<?php 
                        if ($this->_tpl_vars['groupId'] && $this->_tpl_vars['cvID'] && $this->_tpl_vars['editCustomData']) {
                            ?>
                <div class="crm-submit-buttons">
                  <a href="#" class="crm-hover-button crm-custom-value-del"
                     data-post='{"valueID": "<?php 
                            echo $this->_tpl_vars['cvID'];
                            ?>
", "groupID": "<?php 
                            echo $this->_tpl_vars['customGroupId'];
                            ?>
", "contactId": "<?php 
                            echo $this->_tpl_vars['contactId'];
                            ?>
", "key": "<?php 
                            echo smarty_function_crmKey(array('name' => 'civicrm/ajax/customvalue'), $this);
                            ?>
"}'
                     title="<?php 
                            $this->_tag_stack[] = array('ts', array('1' => is_array($_tmp = $this->_tpl_vars['cd_edit']['title']) ? $this->_run_mod_handler('cat', true, $_tmp, " " . $this->_tpl_vars['rowCount']) : smarty_modifier_cat($_tmp, " " . $this->_tpl_vars['rowCount'])));
                            $_block_repeat = true;
                            smarty_block_ts($this->_tag_stack[count($this->_tag_stack) - 1][1], null, $this, $_block_repeat);
                            while ($_block_repeat) {
                                ob_start();
                                ?>
Delete %1<?php 
                                $_block_content = ob_get_contents();
                                ob_end_clean();
                                $_block_repeat = false;
                                echo smarty_block_ts($this->_tag_stack[count($this->_tag_stack) - 1][1], $_block_content, $this, $_block_repeat);
                            }
        <input type="text" name="last_name" id="qa_last_name" class="form-text required" maxlength="64" />
    </div>
</div>

<div class="form-item">
    <div>
        <label for="qa_email"><?php $this->_tag_stack[] = array('ts', array()); $_block_repeat=true;smarty_block_ts($this->_tag_stack[count($this->_tag_stack)-1][1], null, $this, $_block_repeat);while ($_block_repeat) { ob_start(); ?>Email:<?php $_block_content = ob_get_contents(); ob_end_clean(); $_block_repeat=false;echo smarty_block_ts($this->_tag_stack[count($this->_tag_stack)-1][1], $_block_content, $this, $_block_repeat); }  array_pop($this->_tag_stack); ?></label>
    </div>
    <div>
        <input type="email" name="email[1][email]" id="qa_email" class="form-text" maxlength="64" />
    </div>

    <input type="hidden" name="email[1][location_type_id]" value="<?php echo $this->_tpl_vars['primaryLocationType']; ?>
" />
    <input type="hidden" name="email[1][is_primary]" value="1" />
    <input type="hidden" name="ct" value="Individual" />
    <input type="hidden" name="email_greeting_id" value="<?php echo $this->_tpl_vars['email_greeting_id']; ?>
" />
    <input type="hidden" name="postal_greeting_id" value="<?php echo $this->_tpl_vars['postal_greeting_id']; ?>
" />
    <input type="hidden" name="addressee_id" value="<?php echo $this->_tpl_vars['addressee_id']; ?>
" />
    <input type="hidden" name="qfKey" value="<?php echo smarty_function_crmKey(array('name' => 'CRM_Contact_Form_Contact','addSequence' => 1), $this);?>
" />
</div>

<div class="form-item"><input type="submit" name="_qf_Contact_next" value="<?php $this->_tag_stack[] = array('ts', array()); $_block_repeat=true;smarty_block_ts($this->_tag_stack[count($this->_tag_stack)-1][1], null, $this, $_block_repeat);while ($_block_repeat) { ob_start(); ?>Save<?php $_block_content = ob_get_contents(); ob_end_clean(); $_block_repeat=false;echo smarty_block_ts($this->_tag_stack[count($this->_tag_stack)-1][1], $_block_content, $this, $_block_repeat); }  array_pop($this->_tag_stack); ?>" class="crm-form-submit" /></div>

</form>
</div>
<?php $_block_content = ob_get_contents(); ob_end_clean(); $_block_repeat=false;echo smarty_block_crmScope($this->_tag_stack[count($this->_tag_stack)-1][1], $_block_content, $this, $_block_repeat); }  array_pop($this->_tag_stack); ?>
    <input type="hidden" name="email[1][is_primary]" value="1" />
    <input type="hidden" name="ct" value="Individual" />
    <input type="hidden" name="email_greeting_id" value="<?php 
    echo $this->_tpl_vars['email_greeting_id'];
    ?>
" />
    <input type="hidden" name="postal_greeting_id" value="<?php 
    echo $this->_tpl_vars['postal_greeting_id'];
    ?>
" />
    <input type="hidden" name="addressee_id" value="<?php 
    echo $this->_tpl_vars['addressee_id'];
    ?>
" />
    <input type="hidden" name="qfKey" value="<?php 
    echo smarty_function_crmKey(array('name' => 'CRM_Contact_Form_Contact', 'addSequence' => 1), $this);
    ?>
" />
</div>

<div class="form-item"><input type="submit" name="_qf_Contact_next" value="<?php 
    $this->_tag_stack[] = array('ts', array());
    $_block_repeat = true;
    smarty_block_ts($this->_tag_stack[count($this->_tag_stack) - 1][1], null, $this, $_block_repeat);
    while ($_block_repeat) {
        ob_start();
        ?>
Save<?php 
        $_block_content = ob_get_contents();
        ob_end_clean();
        $_block_repeat = false;