<div class="controls">
<input type="text" name="email" id="email" value="<?php
echo $this->item->email;
?>
" />
</div>
</div>
<div class="control-group">
<label for="usergroups_field" class="control-label"><?php
echo JText::_('COM_AKEEBASUBS_COUPON_FIELD_USERGROUPS');
?>
</label>
<div class="controls">
<?php
echo AkeebasubsHelperSelect::usergroups('usergroups[]', empty($this->item->usergroups) ? '-1' : explode(',', $this->item->usergroups), array('multiple' => 'multiple', 'size' => 3));
?>
</div>
</div>
<div class="control-group">
<label for="subscriptions_field" class="control-label"><?php
echo JText::_('COM_AKEEBASUBS_COUPON_FIELD_SUBSCRIPTIONS');
?>
</label>
<div class="controls">
<?php
echo AkeebasubsHelperSelect::levels('subscriptions[]', empty($this->item->subscriptions) ? '-1' : explode(',', $this->item->subscriptions), array('multiple' => 'multiple', 'size' => 3));
?>
</div>
</div>
