<div class="form-group"><label for="exampleInputEmail1">First Name:*</label> 
[text* firstname  class:form-control]
</div>

<div class="form-group"><label for="exampleInputPassword1">Last Name:*</label> [text* lastname  class:form-control]
</div>

<div class="form-group"><label for="exampleInputEmail1">Email:</label> 
[email email  class:form-control]
</div>

<div class="form-group"><label for="exampleInputPassword1">Company:</label>
 [text company  class:form-control]
</div>
<div class="form-group"><label for="exampleInputPassword1">What can we help you with?*</label>
[textarea textarea-244 x5 class:form-control]
</div>

<div class="form-group">[submit class:btn class:btn-default class:send] </div>

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