<?php
if (!isset($lastname)) $lastname = NULL;
print "
<div class='form-row'>
	<label for='lastname' class='form-label'>".LABEL_LASTNAME." *</label>
	<div class='form-cols'>
		<div class='form-col form-medium'>
			<div class='form-controls'>
				<input type='text' class='field' id='lastname' name='lastname' value='".$lastname."'>
			</div><!-- /.form-controls -->
		</div><!-- /.form-col -->
	</div><!-- /.form-cols -->
</div><!-- /.form-row -->

<hr />";