<table cellpadding="4" cellspacing="0" class="wdform_table1" style="border-top:0px solid black;"><tbody id="form_id_tempform_view1" class="wdform_tbody1" page_title="Untitled page" next_title="Next" next_type="button" next_class="wdform_page_button" next_checkable="false" previous_title="Previous" previous_type="button" previous_class="wdform_page_button" previous_checkable="false"><tr class="wdform_tr1"><td class="wdform_td1"><table class="wdform_table2"><tbody class="wdform_tbody2"><tr id="1" type="type_text"><td valign="middle" align="left" id="1_label_sectionform_id_temp" class=""><span id="1_element_labelform_id_temp" class="label">First Name:</span><span id="1_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="1_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="1_typeform_id_temp" id="1_typeform_id_temp"><input type="hidden" value="no" name="1_requiredform_id_temp" id="1_requiredform_id_temp"><input type="hidden" value="no" name="1_uniqueform_id_temp" id="1_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="1_elementform_id_temp" name="1_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;1_elementform_id_temp&quot;)" onblur="return_value(&quot;1_elementform_id_temp&quot;)" onchange="change_value(&quot;1_elementform_id_temp&quot;)"></td><td id="X_1" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;1&quot;)"></td><td id="left_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;1&quot;)"></td><td id="up_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;1&quot;)"></td><td id="down_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;1&quot;)"></td><td id="right_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;1&quot;)"></td><td id="edit_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;1&quot;)"></td><td id="dublicate_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;1&quot;)"></td><td id="page_up_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;1&quot;)"></td><td id="dublicate_1" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;1&quot;)"></td></tr><tr id="11" type="type_editor"><td id="11_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_11" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;11&quot;)"></td><td id="left_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;11&quot;)"></td><td id="up_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;11&quot;)"></td><td id="down_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;11&quot;)"></td><td id="right_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;11&quot;)"></td><td id="edit_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;11&quot;)"><span id="11_element_labelform_id_temp" style="display: none;">custom_11</span></td><td id="dublicate_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;11&quot;)"></td><td id="dublicate_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;11&quot;)"></td><td id="page_up_11" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;11&quot;)"></td></tr><tr id="2" type="type_text"><td valign="middle" align="left" id="2_label_sectionform_id_temp" class=""><span id="2_element_labelform_id_temp" class="label">Last Name:</span><span id="2_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="2_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="2_typeform_id_temp" id="2_typeform_id_temp"><input type="hidden" value="no" name="2_requiredform_id_temp" id="2_requiredform_id_temp"><input type="hidden" value="no" name="2_uniqueform_id_temp" id="2_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="2_elementform_id_temp" name="2_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;2_elementform_id_temp&quot;)" onblur="return_value(&quot;2_elementform_id_temp&quot;)" onchange="change_value(&quot;2_elementform_id_temp&quot;)"></td><td id="X_2" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;2&quot;)"></td><td id="left_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;2&quot;)"></td><td id="up_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;2&quot;)"></td><td id="down_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;2&quot;)"></td><td id="right_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;2&quot;)"></td><td id="edit_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;2&quot;)"></td><td id="dublicate_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;2&quot;)"></td><td id="page_up_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;2&quot;)"></td><td id="dublicate_2" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;2&quot;)"></td></tr><tr id="12" type="type_editor"><td id="12_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_12" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;12&quot;)"></td><td id="left_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;12&quot;)"></td><td id="up_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;12&quot;)"></td><td id="down_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;12&quot;)"></td><td id="right_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;12&quot;)"></td><td id="edit_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;12&quot;)"><span id="12_element_labelform_id_temp" style="display: none;">custom_12</span></td><td id="dublicate_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;12&quot;)"></td><td id="dublicate_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;12&quot;)"></td><td id="page_up_12" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;12&quot;)"></td></tr><tr id="3" type="type_submitter_mail"><td valign="middle" align="left" id="3_label_sectionform_id_temp" class=""><span id="3_element_labelform_id_temp" class="label">E-mail Address:</span><span id="3_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="3_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_submitter_mail" name="3_typeform_id_temp" id="3_typeform_id_temp"><input type="hidden" value="no" name="3_requiredform_id_temp" id="3_requiredform_id_temp"><input type="hidden" value="no" name="3_sendform_id_temp" id="3_sendform_id_temp"><input type="hidden" value="" name="3_uniqueform_id_temp" id="3_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="3_elementform_id_temp" name="3_elementform_id_temp" value="" title="" onfocus="delete_value('3_elementform_id_temp')" onblur="return_value('3_elementform_id_temp')" onchange="change_value('3_elementform_id_temp')"></td><td