<p>Contact Name (required)<br />
    [text* your-name] </p>

<p>Organisation Name (required)<br />
    [text* organisation]</p>

<p>Tel no. (required)<br />
    [text* tel] </p>

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

<p>Model no. <br />
    [text model] </p>

<p>Please let us know the nature of your enquiry<br />
   [select* subject "Service - Request Support" "Service - Technical Enquiry" "Service - Complaint"] </p>

<p>Your Message<br />
    [textarea your-message] </p>

<p>[submit "Send"]</p>