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<input type=checkbox name='date' value='$thisyear-$thismonth-$thisday'
+>

$VAR1 = bless( { '.parameters' => [ 'date', 'bsubmit', 'state' ], 'use
+_tempfile' => 1, '.charset' => 'ISO-8859-1', '.fieldnames' => {}, 'pa
+ram' => { 'bsubmit' => [ 'Next' ], 'date' => [ '2013-05-9', '2013-05-
+10', '2013-05-11' ], 'state' => [ 'add' ] }, 'escape' => 1 }, 'CGI' )
+;

if ( $q->param('bsubmit') eq 'Next' ) {
    my $template = HTML::Template->new( filename => 'reqinfo.html', as
+sociate => $q );
    print $template->output;       
}

<TMPL_IF DATE>
    <TMPL_LOOP DATE>
...
<TMPL_ELSE>
    <b>You Did Not Select Any Days!</b>
</TMPL_IF>