id="X_3" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;3&quot;)"></td><td id="left_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;3&quot;)"></td><td id="up_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;3&quot;)"></td><td id="down_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;3&quot;)"></td><td id="right_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;3&quot;)"></td><td id="edit_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;3&quot;)"></td><td id="dublicate_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;3&quot;)"></td><td id="page_up_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;3&quot;)"></td><td id="dublicate_3" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;3&quot;)"></td></tr><tr id="13" type="type_editor"><td id="13_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_13" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;13&quot;)"></td><td id="left_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;13&quot;)"></td><td id="up_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;13&quot;)"></td><td id="down_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;13&quot;)"></td><td id="right_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;13&quot;)"></td><td id="edit_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;13&quot;)"><span id="13_element_labelform_id_temp" style="display: none;">custom_13</span></td><td id="dublicate_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;13&quot;)"></td><td id="dublicate_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;13&quot;)"></td><td id="page_up_13" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;13&quot;)"></td></tr><tr id="4" type="type_text"><td valign="middle" align="left" id="4_label_sectionform_id_temp" class=""><span id="4_element_labelform_id_temp" class="label">Company / Restaurant Name:</span><span id="4_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="4_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="4_typeform_id_temp" id="4_typeform_id_temp"><input type="hidden" value="no" name="4_requiredform_id_temp" id="4_requiredform_id_temp"><input type="hidden" value="no" name="4_uniqueform_id_temp" id="4_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="4_elementform_id_temp" name="4_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;4_elementform_id_temp&quot;)" onblur="return_value(&quot;4_elementform_id_temp&quot;)" onchange="change_value(&quot;4_elementform_id_temp&quot;)"></td><td id="X_4" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;4&quot;)"></td><td id="left_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;4&quot;)"></td><td id="up_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;4&quot;)"></td><td id="down_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;4&quot;)"></td><td id="right_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;4&quot;)"></td><td id="edit_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;4&quot;)"></td><td id="dublicate_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;4&quot;)"></td><td id="page_up_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;4&quot;)"></td><td id="dublicate_4" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;4&quot;)"></td></tr><tr id="14" type="type_editor"><td id="14_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_14" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;14&quot;)"></td><td id="left_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;14&quot;)"></td><td id="up_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;14&quot;)"></td><td id="down_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;14&quot;)"></td><td id="right_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;14&quot;)"></td><td id="edit_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;14&quot;)"><span id="14_element_labelform_id_temp" style="display: none;">custom_14</span></td><td id="dublicate_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;14&quot;)"></td><td id="dublicate_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;14&quot;)"></td><td id="page_up_14" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;14&quot;)"></td></tr><tr id="5" type="type_text"><td valign="middle" align="left" id="5_label_sectionform_id_temp" class=""><span id="5_element_labelform_id_temp" class="label">Telephone:</span><span id="5_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="5_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="5_typeform_id_temp" id="5_typeform_id_temp"><input type="hidden" value="no" name="5_requiredform_id_temp" id="5_requiredform_id_temp"><input type="hidden" value="no" name="5_uniqueform_id_temp" id="5_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="5_elementform_id_temp" name="5_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;5_elementform_id_temp&quot;)" onblur="return_value(&quot;5_elementform_id_temp&quot;)" onchange="change_value(&quot;5_elementform_id_temp&quot;)"></td><td id="X_5" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;5&quot;)"></td><td id="left_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;5&quot;)"></td><td id="up_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;5&quot;)"></td><td id="down_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;5&quot;)"></td><td id="right_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;5&quot;)"></td><td id="edit_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;5&quot;)"></td><td id="dublicate_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;5&quot;)"></td><td id="page_up_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;5&quot;)"></td><td id="dublicate_5" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;5&quot;)"></td></tr><tr id="15" type="type_editor"><td id="15_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_15" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;15&quot;)"></td><td id="left_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;15&quot;)"></td><td id="up_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;15&quot;)"></td><td id="down_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;15&quot;)"></td><td id="right_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;15&quot;)"></td><td id="edit_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;15&quot;)"><span id="15_element_labelform_id_temp" style="display: