%h1
  Expression of Interest
%p
  Registration for this Conference is not yet open. However, if you are interested
  in attending the FOSS4G 2009 Conference and would like to receive further information,
  please register your interest below.
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  %div
    %label{ :for => "name" }
    Title:
    %br
    %select{ :name => "cm-fo-184922" }
      %option{ :value => "50495" }
        \ 
      %option{ :value => "48793" }
        Mr
      %option{ :value => "48794" }
        Mrs
      %option{ :value => "48795" }
        Miss
      %option{ :value => "48796" }
        Dr
      %option{ :value => "48797" }
        Prof
      %option{ :value => "48798" }
        A/Prof
    %br
    %br
    %label{ :for => "name" }
      Full Name:
    %br
    %input#name{ :name => "name", :size => "20", :type => "text" }
    %br
    %br
    %label{ :for => "Email" }
      Email Address*:
    %br
    %input#Email{ :name => "cm-394102-394102", :type => "text" }
    %br
    %br
    %label{ :for => "Address" }
    Address:
    %br
    %input#Address{ :name => "cm-f-184923", :type => "text" }
    %br
    %br
    %label{ :for => "Organisation" }
    Organisation:
    %br
    %input#Organisation{ :name => "cm-f-184925", :type => "text" }
    %br
    %br
    %label{ :for => "Country" }
    Country*:
    %br
    %input#Country{ :name => "cm-f-184926", :type => "text" }
    %br
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    Options:
    %br
    %input#cm48799{ :name => "cm-fo-184927", :checked => "true", :type => "checkbox", :value => "48799" }
    %label{ :for => "cm48799" }
      Interested in receiving further information on the Conference, plus electronic newsletters
    %br
    %input#cm48800{ :name => "cm-fo-184927", :checked => "true", :type => "checkbox", :value => "48800" }
    %label{ :for => "cm48800" }
      Potential Sponsor
    %br
    %br
    %input{ :type => "submit", :value => "Subscribe", :onclick => "MM_validateForm('','','R','Country','','R');return document.MM_returnValue" }
    %br
    %br
    %em
      *Required Fields