<form action="{$this->ipsclass->base_url}" method="post">
<input type="hidden" name="act" value="Reg" />
<input type="hidden" name="CODE" value="11" />
<div class="borderwrap">
	<div class="maintitle">{$this->ipsclass->lang['lost_pass_form']}</div>
	<div class="subtitle">{$this->ipsclass->lang['lp_header']}</div>
	<div class="tablepad"><span>
<if="$this->ipsclass->vars['ipbli_usertype'] == 'username'">
{$this->ipsclass->lang['lp_text']}
<else />
{$this->ipsclass->lang['lp_text_email']}
</if>
	</span></div>
	<div class="subtitle">{$this->ipsclass->lang['complete_form']}</div>
	<table class='ipbtable' cellspacing="0">
		<tr>
			<td class="row1" width='30%'>
			<if="$this->ipsclass->vars['ipbli_usertype'] == 'username'">
				<strong>{$this->ipsclass->lang['lp_user_name']}</strong>
			<else />
				<strong>{$this->ipsclass->lang['lp_email_address']}</strong>
			</if>
			</td>
			<td class="row2"><input type="text" size="32" name="member_name" /></td>
		</tr>
<if="$this->ipsclass->vars['ipbli_usertype'] == 'username'">
		<tr>
			<td class="row1">
				<strong>{$this->ipsclass->lang['lp_email_or']}</strong>
			</td>
			<td class="row2"><input type="text" size="32" name="email_addy" /></td>
		</tr>
</if>
	</table>
	<div class='row2'>
	<!--{REG.ANTISPAM}-->
	</div>
</div>
<br />
<div class="borderwrap">
	<div class="formbuttonrow" align="center"><input class='button' type="submit" value="{$this->ipsclass->lang['lp_send']}" /></div>
</div>
</form>