none;">custom_15</span></td><td id="dublicate_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;15&quot;)"></td><td id="dublicate_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;15&quot;)"></td><td id="page_up_15" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;15&quot;)"></td></tr><tr id="6" type="type_text"><td valign="middle" align="left" id="6_label_sectionform_id_temp" class=""><span id="6_element_labelform_id_temp" class="label">Alternate Telephone:</span><span id="6_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="6_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="6_typeform_id_temp" id="6_typeform_id_temp"><input type="hidden" value="no" name="6_requiredform_id_temp" id="6_requiredform_id_temp"><input type="hidden" value="no" name="6_uniqueform_id_temp" id="6_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="6_elementform_id_temp" name="6_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;6_elementform_id_temp&quot;)" onblur="return_value(&quot;6_elementform_id_temp&quot;)" onchange="change_value(&quot;6_elementform_id_temp&quot;)"></td><td id="X_6" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;6&quot;)"></td><td id="left_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;6&quot;)"></td><td id="up_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;6&quot;)"></td><td id="down_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;6&quot;)"></td><td id="right_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;6&quot;)"></td><td id="edit_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;6&quot;)"></td><td id="dublicate_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;6&quot;)"></td><td id="page_up_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;6&quot;)"></td><td id="dublicate_6" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;6&quot;)"></td></tr><tr id="16" type="type_editor"><td id="16_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_16" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;16&quot;)"></td><td id="left_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;16&quot;)"></td><td id="up_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;16&quot;)"></td><td id="down_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;16&quot;)"></td><td id="right_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;16&quot;)"></td><td id="edit_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;16&quot;)"><span id="16_element_labelform_id_temp" style="display: none;">custom_16</span></td><td id="dublicate_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;16&quot;)"></td><td id="dublicate_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;16&quot;)"></td><td id="page_up_16" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;16&quot;)"></td></tr><tr id="7" type="type_textarea"><td valign="top" align="left" id="7_label_sectionform_id_temp" class=""><span id="7_element_labelform_id_temp" class="label">Requirements/ Comments:</span><span id="7_required_elementform_id_temp" class="required"></span></td><td valign="top" align="left" id="7_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_textarea" name="7_typeform_id_temp" id="7_typeform_id_temp"><input type="hidden" value="no" name="7_requiredform_id_temp" id="7_requiredform_id_temp"><input type="hidden" value="no" name="7_uniqueform_id_temp" id="7_uniqueform_id_temp"><textarea style="width: 200px; height: 100px;" class="input_deactive" id="7_elementform_id_temp" name="7_elementform_id_temp" title="" value="" onfocus="delete_value('7_elementform_id_temp')" onblur="return_value('7_elementform_id_temp')" onchange="change_value('7_elementform_id_temp')"></textarea></td><td id="X_7" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;7&quot;)"></td><td id="left_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;7&quot;)"></td><td id="up_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;7&quot;)"></td><td id="down_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;7&quot;)"></td><td id="right_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;7&quot;)"></td><td id="edit_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;7&quot;)"></td><td id="dublicate_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;7&quot;)"></td><td id="page_up_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;7&quot;)"></td><td id="dublicate_7" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;7&quot;)"></td></tr><tr id="17" type="type_editor"><td id="17_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_17" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;17&quot;)"></td><td id="left_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;17&quot;)"></td><td id="up_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;17&quot;)"></td><td id="down_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;17&quot;)"></td><td id="right_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;17&quot;)"></td><td id="edit_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;17&quot;)"><span id="17_element_labelform_id_temp" style="display: none;">custom_17</span></td><td id="dublicate_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;17&quot;)"></td><td id="dublicate_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;17&quot;)"></td><td id="page_up_17" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;17&quot;)"></td></tr><tr id="8" type="type_text"><td valign="middle" align="left" id="8_label_sectionform_id_temp" class=""><span id="8_element_labelform_id_temp" class="label">How Did You Hear About Us?