<!-- BEGIN form -->
<form method="POST" action="{form_action}">
<div align="left">
<p>{lang_message}</p>
<p>{select_values}</p>
<p><input type="submit" name="submit" value="{lang_submit}">
<input type="submit" name="cancel" value="{lang_cancel}"></p>
</div>
</form>
<!-- END form -->
