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Rev 11966 Rev 12859
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							<div id="msgComponent" class="textbox-image contact-form-component return-product cancel-order delivery-problem payment-status order-status product-request other recharge-related">
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							<div id="msgComponent" class="textbox-image contact-form-component return-product cancel-order delivery-problem payment-status order-status product-request other recharge-related">
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								<label for="txtaMsg">Message</label>
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								<label for="txtaMsg">Message</label>
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								<textarea id="mailBody" name="message"></textarea>
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								<textarea id="mailBody" name="message"></textarea>
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                            </div>
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                            </div>
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							<div class="clearBoth"></div><br />
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							<div class="clearBoth"></div><br />
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                            <div class="center-text-bold12" style="text-align:left; margin-left: 120px;">Please enter the characters shown below:</div>
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							<div id="captcha-div" style="margin-top: 20px; margin-bottom: 20px; margin-left: 120px;">
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                                <img src="/captcha" id="captchaImage"><br><br>
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                                <input type="text" id="captcha_response_box" class="captcha_text_blur" name="captcha_response_field" autocomplete="off">
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                                <br>
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                                <span style="font-size:12px">Cannot read the image? <a id="captchaanchor" style="cursor: pointer;">Click here</a>.</span>
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                            </div>
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							<div class="yellow-image contact-form-button">
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							<div class="yellow-image contact-form-button">
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								<input type="submit" class="button" name="submit" id="submit" value="Submit" disabled />
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								<input type="submit" class="button" name="submit" id="submit" value="Submit" disabled />
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							</div>
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							</div>
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							<div class="yellow-image contact-form-button">
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							<div class="yellow-image contact-form-button" style="margin-left: 30px;">
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								<input type="button" class="button" id="resetFormButton" value="Reset" disabled />
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								<input type="button" class="button" id="resetFormButton" value="Reset" disabled />
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							</div>	
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							</div>	
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							<div class="clearBoth"></div>
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							<div class="clearBoth"></div>
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							<div id="bulk-order-alert">
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							<div id="bulk-order-alert">
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							<p>
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							<p>
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								If you are interested in placing bulk orders or enquiring about corporate gifting, just leave your details in the form & our executive will get back to you soon.
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								If you are interested in placing bulk orders or enquiring about corporate gifting, just leave your details in the form & our executive will get back to you soon
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								or alternately, You can contact us at <a href="mailto:bulkdeals@${domain.name}">bulkdeals@${domain.name}</a>
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								or alternately, you can contact us at <a href="mailto:bulkdeals@${domain.name}">bulkdeals@${domain.name}</a>
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							</p>
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							</p>
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						</div>
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						</div>
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						</form>
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						</form>
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                        </div>
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                        </div>
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						<div id="postalAddress">
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						<div id="postalAddress">