?>
<input type="hidden" id="countryId" name="countryId" value="<?php
echo osc_esc_html($aCountries[0]['pk_c_code']);
?>
"/>
<div class="control-group">
<label class="control-label" for="region"><?php
_e('Region', 'bender');
?>
</label>
<div class="controls">
<?php
if (bender_default_location_show_as() == 'dropdown') {
ItemForm::region_select($aRegions, osc_user());
} else {
ItemForm::region_text(osc_user());
}
?>
</div>
</div>
<?php
}
?>
<div class="control-group">
<label class="control-label" for="city"><?php
_e('City', 'bender');
?>
</label>
<div class="controls">
<?php
?>
</label>
<div class="input">
<?php
ItemForm::country_text();
?>
</div>
</div>
<div class="input-line">
<label><?php
_e('Region');
?>
</label>
<div class="input">
<?php
ItemForm::region_text();
?>
</div>
</div>
<div class="input-line">
<label><?php
_e('City');
?>
</label>
<div class="input">
<?php
ItemForm::city_text();
?>
</div>
</div>
<div class="input-line">
