<br />
<div id="content">
<form
action="" method="POST">
<table
width="519">
<tr>
<td
class="c"
colspan="2">{al_your_request_title}</td>
</tr>
<tr>
<th
colspan="2">{request_text}</th>
</tr>
<tr>
<th colspan="2"><input
type="submit" name="bcancel"
value="{button_text}"></th>
</tr>
</table>
</form>
</div>