<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>

<br />
<br />
Kidney Cancer - Contact Request
[text-527] [text-363] <info@kidneycancer.tv>
Hi Admin, 

A contact request has been submitted with below details.

Name: [firstname] [lastname]

Email Address: [email]

Company: [company]

What can we help you with: [textarea-244]
mahesh@bosswebtech.com
Reply-To: [email-232]




[your-subject]
kidney_cancer <wordpress@shopmobionline.com>
Message Body:
[your-message]

--
This e-mail was sent from a contact form on kidney_cancer (http://shopmobionline.com/projects/kidney_cancer)
[your-email]
Reply-To: mahesh@bosswebtech.com



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