<form class="form-inline" method="POST" action="redirection/post">
	<fieldset>
		<legend>Create New Short Cut</legend>
		<select id="domain" class="span2" name="domain" class="input-medium">
			<?php foreach ($domains as $do): ?>
				<option><?php echo $do->domain; ?></option>
			<?php endforeach ?>
		</select>
		<label>/</label>
		<input type="text" class="span3" id="path" name="path" placeholder="path" pattern="[A-Za-z0-9]*" required>
		<div class="control-group">
		<span class="help-block" id="help-path">What short cut would you like to create?</span>
		</div>
		<input type="text" class="span5" id="url" name="url" placeholder="URL" pattern="[^\s]*" required>
		<span class="help-block" id="help-url">To point to which URL?</span>
		<button type="submit" class="btn" disabled>Submit</button>
	</fieldset>
</form>
