Service Claim Rendered

		<form action="" method="post"><div style='display:none'><input type='hidden' name='csrfmiddlewaretoken' value='K6sXYTCfLawKmRe8EmPkjp2m0gLCQSkM' /></div>
			<div class="fieldWrapper">
				<label for="id_distance">Mileage claim:</label>
				<input id="id_distance" type="text" name="distance" maxlength="20" />
			</div>
			<div class="fieldWrapper">
				<label for="id_principal_instrument">Principal instrument:</label>
				<input id="id_principal_instrument" type="text" name="principal_instrument" maxlength="50" />
			</div<
			<p><input type="submit" value="Submit request" /></p>
		</form>
		<div onload="initialize()">
			<form action="#" onsubmit="showLocation(); return false;">
				<div id="mus-title">Distance Calculator</div><br/>
					<p>Enter city, state (e.g. Little Rock, AR)</p>
				  <p>
					Starting city: <input type="text" name="address1" value="city 1" /><br/>
					Destination city: <input type="text" name="address2" value="city 2" />
					<input type="submit" value="Get mileage" />
				  </p>
			</form>
		</div>
		<p><i>Please submit a new form for each concert/service week.  You will receive an email confirmation
		of your submission immediately.</i></p>
			</div>