<table cellspacing="0" cellpadding="4" border="0">
<form method="post" enctype="multipart/form-data" action="{subscribe_url}">
<tr>
<td>{rs:NAME}:</td>
<td><input type="text" name="r[name]" value=""></td>
</tr>

<tr>
<td>{rs:MAIL}:</td>
<td><input type="text" name="r[mail]" value=""></td>
</tr>

{if:format}
<tr>
<td>{rs:FORMAT}</td>
<td>	<select name="r[receive_format]">
	{row:RECEIVE_FORMAT_SELECT}<option value="{id}"{selected}>{title}</option>
	{/row}
	</select>
</td>
</tr>
{/if}

{if:encoding}
<tr>
<td>{rs:ENCODING}:</td>
<td>	<select name="r[encoding]">
	{row:ENCODING_SELECT}<option value="{id}"{selected}>{title}</option>
	{/row}
	</select>
</td>
</tr>
{/if}

<tr>
<td valign="top">{rs:MAILING_GROUPS}:</td>
<td>	{row:GROUPS_SELECT}<div><input type="checkbox" name="r[group_id][]" value="{id}">{title}</div>
	{/row}
</td>
</tr>

{row:CUSTOM_FIELDS}
<tr>
<td valign="top">{title}{if:not_null}{/if}:</td>
<td>{line}</td>
</tr>
{/row}

<tr>
<td><img src="{global:PATH}img/spacer.gif" width="100" height="1" border="0" alt=""></td>
<td align="left">
	<input type="hidden" name="r[is_format]" value="{if:format}1{/if}{if:!format}0{/if}">
	<input type="hidden" name="r[is_encoding]" value="{if:encoding}1{/if}{if:!encoding}0{/if}">
	<input type="hidden" name="r[group_list]" value="{row:GROUPS_SELECT}{if:!first},{/if}{id}{/row}">
	<input type="hidden" name="r[cf_list]" value="{row:CUSTOM_FIELDS}{if:!first},{/if}{id}{/row}">
	<input type="hidden" name="r[owner_id]" value="{owner_id}">
	<input type="hidden" name="save" value="1">
	<input type="submit" value="{rs:ACTION_SUBSCRIBE}" class="submit">
</td>
</tr>
</form>
</table>

