<label class="radio-inline">
      <input type="radio" name="radio" value="le_activated">'.$_language->module['left_is_activated'].'
    </label>
    <label class="radio-inline">
      <input type="radio" name="radio" value="re_activated">'.$_language->module['right_is_activated'].'
    </label>
    <label class="radio-inline">
      <input type="radio" name="radio" value="activated">'.$_language->module['activated'].'
    </label>

<select name="le_activated">
<option value="deact">Deactivated</Option>
<option value="acti">Activated</Option>
</select>
<select name="re_activated">
<option value="deact">Deactivated</Option>
<option value="acti">Activated</Option>
</select>
<select name="activated">
<option value="deact">Deactivated</Option>
<option value="acti">Activated</Option>
</select>