{load_language_text section="contact_us"} {load_language_text section="buttons" name="button"} {block name="callback_service"} {if $CONTENT_TEXT} {block name="callback_service_content"}

{$CONTENT_TEXT}

{/block} {/if} {block name="callback_service_form"} {block name="callback_service_alert_danger"} {include file="get_usermod:{$tpl_path}alert_message.html" message=$error type="danger" hidden=true} {/block} {block name="callback_service_alert_success"} {include file="get_usermod:{$tpl_path}alert_message.html" message=$error type="success" hidden=true} {/block} {block name="callback_service_fieldset"}
{block name="callback_service_mandatory"}

{$txt.text_required}

{/block} {block name="callback_service_name"}
{block name="callback_service_name_label"} {$NAME} {/block} {block name="callback_service_name_container"}
{block name="callback_service_name_input"} {/block}
{/block}
{/block} {block name="callback_service_email"}
{block name="callback_service_email_label"} {$EMAIL} {/block} {block name="callback_service_email_container"}
{block name="callback_service_email_input"} {/block}
{/block}
{/block} {block name="callback_service_telephone"}
{block name="callback_service_telephone_label"} {$TELEPHONE} {/block} {block name="callback_service_telephone_container"}
{block name="callback_service_telephone_input"} {/block}
{/block}
{/block} {block name="callback_service_time"}
{block name="callback_service_time_label"} {$TIME} {/block} {block name="callback_service_time_container"}
{block name="callback_service_time_input"} {/block}
{/block}
{/block} {block name="callback_service_message"}
{block name="callback_service_message_label"} {$MESSAGE} {/block} {block name="callback_service_message_container"}
{block name="callback_service_message_input"} {$INPUT_TEXT_VALUE} {/block}
{/block}
{/block} {if $VALIDATION_ACTIVE == 'true'} {block name="callback_service_captcha"}
{block name="callback_service_captcha_label"} {$VALIDATION} {/block} {block name="callback_service_captcha_container"}
{block name="callback_service_captcha_input"} {$GM_CAPTCHA} {/block}
{/block}
{/block} {/if}
{/block} {if $GM_PRIVACY_LINK != '0'} {block name="callback_service_privacy"}
{if $show_privacy_checkbox} {block name="callback_service_privacy_checkbox"} {$GM_PRIVACY_LINK} {/block} {else} {block name="callback_service_privacy_link"} {$GM_PRIVACY_LINK} {/block} {/if}
{/block} {/if} {block name="callback_service_buttons"}
{block name="callback_service_buttons_back"} {$button.back} {/block}
{* ADD FAKE INPUT FIELD FOR ANTI SPAM BOT MECHANISM *} {block name="callback_service_buttons_submit"}
{/block}
{/block} {/block} {/block}