{JAVASCRIPTCODE}
{TXT_TITLE}
{TXT_EMAIL_ADDRESS}
{TXT_LASTNAME}
{TXT_FIRSTNAME}
{TXT_STREET}
{TXT_ZIP}
{TXT_CITY}
{TXT_COUNTRY}
{TXT_PHONE}
{TXT_BIRTHDAY}
 
{TXT_ACTIVE}
{TXT_OPEN_ISSUE}
 
{TXT_NEWSLETTER_CATEGORYS} {CATEGORY_VALUES}
 
{TXT_CHOOSE_SEPERATOR}