silverstripe-userforms/templates/EditableOption.ss

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<li>
<img class="handle" src="framework/images/drag.gif" alt="<% _t('DRAG', 'Drag to rearrange order of options') %>" />
<input type="text" name="{$FieldName}[Title]" value="$Title" />
<input type="hidden" class="sortOptionHidden hidden" name="{$FieldName}[Sort]" value="$Sort" />
<% if canEdit %>
<a href="$ID" class="deleteOption"><img src="cms/images/delete.gif" alt="<% _t('DELETE', 'Remove this option') %>" /></a>
<% else %>
<img src="cms/images/locked.gif" alt="<% _t('LOCKED', 'These fields cannot be modified') %>" />
<% end_if %>
</li>