[% USE CGI %] [% elements = [ { label = 'Name:' name = 'name' } { label = 'Address 1:' name = 'address1' } { label = 'Address 2:' name = 'address2' } { label = 'City/State:' name = 'city' } { label = 'Country:' name = 'country' } { label = 'Zipcode:' name = 'zip' } ] %] [% BLOCK row %]