[[+partition:is=`create`:then=`
<div class="container">
  <form data-id="user_referral" data-style="default" novalidate>
    <div class="input" data-type="text">
      <label for="user_referral:fullname">[[%your_friends_name? &namespace=xtra &topic=default]]</label>
      <div class="input-inner">
        <input type="text" id="user_referral:fullname" />
      </div>
    </div>
    <div class="input" data-type="text">
      <label for="user_referral:email">[[%your_friends_email? &namespace=xtra &topic=default]]</label>
      <div class="input-inner">
        <input type="text" id="user_referral:email" />
      </div>
    </div>
    <div class="input" data-type="select">
      <span class="flabel">[[%division? &namespace=xtra &topic=default]]</span>
      <div class="input-inner">
        <label for="user_referral:division">
          <select id="user_referral:division">
            <option value="">[[%please_select? &namespace=xtra &topic=default]]</option>
            [[+division.options]]
          </select>
        </label>
      </div>
    </div>
    <div class="input" data-type="textarea">
      <label for="user_referral:message">[[%message? &namespace=xtra &topic=default]]</label>
      <div class="input-inner">
        <textarea id="user_referral:message"></textarea>
      </div>
    </div>
  </form>
</div>
`]]