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<TR>
<TH ALIGN="right" VALIGN="center"><% mt('First name') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>firstname" SIZE=54></TD>
</TR>
<TR>
<TH ALIGN="right" VALIGN="center"><% mt('Last name') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>lastname" SIZE=54></TD>
</TR>
<TR>
<TH ALIGN="right" VALIGN="center"><% mt('Email') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>email" SIZE=54></TD>
</TR>
<TR>
<TH ALIGN="right" VALIGN="center"><% mt('Home Phone') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>homephone" SIZE=54></TD>
</TR>
<TR>
<TH ALIGN="right" VALIGN="center"><% mt('Work Phone') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>workphone" SIZE=54></TD>
</TR>
<TR>
<TH ALIGN="right" VALIGN="center"><% mt('Mobile Phone') |h %></TH>
<TD><INPUT TYPE="text" NAME="<%$field_prefix%>mobilephone" SIZE=54></TD>
</TR>
<%init>
my %opt = @_;
my $field_prefix = $opt{'pre_fix'} ? $opt{'pre_fix'} : '';
</%init>
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