% unless ( $opt{'js_only'} ) {

  <INPUT TYPE="hidden" NAME="<%$name%>" ID="<%$id%>" VALUE="<% $curr_value %>">

  <TABLE>
    <TR>
%     foreach my $field ( @fields ) {
        <TD>
          <INPUT TYPE = "text"
                 NAME = "<%$name%>_<%$field%>"
                 ID   = "<%$id%>_<%$field%>"
                 VALUE = "<% scalar($cgi->param($name."_$field"))
                             || $contact->get($field) |h %>"
                 <% $onchange %>
          ><BR>
          <FONT SIZE="-2"><% $label{$field} %></FONT>
        </TD>
%     }
    </TR>
  </TABLE>

% }
<%init>

my( %opt ) = @_;

my $name = $opt{'element_name'} || $opt{'field'} || 'contactnum';
my $id = $opt{'id'} || 'contactnum';

my $curr_value = $opt{'curr_value'} || $opt{'value'};

my $onchange = '';
if ( $opt{'onchange'} ) {
  $onchange = $opt{'onchange'};
  $onchange .= '(this)' unless $onchange =~ /\(\w*\);?$/;
  $onchange =~ s/\(what\);/\(this\);/g; #ugh, terrible hack.  all onchange
                                        #callbacks should act the same
  $onchange = 'onChange="'. $onchange. '"';
}

my $contact;
if ( $curr_value ) {
  $contact = qsearchs('contact', { 'contactnum' => $curr_value } );
} else {
  $contact = new FS::contact {};
}

tie my %label, 'Tie::IxHash',
  'first'  => 'First name',
  'last'    => 'Last name',
  'title'   => 'Title/Position',
  'comment' => 'Comment',
;
my @fields = keys %label;

</%init>