--- /dev/null
+{app_header}
+
+<center>
+ <form action="{actionurl}" method="POST">
+ <input type=hidden name=interviewer value={interviewer}>
+ <input type=hidden name=elder value={elder}>
+ <input type=hidden name=aaronic value={aaronic}>
+ <input type=hidden name=companionship value={companionship}>
+ <input type=hidden name=eqpresppi value={eqpresppi}>
+ <table border="0" width="60%" cellspacing="2" cellpadding="2">
+ <tr>
+ <td align="center" bgcolor="#c9c9c9"><font face="{font}"><b>{lang_action}: {name}</b></font></td>
+ </tr>
+ <tr>
+ <td align="left"><font face="{font}"><b>Name:</b>
+ <input type=text size="30" name="name" value="{name}" READONLY></td>
+ </tr>
+ <tr>
+ <td align="left"><font face="{font}"><b>Interviewer:</b>
+ <select name="interviewer" disabled>
+<!-- BEGIN interviewer_list -->
+ <option value={interviewer}>{interviewer_name}</option>
+<!-- END interviewer_list -->
+ </select>
+ </tr>
+ <tr>
+ <td align="left"><font face="{font}"><b>Date:</b>
+ {cal_date}
+ </td>
+ </tr>
+ <tr>
+ <td align="left"><font face="{font}"><b>Notes:</b></font></td>
+ </tr>
+ <tr>
+ <td align="left"><font face="{font}" size="{font_size}">
+ <textarea cols="60" rows="10" name="notes" wrap="virtual" {readonly}>{notes}</textarea></font></td>
+ </tr>
+ </table>
+
+<!-- BEGIN add -->
+ <table width="70%" border="0" cellspacing="2" cellpadding="2" align=left>
+ <tr valign="bottom">
+ <td height="50" align="right">
+ <font face="{font}"><input type="submit" name="addnote" value="{lang_save}"></font></td>
+ <td height="50" align="center">
+ <font face="{font}"><input type="reset" name="reset" value="{lang_reset}"></font></form></td>
+ <td height="50" align="center">
+ <form action="{done_action}" method="POST">
+ <font face="{font}"><input type="submit" name="done" value="{lang_done}"></font></form></td>
+ </tr>
+ </table>
+</center>
+<!-- END add -->
+
+<!-- BEGIN edit -->
+ <table width="50%" border="0" cellspacing="2" cellpadding="2" align=left>
+ <tr valign="bottom" align="left">
+ <td height="50" align="right" valign="middle">
+ <font face="{font}"><input type="submit" name="editnote" value="{lang_save}"></font>
+ </form></td>
+ <td height="50" align="center" valign="middle">
+ <form action="{done_action}" method="POST">
+ <font face="{font}"><input type="submit" name="done" value="{lang_done}"></font></form></td>
+ </tr>
+ </table>
+</center>
+
+<!-- END edit -->
+
+<!-- END form -->
+
+