<th align="right" nowrap>[% 'Notes' | $T8 %]</th>
<td colspan="3"><input name="notes" size="40"></td>
</tr>
+ <tr>
+ <th align="right" nowrap>[% 'Country' | $T8 %]</th>
+ <td colspan="3"><input name="country" size="40"></td>
+ </tr>
<tr><td colspan="2"><hr size="3" noshade></td></tr>