<!-- IF CAPTCHA_HTML -->
<script type="text/javascript">
ajax.callback.user_register = function(data){
	$('#'+ data.mode).html(data.html);
};
</script>
<!-- ENDIF -->

<form action="{S_PROFILE_ACTION}" method="post">
{S_HIDDEN_FIELDS}

<div class="box box-primary">
	<div class="box-header with-border">
		<h3 class="box-title">{L_FORGOTTEN_PASSWORD}<small> {L_ITEMS_REQUIRED}</small></h3>
	</div>
	<div class="box-body no-padding">
	<table class="table">
	<tbody>
	<tr>
		<td><div class="input-group"><span class="input-group-addon">{L_EMAIL_ADDRESS}: *</span><input type="text" class="form-control" name="email" placeholder="{L_EMAIL_ADDRESS} ..." /></div></td>
	</tr>
	<!-- IF CAPTCHA_HTML -->
	<tr>
		<td>{L_CAPTCHA}: *</td>
		<td>{CAPTCHA_HTML}</td>
	</tr>
<!-- ENDIF -->
</tbody>
</table>
	</div>
	<div class="box-footer text-center">
		<input type="submit" name="submit" class="btn btn-primary btn-sm" value="{L_SUBMIT}" />
		<input type="reset" name="reset" class="btn btn-default btn-sm" value="{L_RESET}" />
	</div>
</div>

</form>