AppStateESS/homestead

<div class="hms">
  <div class="box">
    <div><h1>Add Eligibility Waiver</h1></div>
    <div class="box-content">
        <!-- BEGIN error_msg -->
        <span class="error">{ERROR_MSG}There was an error creating the waiver.<br /></span>
        <!-- END error_msg -->
        
        <!-- BEGIN success_msg -->
        <span class="success">{SUCCESS_MSG}Waiver created successfully.<br /></span>
        <!-- END success_msg -->

        <br />
        {START_FORM}
        {USERNAMES_LABEL}<br />
        {USERNAMES}
        <br /><br />
        {SUBMIT_BTN}
        {END_FORM}
    </div>
</div>