<?php
  $model = & JModel::getInstance('Model','Jomsocial');
  $options =  array();
  $options = $model->getFieldsOption();
?>

 <table>
                              <tr>
                               <td>
                                 <?php echo JText::_( 'DT_JOMSOCIAL_INSTRUCTIONS' ); ?>:
                               </td>
                              </tr>
                            </table>
                            <table>
                              
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_ORGANIZATION') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_org","","value","text",$map_joms_org);
								                 ?>
                                 </td><td></td>
                              </tr>
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_TITLE') ?>:</strong></td><td>
                                  <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_title","","value","text",$map_joms_title);
								 ?>
                                  </td><td></td>
                              </tr>
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_ADDRESS') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_address","","value","text",$map_joms_address);
								 ?>
                                 </td><td></td>
                              </tr>
                              
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_ADDRESS2') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_address2","","value","text",$map_joms_address2);
								 ?>
                                 </td><td></td>
                              </tr>
                              <tr>
                                 <td><strong><?php echo JText::_( 'DT_CITY') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_city","","value","text",$map_joms_city);
								 ?>
                                 </td><td></td>
                              </tr>
                              <tr>
                                 <td><strong><?php echo JText::_( 'DT_STATE') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_state","","value","text",$map_joms_state);
								 ?>
                                 </td><td></td>
                              </tr>
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_ZIPCODE') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_zip","","value","text",$map_joms_zip);
								 ?>
                                 </td><td></td>
                              </tr>
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_COUNTRY') ?>:</strong></td><td>
                                 <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_country","","value","text",$map_joms_country);
								 ?>
                                 </td><td></td>
                              </tr>
                               <tr>
                                 <td><strong><?php echo JText::_( 'DT_PHONE') ?>:</strong></td><td>
                                  <?php
                                 
                                  echo JHTML::_('select.genericlist', $options,"map_joms_phone","","value","text",$map_joms_phone);
								 ?>
                                 </td><td></td>
                              </tr>
                            </table>