<div class="form-block menu-permissions-change">

	<div class="block-header">
		<div class="block-name"><?php echo $data['PAGE']; ?></div>
	</div>

	<div class="block-line"></div>

	<form class="form-horizontal" method="post">

		<div class="control-group">
			<label class="control-label" for="inputTitle"><?php echo $this->lng_m['perm_field_name']; ?></label>
			<div class="controls">
				<input type="text" class="span10" name="title" value="<?php echo $data['TITLE']; ?>" id="inputTitle" placeholder="<?php echo $this->lng_m['perm_field_name']; ?>" required>
			</div>
		</div>

		<div class="control-group">
			<label class="control-label" for="textareaText"><?php echo $this->lng_m['perm_field_desc']; ?></label>
			<div class="controls">
				<textarea name="text" class="span10" placeholder="<?php echo $this->lng_m['perm_field_desc']; ?>" rows="8" maxlength="255" id="textareaText"><?php echo $data['TEXT']; ?></textarea>
			</div>
		</div>

		<div class="control-group">
			<label class="control-label" for="inputPerm"><?php echo $this->lng_m['perm_field_value']; ?></label>
			<div class="controls">
				<input type="text" class="span10" name="value" value="<?php echo $data['VALUE']; ?>" id="inputPerm" placeholder="<?php echo $this->lng_m['perm_field_value']; ?>">
			</div>
		</div>

		<div class="control-group">
			<label class="control-label" for="inputPerm"><?php echo $this->lng_m['perm_field_type']; ?></label>
			<div class="controls">
				<select name="type" class="span10" id="perm-type">
					<?php echo $data['TYPES']; ?>
				</select>
			</div>
		</div>

		<div class="control-group">
			<label class="control-label" for="inputDefault"><?php echo $this->lng_m['perm_field_default']; ?></label>
			<div class="controls" id="perm-default">
				<?php echo $data['DEFAULT']; ?>
			</div>
		</div>

		<div class="control-group">
			<div class="controls">
				<button type="submit" class="btn" name="submit"><?php echo $data['BUTTON']; ?></button>
			</div>
		</div>
	</form>
		
</div>