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+<form action="%wakeup_link%&amp;action=create" method="post">
+<table>
+ <tr>
+ <td align="right"> %date_text%: </td>
+ <td><input type="text" name="Date" value="%date_value%"></td>
+ </tr>
+ <tr>
+ <td align="right"> %place_text% </td>
+ <td><input type="text" name="Ort" value=""></td>
+ </tr>
+ <tr>
+ <td align="right"> %comment_text% </td>
+ <td><textarea name="Bemerkung" rows="5" cols="40">
+%comment_value%</textarea></td>
+ </tr>
+</table>
+<input type="submit" name="submit" value="%submit_text%" />
+</form>