<html>
    <head>
        <link href="/themes/default/css/errors.css" type="text/css" rel="stylesheet"/>
        <style> p { text-align: center; } </style>
    </head>
    <body>
        
        <form id="error-report" method="post" class="better-form-styling">
            <input type="hidden" name="submitted" value="hbr-error-report" />
            <input type="hidden" name="guid" value="1A49D5E5-F488-DCC3-0587-A2474F62C902" />
            <p>We're sorry but there has been an error. Please say with what you were doing and submit the form below to send this to our report team.</p>
            <fieldset>
                <div class='field'>
                    <label>Name</label>
                    <input type="text" name="name" value="" class="input" />
                </div>
                <div class='field'>
                    <label>Contact Email</label>
                    <input type="text" name="email" value="" class="input" />
                </div>
                <div class='field'>
                    <label>Contact Number</label>
                    <input type="text" name="number" value="" class="input" />
                </div>
                <div class='field'>
                    <label>What were you doing that resulted in this error page?</label>
                    <textarea class="input" name="reason"></textarea>
                </div>
                <input type="submit" value="Send Error Report" />
            </fieldset>
        </form>
    </body>
</html>