<label> First Name *
    [text* first-name] </label>

<label> Last Name *
    [text* last-name] </label>

<label> Your email *
    [email* your-email] </label>

<label> Phone Number *
    [tel* phone] </label>

<label> Company Name
    [text* company] </label>

<label> I'm interested in *
    [checkbox* interested "New Equipment" "Training" "Other" "Distributor Inquiry"]
 </label>

<label style="margin:15px 0px;"> Country *
    [countrytext* country]</label>

<label> City*
    [text* city] </label>

<label> Your message 
    [textarea your-message] </label>

[submit "Submit"]