		<td width="200" class="FieldLabel">
			%%GLOBAL_Required%% 
			%%GLOBAL_FieldName%%:&nbsp;
		</td>
		<td>
			<input type="text" id="CustomFields[%%GLOBAL_FieldID%%]" name="CustomFields[%%GLOBAL_FieldID%%]" value="%%GLOBAL_DefaultValue%%" class="Field250">
		</td>