</span><span id="8_required_elementform_id_temp" class="required"></span></td><td valign="middle" align="left" id="8_element_sectionform_id_temp" class=" toolbar_padding"><input type="hidden" value="type_text" name="8_typeform_id_temp" id="8_typeform_id_temp"><input type="hidden" value="no" name="8_requiredform_id_temp" id="8_requiredform_id_temp"><input type="hidden" value="no" name="8_uniqueform_id_temp" id="8_uniqueform_id_temp"><input type="text" style="width: 200px;" class="input_deactive" id="8_elementform_id_temp" name="8_elementform_id_temp" value="" title="" onfocus="delete_value(&quot;8_elementform_id_temp&quot;)" onblur="return_value(&quot;8_elementform_id_temp&quot;)" onchange="change_value(&quot;8_elementform_id_temp&quot;)"></td><td id="X_8" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;8&quot;)"></td><td id="left_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;8&quot;)"></td><td id="up_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;8&quot;)"></td><td id="down_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;8&quot;)"></td><td id="right_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;8&quot;)"></td><td id="edit_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;8&quot;)"></td><td id="dublicate_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;8&quot;)"></td><td id="page_up_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;8&quot;)"></td><td id="dublicate_8" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;8&quot;)"></td></tr><tr id="18" type="type_editor"><td id="18_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding"><br></td><td id="X_18" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;18&quot;)"></td><td id="left_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;18&quot;)"></td><td id="up_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;18&quot;)"></td><td id="down_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;18&quot;)"></td><td id="right_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;18&quot;)"></td><td id="edit_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;18&quot;)"><span id="18_element_labelform_id_temp" style="display: none;">custom_18</span></td><td id="dublicate_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;18&quot;)"></td><td id="dublicate_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;18&quot;)"></td><td id="page_up_18" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;18&quot;)"></td></tr><tr id="9" type="type_editor"><td id="9_element_sectionform_id_temp" align="left" valign="top" colspan="2" class="toolbar_padding">* Indicates required fields</td><td id="X_9" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;9&quot;)"></td><td id="left_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;9&quot;)"></td><td id="up_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;9&quot;)"></td><td id="down_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;9&quot;)"></td><td id="right_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;9&quot;)"></td><td id="edit_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;9&quot;)"><span id="9_element_labelform_id_temp" style="display: none;">custom_9</span></td><td id="dublicate_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;9&quot;)"></td><td id="dublicate_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;9&quot;)"></td><td id="page_up_9" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;9&quot;)"></td></tr><tr id="10" type="type_submit_reset"><td colspan="2" class="toolbar_padding" id="10_label_and_element_sectionform_id_temp"><table id="10_elemet_tableform_id_temp"><tbody><tr><td valign="middle" align="left" id="10_label_sectionform_id_temp" style="display: none;" class=""><span id="10_element_labelform_id_temp" style="display: none;">type_submit_reset_10</span></td><td valign="middle" align="left" id="10_element_sectionform_id_temp" class=""><input type="hidden" value="type_submit_reset" name="10_typeform_id_temp" id="10_typeform_id_temp"><button type="button" class="button_submit" id="10_element_submitform_id_temp" value="Submit" onclick="check_required('submit', 'form_id_temp');">Submit</button><button type="button" class="button_reset" id="10_element_resetform_id_temp" value="Reset" onclick="check_required('reset');">Reset</button></td></tr></tbody></table></td><td id="X_10" valign="middle" align="right" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/delete_el.png" height="17" title="Remove the field" style="cursor: pointer; margin: 2px;" onclick="remove_row(&quot;10&quot;)"></td><td id="left_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/left.png" title="Move the field to the left" style="margin: 2px; cursor: pointer;" onclick="left_row(&quot;10&quot;)"></td><td id="up_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/up.png" title="Move the field up" style="cursor: pointer;" onclick="up_row(&quot;10&quot;)"></td><td id="down_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/down.png" title="Move the field down" style="margin: 2px; cursor: pointer;" onclick="down_row(&quot;10&quot;)"></td><td id="right_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/right.png" title="Move the field to the right" style="cursor: pointer;" onclick="right_row(&quot;10&quot;)"></td><td id="edit_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/edit.png" title="Edit the field" style="margin: 2px; cursor: pointer;" onclick="edit(&quot;10&quot;)"></td><td id="dublicate_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/dublicate.png" title="Dublicate the field" style="margin: 2px; cursor: pointer;" onclick="dublicate(&quot;10&quot;)"></td><td id="page_up_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_up.png" title="Move the field to the upper page" style="margin: 2px; cursor: pointer;" onclick="page_up(&quot;10&quot;)"></td><td id="dublicate_10" valign="middle" class="element_toolbar"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_down.png" title="Move the field to the lower  page" style="margin: 2px; cursor: pointer;" onclick="page_down(&quot;10&quot;)"></td></tr></tbody></table></td></tr><tr class="wdform_footer"><td colspan="100" valign="top"><table width="100%" style="padding-right:170px"><tbody><tr id="form_id_temppage_nav1"></tr></tbody></table></td></tr></tbody><tbody id="form_id_tempform_view_img1" style="float:right !important ;"><tr><td width="0%"></td><td align="right"><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/minus.png" title="Show or hide the page" class="page_toolbar" onclick="show_or_hide('1')" id="show_page_img_1"></td><td><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_delete.png" title="Delete the page" class="page_toolbar" onclick="remove_page('1')"></td><td><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_delete_all.png" title="Delete the page with fields" class="page_toolbar" onclick="remove_page_all('1')"></td><td><img src="http://www.puertobarillas.com/welcome/wp-content/plugins/contact-form-maker/images/page_edit.png" title="Edit the page" class="page_toolbar" onclick="edit_page_break('1')"></td></tr></tbody></table>