<div class="contact-form">
<div class="input-group">
<div class="input-box"><label>Company Name</label>[text* company-name]</div>
<div class="input-box"><label>Company Website</label>[url* company-website]</div>
</div>
<div class="input-group">
<div class="input-box"><label>Company Email</label>[email* company-email]</div>
<div class="input-box"><label>City</label>[text* your-City]</div>
</div>
<div class="input-group">
<div class="input-box"><label>Country</label>[select country "-- Select Country --" "Afghanistan" "Albania" "Algeria" "Andorra" "Angola" "Antigua and Barbuda" "Argentina" "Armenia" "Australia" "Austria" "Azerbaijan" "The Bahamas" "Bahrain" "Bangladesh" "Barbados" "Belarus" "Belgium" "Belize" "Benin" "Bhutan" "Bolivia" "Bosnia and Herzegovina" "Botswana" "Brazil" "Brunei" "Bulgaria" "Burkina Faso" "Burundi" "Cabo Verde" "Cambodia" "Cameroon" "Canada" "Central African Republic" "Chad" "Chile" "China" "Colombia" "Comoros" "Congo, Democratic Republic of the" "Congo, Republic of the" "Costa Rica" "Côte d’Ivoire" "Croatia" "Cuba" "Cyprus" "Czech Republic" "Denmark" "Djibouti" "Dominica" "Dominican Republic" "East Timor (Timor-Leste)" "Ecuador" "Egypt" "El Salvador" "Equatorial Guinea" "Eritrea" "Estonia" "Eswatini" "Ethiopia" "Fiji" "Finland" "France" "Gabon" "The Gambia" "Georgia" "Germany" "Ghana" "Greece" "Grenada" "Guatemala" "Guinea" "Guinea-Bissau" "Guyana" "Haiti" "Honduras" "Hungary" "Iceland" "India" "Indonesia" "Iran" "Iraq" "Ireland" "Israel" "Italy" "Jamaica" "Japan" "Jordan" "Kazakhstan" "Kenya" "Kiribati" "Korea, North" "Korea, South" "Kosovo" "Kuwait" "Kyrgyzstan" "Laos" "Latvia" "Lebanon" "Lesotho" "Liberia" "Libya" "Liechtenstein" "Lithuania" "Luxembourg" "Madagascar" "Malawi" "Malaysia" "Maldives" "Mali" "Malta" "Marshall Islands" "Mauritania" "Mauritius" "Mexico" "Micronesia, Federated States of" "Moldova" "Monaco" "Mongolia" "Montenegro" "Morocco" "Mozambique" "Myanmar (Burma)" "Namibia" "Nauru" "Nepal" "Netherlands" "New Zealand" "Nicaragua" "Niger" "Nigeria" "North Macedonia" "Norway" "Oman" "Pakistan" "Palau" "Panama" "Papua New Guinea" "Paraguay" "Peru" "Philippines" "Poland" "Portugal" "Qatar" "Romania" "Russia" "Rwanda" "Saint Kitts and Nevis" "Saint Lucia" "Saint Vincent and the Grenadines" "Samoa" "San Marino" "Sao Tome and Principe" "Saudi Arabia" "Senegal" "Serbia" "Seychelles" "Sierra Leone" "Singapore" "Slovakia" "Slovenia" "Solomon Islands" "Somalia" "South Africa" "Spain" "Sri Lanka" "Sudan" "Sudan, South" "Suriname" "Sweden" "Switzerland" "Syria" "Taiwan" "Tajikistan" "Tanzania" "Thailand" "Togo" "Tonga" "Trinidad and Tobago" "Tunisia" "Turkey" "Turkmenistan" "Tuvalu" "Uganda" "Ukraine" "United Arab Emirates" "United Kingdom" "United States" "Uruguay" "Uzbekistan" "Vanuatu" "Vatican City" "Venezuela" "Vietnam" "Yemen" "Zambia" "Zimbabwe"]</div>
<div class="input-box"><label>Company Size</label>[select company-size include_blank "1 - 10 employees" "10 - 100 employees" "100 - 500 employees" "500+ employees"]</div>
</div>
<div class="input-box"><label>What region(s) do you serve? and who are your target customers?</label>[textarea* your-message]</div>
<div class="submit-box">[submit "Submit"]</div>
</div>