<div class="row">
   <div class="col-md-6">
      <div class="form-group">
         <label for="name">Name:*</label>
         [text* Name id:name class:form-control]
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="email">Your Email:*</label>
         [email* YourEmail id:email class:form-control]
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="number">Contact Number:*</label>
         [tel* number id:number class:form-control]
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="iwanttosee">I would like to see:</label>
         <div class="select-wrap">
         [select* iwanttosee id:iwanttosee class:form-control "Make a selection" "Aaliyah" "Abba " "Abbie " "Adele " "Aisha " "Alba " "Alice " "Alizah " "Amber " "Amie " "ANDREEA" "ANGEL" "ANNA" "ANNABELL" "ANTONIA" "BARBIE" "BECKY" "BELL" "BELLA" "BELLE" "BIANCA" "BRITTANY" "BROOKE" "CANDY" "CHANEL" "CHELSEA" "CHLOE" "CINDY" "CLAUDIA" "CRYSTALL" "DANIELLE" "DIANA" "EMILY" "EMMA" "EVA" "FOXY" "GABRIELLA" "HINA" "HONEY" "JADE" "JESS" "JESSIE" "JORDON" "JULIA" "KATIE" "KEIRA" "KELLY" "KENDAL" "KIM" "KIRSTY" "LARISA" "LAURA" "LAYLA" "LEANNE" "LEONA" "LILY" "LOUISE" "MACKENZIE" "MONIKA" "MORGAN" "MYA" "NADIA" "NICKI" "NICOLE" "NINA" "REBECCA" "ROBYN" "ROSE" "ROXY" "RUBY" "SARAH" "SASHA" "SCARLET" "SKY" "SOPHIA" "TASHA" "TIFFANY" "VANESSA" "YASMIN"]
</div>
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="girls">Girls or girl:</label>
         [text* Girls id:girl class:form-control]
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="date">Date of Appointment:</label>
         [date* date min:2022-06-07 id:date class:form-control]
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="duration">Duration of Appointment:</label>
<div class="select-wrap">
[select* duratiom id:duration class:form-control "Make a selection" "1 hour" "1.5 hours" "2 Hours" "3 Hours" "Dinner Date" "Overnight" ]
</div>
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="incall">I would like this appointment :</label>
<div class="select-wrap">
         [select* incall id:incall class:form-control "Make a Selection" "Incall" "Outcall"]
</div>
      </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="location">Location:</label>
         [text* Location id:location class:form-control]
      </div>
   </div>
  
   <div class="col-md-6">
      <div class="form-group">
         <label for="find">Where did you find us?:</label>
<div class="select-wrap">
[select* find id:incall class:form-control "Make a Selection" "Google" "Yahoo" "Msn" "Others"]
</div>
      </div>
   </div>
</div>


<div class="row">
   <div class="col-md-12">
     <div class="form-group">
         <label for="find">Where did you find us?:</label>
         [textarea* Comments id:comments class:form-control placeholder]
     </div>
   </div>
   <div class="col-md-6">
      <div class="form-group">
         <label for="payment">Payment:</label>
[radio payment id:payment use_label_element default:1 "Cash" "Credit Card"]
      </div>
   </div>
</div>

[submit id:submit class:submit-btn "Submit"]