<{t}>Basic contact information<{/t}>
<{t}>surname<{/t}>:
*
<{t}>name<{/t}>:
*
<{t}>phone<{/t}>:
*
<{t}>fax<{/t}>:
<{t}>country<{/t}>:
<{t}>Please select country<{/t}>
<{if $country neq ""}> <{foreach from=$country item=item}>
selected="selected"<{/if}>><{$item['country_name']}>
<{/foreach}> <{/if}>
*
<{t}>state<{/t}>:
*
<{t}>city<{/t}>:
*
<{t}>postalCode<{/t}>:
*
<{t}>address<{/t}>:
*
<{t}>submit<{/t}>