<div id="Wizard" style="width:500px">
  <style>
    #Wizard label {
      width:20%;
      
    }
    #Wizard textarea.long, #Lightbox input {
      width:290px;
      color:#666;
    }
    textarea {
      height : 48px;
    }
  </style>
  <form onsubmit="return $ajax(this)" method="post" id="BugForm" action="http://www.oestesurf.com/articulos/~SendBugReport">
    <input type="hidden" name="exceptionId" style="display : none;" value="">
    </input>
    <a href="#" onclick="return $lightbox(true);" class="Close-Lightbox">
      <img src="http://www.oestesurf.com/images/close_navigation.gif" onmouseover="this.src = '/images/close_navigation_hover.gif';" onmouseout="this.src = '/images/close_navigation.gif';" />
    </a>
    <h1>
      <strong>
        <phrase name="Report a bug"> Report a bug</phrase>
      </strong>
    </h1>
    <div class="White-Container">
      <p class="Indent">Thanks for taking the time to report a bug. We really appreciate your feedback.</p>
      <p class="Indent">
        <strong>If you need help using Webjam, why not consult with users and experts:</strong>
      </p>
      <ul class="reportBug">
        <li class="reportBug">
          <a href="http://www.webjam.com/webjam/webjamtalkback/" name="Webjammers' forum">Webjammers Forum</a>
        </li>
        <li class="reportBug">
          <a href="http://help.webjam.com/webjam/hints" name="Tips page">Tips page</a>
        </li>
        <li class="reportBug">
          <a href="http://help.webjam.com/webjam/help/" name="FAQ">Frequently Asked Questions</a>
        </li>
      </ul>
      <div class="Ajax-Panel Form-Response" id="Customer-Service-Form-Response" style="display:none;">
      </div>
      <div class="Form-Field">
        <label for="fromName">
          <phrase name="Full name">Full Name</phrase>
        </label>
        <input type="text" id="fromName" name="fromName">
        </input>
        <span class="Required">*</span>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="URL">
          <phrase name="URL of inappropiate page">URL </phrase>
        </label>
        <input type="text" id="URL" name="URL" value="http://www.oestesurf.com/articulos">
        </input>
        <span class="Required">*</span>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="module">Module</label>
        <select id="module" name="module">
          <option value=""> --Choose module--</option>
          <option value="Activities">Activities</option>
          <option value="Adopt a webjam form">Adopt a webjam form</option>
          <option value="Amazon search">Amazon search</option>
          <option value="Blog">Blog</option>
          <option value="Bookmarks">Bookmarks</option>
          <option value="Bulletin">Bulletin</option>
          <option value="Copy this page">Copy this page</option>
          <option value="Engage your community">Engage your community</option>
          <option value="Feed">Feed</option>
          <option value="Flickr photos">Flickr photos</option>
          <option value="Forum">Forum / Message boards</option>
          <option value="Free HTML">Free HTML</option>
          <option value="Gmail">Gmail</option>
          <option value="Google calendar">Google calendar</option>
          <option value="Google map">Google map</option>
          <option value="Horoscope">Horoscope</option>
          <option value="Join webjam button">Join webjam button</option>
          <option value="MP3 Player">MP3 Player</option>
          <option value="My Friends">My Friends</option>
          <option value="My mood cloud">My mood cloud</option>
          <option value="My Profile">My Profile</option>
          <option value="My webjams">My webjams</option>
          <option value="Notepad">Notepad</option>
          <option value="Page navigation">Page navigation</option>
          <option value="Photos">Photos</option>
          <option value="Poll">Poll</option>
          <option value="POP3 Email">POP3 Email</option>
          <option value="Related webjams">Related webjams</option>
          <option value="Shopping search">Shopping search</option>
          <option value="Weather">Weather</option>
          <option value="Web Search">Web Search</option>
          <option value="Yahoo! Mail">Yahoo! Mail</option>
          <option value="Youtube videos">Youtube videos</option>
        </select>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="wantToDo">
          <phrase name="What did you want to do?">What did you want to do?</phrase>
        </label>
        <textarea id="wantToDo" name="wantToDo" class="long" onclick="if($('#wantToDo')[0].value == 'Please provide as much detail as you can') $('#wantToDo')[0].value ='';">Please provide as much detail as you can</textarea>
        <span class="Required">*</span>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="expectToSee">
          <phrase name="What did you expect to happen?">What did you expect to happen?</phrase>
        </label>
        <textarea id="expectToSee" name="expectToSee" class="long" onclick="if($('#expectToSee')[0].value == 'Please provide as much detail as you can') $('#expectToSee')[0].value='';">Please provide as much detail as you can</textarea>
        <span class="Required">*</span>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="actuallyHappened">
          <phrase name="What actually happened">What actually happened</phrase>
        </label>
        <textarea id="actuallyHappened" name="actuallyHappened" class="long" onclick="if($('#actuallyHappened')[0].value == 'Please provide as much detail as you can. Did you receive an error message? Copy and paste the text of the error') $('#actuallyHappened')[0].value='';">Please provide as much detail as you can. Did you receive an error message? Copy and paste the text of the error</textarea>
        <span class="Required">*</span>
        <br clear="left" />
      </div>
      <div class="Form-Field">
        <label for="fromEmail">
          <phrase name="Email address">Email address:</phrase>
        </label>
        <input type="text" id="fromEmail" name="fromEmail">
        </input>
        <span class="Required">*</span>
        <br clear="left" />
        <br />
      </div>
      <p class="Indent">
        <span class="Required LeftPosition"> * </span> Required field</p>
      <br clear="left" />
    </div>
    <div class="InputButtons SendNotification">
      <button type="submit" class="Green">Send</button>
      <button type="button" onclick="$lightbox(true);" class="InputButton">Cancel</button>
    </div>
  </form>
</div>