<h3 align="center"><?php echo $heading ; ?></h3>

<div align="center" style="width:100%;">

<div class="err_msg" >
<?php 
echo validation_errors(); 
echo $str; 
?>
</div>

<div style="width:470px; height:auto; text-align:left;">


<form name="form1" method="post" action="">

<p>
<label>Area *</label><br />
<input name="area" class="input" size="20" maxlength="20" type="text" value="<?=$area?>" />
</p>

<p>
<label>Shipping Charge *</label><br />
<input name="cost" class="input" size="20" maxlength="20" type="text" value="<?=$cost?>" />
</p>


<p>
<input name="submit" class="button-primary" value="Submit" type="submit" />
</p>

</form>

</div>

</div>

<p>&nbsp;</p>
