%!input_name_title!%: %!input_name_form!%  
  %!input_age_title!%: %!input_age_form!%
  %!input_city_title!%: %!input_city_form!%  
  %!input_mailaddress_title!%: %!input_mailaddress_form!%  
    %!input_ciphermail_check!% %!input_ciphermail_title!%  
  %!input_icq_title!% %!input_icq_form!%  
       
  %!input_homepage_title!%:  
  %!input_homepage_form!%  
     
  %!input_message_title!%:  
    %!input_message_form!% %!input_smileyhelp_title!%
%!input_captcha_code!%: