<label> Your Name (required)
    [text* your-name] </label>

<label> Company Name (required)
    [text* your-company] </label>

<label> Phone  (required)
    [text* your-phone] </label>

<label> Email (required)
    [email* your-email] </label>

<label> # of Staff members on your team (required)
    [text* your-staff] </label>

<label> # of websites you have built previously (required)
    [text* your-websites] </label>

<label> Lowest Price WordPress Website package (required)
    [text* your-package] </label>

[select PartnerType include_blank "Private Label " "Revenue Sharing"]

<label> Please provide at least 1 URL of a client (required)
    [text* your-client] </label>




[submit "Send"]