    <form action="" method="post" id="<?php echo $formid = "validateform";?>" class="testiform">
   <?php ?> 
        <div id="col1" class="testicols"  > 
			<?php 
			echo  formInput(array('postname' => 'firstName', 'fbfield' => 'first_name', 'label' => 'First Name*', 'tabindex'=>'1','classes'=>'text required left'   )   );
			echo  formInput(array('postname' => 'lastName', 'fbfield' => 'last_name',  'label' => 'Last Name', 	'tabindex'=>'2','classes'=>'right'    )   ) ;
			echo  formInput(array('postname' => 'city',      'fbfield' => 'city',  		'label' => 'City', 		'tabindex'=>'3','classes'=>'left'    )   );
			echo  formInput(array('postname' => 'state',    'fbfield' => 'state',  		'label' => 'State', 	'tabindex'=>'4','classes'=>'right'    )   ) ;?>
			<?php /*?> <div class="contactcolclear"></div> <?php */?>     
            <?php echo  formInput(array('postname' => 'email_address', 'fbfield' => 'email',  'label' => 'Your Email*', 'tabindex'=>'5','classes'=>'text email required left'    )   ); ?>
			<?php 
				//if($fb_user_id){ 
				//$permbox = '<input name="permissiondis" type="checkbox" class="honey"   disabled checked="checked"  tabindex="6"  />
				//<input name="permission" type="hidden" class="text"   value="on"   />';
				//}else{
				$check = post_val('permission') ? ' checked="checked"' : ' checked="checked"' ;
				echo  '<input name="permission" type="checkbox" class="text honey" '.$check.' tabindex="6"  />';
				//}
            ?>
       </div>   <!-- /id="col1" class="testicols"  -->
    
    <div id="col2" class="testicols" >
                <div class="row clearfix" id="testicommentdiv">
                <?php
                      $placeholder = getThemeOption('testiformcommentboxplaceholder');
                      echo  formTextarea(array('postname' => 'usertestimonial', 'rows'=>'10','cols'=>'78',  'label' => $placeholder, 'tabindex'=>'7', 'classes'=>'required'    )   ) ;?>
                        
                     <?php if (function_exists('kk_addRating')){
                        echo div('class="testirating"');
                            $class = 'styled';
                            $options[] = array('value'=>'1', 'label'=>'', 'class'=>$class);
                            $options[] = array('value'=>'2', 'label'=>'', 'class'=>$class);
                            $options[] = array('value'=>'3', 'label'=>'', 'class'=>$class);
                            $options[] = array('value'=>'4', 'label'=>'', 'class'=>$class);
                            $options[] = array('value'=>'5', 'label'=>'', 'class'=>$class, 'checked'=>true);
                            echo radiogroup(array('desc' => 'Rate our Service', 'group' => 'stars', 'options'=>$options));
                        echo div(0);
                    }// if kk_addRating
					?>

                </div><!-- / row --> 
                 <div class="row clearfix">
                
                     <div id="testicheckboxes" class="clearfix">
                        <div class="testicheckboxesCol ">
                            <div class="testicheckbox">
                                 <input name="permission" type="checkbox" class="text"   <?= post_val('newsletter') ? ' checked="checked"' : ' checked="checked"' ?>    />
                            </div>
                            <div class="testicheckboxTextDiv">
                                 <div class="intro"><?=getThemeOption('testimonialpermissionsentance')?></div>
                            </div>
                        </div>
                        <input name="newsletter" type="hidden"  value="on" />
                        <?php /*?><div class="testicheckboxesCol last ">
                            <div class="testicheckbox">
                                 <input name="newsletter" type="checkbox" class="text"  <?= post_val('newsletter') ? ' checked="checked"' : ' checked="checked"' ?> tabindex="6"  />
                                 
                            </div>
                            <div class="testicheckboxTextDiv">
                                 <div class="intro"><?=getThemeOption('iwantnewsletter')?></div>
                            </div>
                        </div><?php */?>
                    </div><!-- /checkboxes -->
                    
                  <div id="testisub"  >
                  	<?php  //<input type="submit"  name="e-button"   value="Submit"   />
                    $button = urltoglobal.'form/orange-done-button.png'; ?>
                  	<input type="image" src="<?=$button?>"  name="was_e-button"   value="Submit"   />
                  	<input type="hidden"    name="e-button"   value="Submit"   />
                  </div>
					<?php echo addautocomplete(array('list'=>getquotedstates(),'id'=>'#state'));//'"asdf","bog","dfgh"'?>
                  </div> <!-- /  class="row --> 



    </div>
    
    <?php 
    $args = array('frompage' => 'testimonial','maillist_list_id' => 'testimonial','bindprocessor' => 'testimonialaction');
    echo formHidden($args);
    echo validateForm($formid);
?>