->
						<div class="clear"></div>
						<div class="">
							<h3 class="separator">{ITEM_TITLE}</h3>
						</div>
						<div class="clear"></div>
						
<!--E:separator-->
				
<!--S:usertext--><input {FIELD_REQUIRED} type="text" name="{ITEM_FIELD}" value="{VALUE}" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item"/><!--E:usertext-->
<!--S:useremail--><input {FIELD_REQUIRED} type="text" name="{ITEM_FIELD}" value="{VALUE}" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item"><!--E:useremail-->
<!--S:usermessage--><textarea {FIELD_REQUIRED} name="{ITEM_FIELD}" rows="5" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item">{VALUE}</textarea><!--E:usermessage-->
<!--S:calendar--><input {FIELD_REQUIRED} type="text" name="{ITEM_FIELD}" value="{VALUE}" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item" data-calendar="true"/><!--E:calendar-->
<!--S:calendartime--><input {FIELD_REQUIRED} type="text" name="{ITEM_FIELD}" value="{VALUE}" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item" data-calendar-time="true"/><!--E:calendartime-->
<!--S:time--><input {FIELD_REQUIRED} type="text" name="{ITEM_FIELD}" value="{VALUE}" placeholder="{ITEM_TITLE}" class="form-line-group-item form-item" data-time="true"/><!--E:time-->

<!--S:field_required-->* <!--E:field_required-->

<!--S:holder_required--><span class="red">*</span><!--E:holder_required-->

<!--S:userdroplist-->
							<div class="form-item-select form-item">
								<select name="{ITEM_FIELD}" placeholder="{ITEM_TITLE}">
									<option></option>
									{OPTIONS}
								</select>
							</div>
<!--E:userdroplist-->

<!--S:departments-->
							<div class="form-item-select form-item">
								<select name="department" placeholder="{ITEM_TITLE}">
									<option></option>
									{OPTIONS}
								</select>
							</div>
<!--E:departments-->

<!--S:department-->
	<input type="hidden" name="department" value="{SET_DEPARTMENT}"/>
<!--E:department-->


<!--S:image-->

<!--E:image-->

<!--S:Success-->
	<script>	
		$(".contact-module-form").find("input[type=text], textarea").val("");
		$(".contact-module-form").find("select").prop('selectedIndex',0);
	</script>
<!--E:Success-->