{% extends "oahpa.html" %}
{% load i18n %}

{% block content %}

<table>
<tr>
<td>
{% trans "Message:" %}<br/>
{{ form.message }}
</td>
</tr>
<td>
</td>
</tr>
<tr><td>
<p>{% trans "The following information is optional." %} <br/>
{% trans "An email address is required if you would like us to contact you about the feedback." %}</p>
</td>
</tr>
<tr>
<td>
{% trans "Your name:" %}<br/>
{{ form.name }}
</td>
</tr>
<tr>
<td>
{% trans "Institution/language course:" %}<br/>
{{ form.place }}
</td></tr>
<tr>
<td>
{% trans "email:" %}<br/>
{{ form.email }}
</td>
</tr>
<tr>
<td>
<p>{% trans "I would like to be contacted about my question:" %} {{ form.confirmation }}</p>
   <input type="submit" name="test" value="{% trans "Send message" %}"/>

</td>
</tr>
</table>
{% endblock %}