{if !$sent}	
		<div class="contact-page">	 
			<div class="contact">  		
				<div class="form-group row">
				    <div class="left">	
						<div class="col-md-4 col-sm-12 col-xs-12">
							<input type="text" id="ins_1" placeholder="Summary" name="ins_1" value="" class="form-control">
						</div>	
					</div>
					<div class="middle">	
						<div class="col-md-4 col-sm-12 col-xs-12">
							<input type="text" id="in_2" placeholder="Name" name="ins_2" value="" class="form-control">
						</div>	
					</div>	
					<div class="right">	
						<div class="col-md-4 col-sm-12 col-xs-12">
							<input type="email" id="ins_3" placeholder="Email" name="ins_3" value="" class="form-control">
						</div>
					</div>
		    	</div>				
				<div class="form-group row">
					<div class="col-md-12 col-sm-12 col-xs-12">
						<textarea rows="20" name="ins-4" id="" placeholder="Message" class="form-control" _simple='y' _toolbars='n'></textarea>
					</div>
				</div>
				<div class="form-group text-center">
					<div class="col-md-12 col-sm-12 col-xs-12">
						<input type="submit" class="submit btn btn-primary btn-sm" name="action0" value="Send" onclick="needToConfirm=false">
					</div>
				</div>
			</div>
		</div>			
{/if}


