<div class="o-grid o-grid--8/3 o-grid--float o-grid--layout">
<form class="mp-dynamicform c-form">
<header class="c-form__header">
<h1 class="c-form__heading">You're almost done...</h1>
<p class="c-form__lede">Just one more step and our sales team will have everything they need to contact you. Complete the form below and our team will aim to be in touch within 1 business day.</p>
</header>
<fieldset class="c-form__section">
<legend class="c-form__section-title">Your enquiry</legend>
<div class="c-form__group">
<div class="c-form__field Product">
<div class="c-form__input-wrap">
<label class="c-form__label" for="Product">Product</label>
<select class="c-form__input c-form__input--select Product" name="Product" id="Product">
<option value=""></option>
<option value="option-1">Option 1</option>
<option value="option-2">Option 2</option>
<option value="option-3">Option 3</option>
</select>
</div>
</div>
</div>
<div class="c-form__group o-grid o-grid--of-two">
<div class="c-form__field FirstName required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="FirstName">First name</label>
<input type="text" class="c-form__input" name="FirstName" value="" placeholder="" id="FirstName" required="" />
</div>
</div>
<div class="c-form__field LastName required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="LastName">Last name</label>
<input type="text" class="c-form__input" name="LastName" value="" placeholder="" id="LastName" required="" />
</div>
</div>
</div>
<div class="c-form__group">
<div class="c-form__field EmailAddress required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="EmailAddress">Email address</label>
<input type="email" class="c-form__input" name="EmailAddress" value="" placeholder="" id="EmailAddress" required="" />
</div>
</div>
</div>
<div class="c-form__group">
<div class="c-form__field Telephone required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="Telephone">Telephone</label>
<input type="tel" class="c-form__input" name="Telephone" value="" placeholder="" id="Telephone" required="" />
</div>
</div>
</div>
</fieldset>
<fieldset class="c-form__section">
<legend class="c-form__section-title">
About your company or institution</legend>
<div class="c-form__group">
<div class="c-form__field CompanyName required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="CompanyName">Company / institution</label>
<input type="text" class="c-form__input" name="CompanyName" value="" placeholder="" id="CompanyName" required="" />
</div>
</div>
</div>
<div class="c-form__group o-grid o-grid--of-two">
<div class="c-form__field City required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="City">City</label>
<input type="text" class="c-form__input" name="City" value="" placeholder="" id="City" required="" />
</div>
</div>
<div class="c-form__field Country required">
<div class="c-form__input-wrap">
<label class="c-form__label c-form__label--required" for="Country">Country</label>
<select class="c-form__input c-form__input--select Country" name="Country" id="Country" required="">
<option value=""></option>
<option value="option-1">Option 1</option>
<option value="option-2">Option 2</option>
<option value="option-3">Option 3</option>
</select>
</div>
</div>
</div>
</fieldset>
<fieldset class="c-form__section">
<legend class="c-form__section-title">More details</legend>
<div class="c-form__group">
<div class="c-form__field ApplicationDetails">
<div class="c-form__input-wrap">
<label class="c-form__label u-flex-1" for="ApplicationDetails">Please give more details about your requirements / application (optional)</label>
<textarea class="c-form__input c-form__input--textarea ApplicationDetails" cols="20" id="ApplicationDetails" name="ApplicationDetails" rows="2"></textarea>
</div>
</div>
</div>
<div class="c-form__group">
<div class="c-form__field emailOptIn">
<input class="c-form__input c-form__input--checkbox" id="emailOptIn" name="emailOptIn" type="checkbox" value="true" /><input name="emailOptIn" type="hidden" value="false" />
<label for="emailOptIn">I wish to receive emails tailored to my personal preferences (you can unsubscribe at any time)<br />For more information please read our <a class="u-link" href="">Privacy Policy</a></label>
</div>
</div>
</fieldset>
<div class="c-form__section c-form__section--submit">
<button id="btnSubmit" class="mp c-button c-button--inline">Contact sales</button>
</div>
</form>
</div>