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

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

<label> Title
    [text* title] </label>

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

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

<label> Phone Number
    [tel* your-phone-number] </label>

<label> Notes
    [textarea your-notes] </label>

<form action="/action_page.php" method="get">
  <input type="checkbox" name="understand" value="information"> Yes, I understand I am sharing this information with PT. Sumber Djaja Perkasa and they will use it to contact me and send me information about their products and services.<br>

[submit "Send"]